Drug decriminalization movement gaining momentum in Canada as overdose deaths surge

As overdose deaths keep surging in Canada, the movement to decriminalize illicit drugs is gaining steam, with one of the country's largest mental health facilities joining national advocates and several major cities in putting pressure on the federal government to act.

Earlier this summer, mayors from across B.C. signed a letter in support of Vancouver city officials who are seeking Health Canada's approval to decriminalize the possession of small amounts of illegal drugs. 

Toronto is gearing up to submit a similar request, a move which follows the city recently hitting its highest one-day opioid overdose count in late July.

Now, the country's largest mental health teaching hospital, the Centre for Addiction and Mental Health (CAMH) in Toronto, is for the first time formally pushing for countrywide drug decriminalization as well, CBC News has learned.

In a new policy statement being released publicly on Wednesday, the hospital is calling on the federal government to decriminalize all drugs while working with the provinces to ramp up treatment and harm-reduction services and replace the "unregulated, toxic drug supply."

"The driving factor behind the shift has been the harms we're seeing," said Dr. Leslie Buckley, chief of the addictions division at CAMH, during an interview.

Buckley says the legal framework around substance use hasn't been successful at curbing drug use, and instead causes social harms which disproportionately affect racialized communities.

"We should be thinking about substance use through a health lens," Buckley said, "and focusing on how to help people be well, rather than face criminal penalties."

CAMH is specifically calling on the federal government to "ensure decriminalization applies across the country and to all currently illicit drugs" — rather than a piecemeal approach relying on regional or substance-specific exemptions — with no fines or other administrative penalties. 

The push comes as overdose deaths are hitting new highs in much of the country, in part fuelled by an increasingly toxic illegal drug supply and, advocates say, by the social isolation and stress sparked by the ongoing COVID-19 pandemic. 

Federal data shows there were nearly 7,000 apparent opioid toxicity deaths reported in Canada between April 2020 and March 2021 — an 88 per cent increase from the same time period prior to the pandemic — with the bulk of the most recent deaths reported in British Columbia, Alberta and Ontario.

"We have not seen a commensurate response in prevention that signifies that there is urgency," said Angela Robertson, executive director of the Parkdale Queen West Community Health Centre, which operates sites for safer, monitored drug use in Toronto. 

"Here is a public health crisis that warrants a public health crisis response."

There were some signals on the campaign trail that the Trudeau government may be open to exploring new avenues to tackle overdose-related deaths.

Although the Liberal platform didn't mention decriminalization specifically, or offer a commitment to providing a safe drug supply — approaches which were backed by other parties — Prime Minister Justin Trudeau has expressed a willingness to work with groups pursuing those solutions. 

"We've seen a number of provinces, particularly British Columbia, very interested in moving forward on some forms of decriminalization and we are absolutely open to working with them," Trudeau said during an announcement on mental health commitments.

Fewer Canadians are also being charged with drug possession in recent years, with the number of people facing charges dropping from more than 35,000 people in 2015 to roughly 18,000 in 2019, the latest available Statistics Canada data show.

'People are really listening now'

It's a shift not lost on advocates like Arlene Last-Kolb, who lost her 24-year-old son Jesse to fentanyl poisoning in July 2014.

The Manitoba mother has since been calling for changes in how Canada handles the opioid crisis.

"We talk about decriminalization for people that have no choice but to go to the streets to get what they need, and they're most likely going to die from that," said Last-Kolb, who is a board member of the advocacy group Moms Stop the Harm and co-founder of Overdose Awareness Manitoba.

"Why are we not talking about making it safer?"

Recently, there's been growing momentum around those kinds of harm-reduction approaches, she said. "What is new is that people are really listening now — and they're really starting to understand it."

Yet drug use policies remain a patchwork across the country, with varying levels of support and access to facilities like supervised injection sites, even as deaths have surged in recent years.

In Edmonton, daily drug poisonings are now putting extra strain on a health system that's also being overwhelmed by patients battling COVID-19, said family physician Dr. Ginetta Salvalaggio, an associate professor at the University of Alberta.

As co-chair of the Edmonton Zone Medical Staff Association's opioid poisoning committee, Salvalaggio is part of a group advocating for the urgent expansion of new overdose prevention sites in all of Alberta's major cities and broader access to a safer drug supply to tackle the current crisis — and she said longer-term, decriminalization needs to remain part of the conversation.

"The drug supply that is currently circulating is, if anything, just getting from bad to worse, and that's not going to get solved by trying to take what's currently on the street off," Salvalaggio added. "So we need a much more comprehensive approach."

According to Buckley, the physician from CAMH, curbing the overdose crisis in both the short and long term requires a slate of tactics — including decriminalizing drugs, improving access to a safer drug supply and addiction treatments, and educating Canadians on the potential harms of drug use.

"We know that there is a possibility that we can be normalizing substance use, which we know can lead to people thinking it's less harmful," she acknowledged.

"Today's substances are not your parent's substances. The context has really changed."

Last-Kolb stresses that people like her late son have long used illegal drugs for a variety of reasons, and she maintains they deserve safer, legal options — just like those available to Canadians who choose to drink alcohol or smoke cannabis.

"My son would be married now with children. That's what I want for other people. I want people to be safe, I want our children to be safe," she said.

"And I don't want them to have to go to the streets and get something illegal that will most likely kill them."