Toronto Indigenous Overdose Strategy

For Indigenous communities in Toronto, the lack of culturally-safe services that reflect the diversity of Indigenous values and traditions are contributing to this crisis. The need for a separate Indigenous-led process to develop an overdose prevention and response strategy for Indigenous People in Toronto was recommended in the Toronto Overdose Action Plan (TOAP). This staff report provides an overview of the recently-developed Toronto Indigenous Overdose Strategy (TIOS), which is intended as a companion document to the TOAP. Development of the TIOS was led by an Indigenous facilitator, in collaboration with an Advisory Committee comprised of Indigenous service providers and community members and Toronto Public Health (TPH) staff. Indigenous service providers and non-Indigenous service providers that work with Indigenous People who use substances were consulted as part of this initiative. However, this report is deeply rooted in the perspectives and advice received from a diverse range of Indigenous People who use/have used substances and who were the main stakeholders consulted for this Strategy. The directions in the TIOS align well with those of the TOAP. The TIOS directs recommendations to all levels of government and community service providers in the areas of prevention, harm reduction, and treatment. The recommendations are grounded in an Indigenous world view that seeks to reconnect Indigenous People to their culture and traditions as part of improving health and well-being holistically. Overall, people said they want Indigenous services delivered by Indigenous service providers, in particular, Indigenous peer workers with lived experience of substance use. TPH is strongly committed to supporting implementation of the recommended actions in TIOS, and will undertake the actions directed to TPH. TPH will dedicate an Indigenous staff resource to assist in supporting the implementation of TIOS in collaboration with Indigenous service providers and community members, including Indigenous People who use/have used substances, and City divisions.

4. The Board of Health urge the federal and provincial governments to contribute funding to Toronto Public Health's Toronto Urban Health Fund Indigenous Stream, which is under development, to support Indigenous agencies. 5. The Board of Health urge the federal and provincial governments to contribute funding to Toronto Public Health's Toronto Urban Health Fund to enhance support to Indigenous-specific programs and services in mainstream organizations to expand their outreach and harm reduction capacity. 6. The Board of Health urge the Ministry of Health and Long-Term Care to dedicate funding for 24/7 Indigenous-led Consumption and Treatment Services in Toronto, as part of the new Consumption and Treatment Services Program. 7. The Board of Health urge the Ministry of Health and Long-Term Care to ensure the availability of culturally-safe medical care to Indigenous Peoples who use substances now and into the future. Health care providers should explore opportunities to support the use of traditional medicines and approaches to healing, including facilitating access to Ceremony, Healing Circles, Elders, and/or Healers for their Indigenous clients. 8. The Board of Health urge the Ministry of Health and Long-Term Care to require all provincially-funded health care providers that provide medical services to Indigenous Peoples in Toronto to demonstrate accountability through formal mandates and strategic plans for their investments and outcomes related to culturally-safe care for Indigenous Peoples, including ongoing Indigenous cultural safety training and education for non-Indigenous health care providers. 9. The Board of Health urge the Ministry of Health and Long-Term Care to increase and target funding to support the development and operationalization of culturally-safe, appropriate, and on-demand abstinence-based treatment spaces for Indigenous Peoples. 10. The Board of Health forward the Toronto Indigenous Overdose Strategy to the Ministry of Health and Long-Term Care, the Toronto Indigenous Health Advisory Circle, the City's Aboriginal Affairs Committee, the City's Indigenous Affairs Office, the City's Shelter, Support and Housing Administration Division, the Toronto Aboriginal Support Services Council, and all local public health units in Ontario. 11. The Board of Health direct the Medical Officer of Health to provide a one-year progress report on the implementation of the Toronto Indigenous Overdose Strategy to the Board of Health and the Toronto Indigenous Health Advisory Circle in 2020.