Toronto Overdose Action Plan: Status Report 2022

Alarming trends are also being observed at the provincial level. Across Ontario, 2,819 people died due to confirmed or probable opioid overdoses in 2021. This significant loss of life is reverberating throughout Toronto communities, impacting the families, chosen families, friends, and co-workers of people who use drugs. First-responders and frontline shelter, health, and social support workers are also grieving these losses. Overdose deaths are preventable and are due in large part to the unregulated drug supply, where the use of highly-potent opioids combined with more unexpected and concerning substances are significantly increasing the risk of overdose. This staff report highlights actions taken by TPH and City Divisions towards the continued implementation of the TOAP and provides an update on Board of Health direction for the Medical Officer of Health to submit a request to Health Canada for an exemption under Section 56(1) of the Controlled Drugs and Substances Act. This report also recommends further actions that are urgently needed by the Provincial and Federal governments to prevent additional drug poisoning deaths. Shelter Support and Housing Division (SSHA), Social Development, Finance and Administration (SDFA), Toronto Community Housing Corporation (TCHC), and community partners were consulted in the development of this report.

Support and fund additional safer supply options in Toronto. 3. The Board of Health reiterate requests for the following actions from the Province of Ontario: a. Expand funding for harm reduction and treatment services for disproportionately impacted communities, including African, Caribbean, Black, and Indigenous people to allow additional hours of operation, expand supervised consumption services to include supervised inhalation and smoking, and hire additional peer workers; b. Expand funding for a comprehensive continuum of harm reduction and treatment services that respect the diverse needs of people who use drugs; c. Remove the cap of 21 Consumption and Treatment Services Sites in Ontario; d. Fund the proposal submitted to Ontario Health for the Substance Use Crisis Centre - Toronto (SCC-T); e. Integrate long-term and sustainable program funding for injectable Opioid Agonist Treatment (iOAT) and other safer supply tablet programs to ensure a seamless transition for clients on this medication once Health Canada's Substance Use and Addictions Program (SUAP) funding expires in March 2023; f. Support safer supply options, including listing high dose hydromorphone on the Ontario Drug Benefit Formulary and exploring other evidence-informed options; g. Identify and remove barriers to safe inhalation and smoking at Consumption and Treatment Service sites; h. Formally integrate drug checking into harm reduction services in Ontario by extending funding for the only drug checking service currently operating in Ontario, and expanding drug checking services to all supervised consumption services in Ontario; and i. Provide sustainable funding for the Integrated Prevention and Harm Reduction initiative (iPHARE), and expand funding for harm reduction services in the shelter system. 4. The Board of Health direct the Medical Officer of Health to continue working with Health Canada on the conditions that would allow for an exemption approval under Section 56(1) of the Controlled Drugs and Substances Act within the City of Toronto. 5. The Board of Health request the Medical Officer of Health to conduct community consultations throughout 2022 to inform a refreshed Toronto Drug Strategy for consideration by the Board of Health in 2023.