Item - 2020.HL23.2

Tracking Status

  • This item was considered by Board of Health on November 16, 2020 and was adopted with amendments.

HL23.2 - Opioid Poisoning Crisis in Toronto - Update

Decision Type:
ACTION
Status:
Amended
Wards:
All

Board Decision

The Board of Health:

 

1.  Reiterated its call urging the Federal Minister of Health to use the authority under the Controlled Drugs and Substances Act to permit the simple possession of all drugs for personal use, the need for which has become critical as the opioid poisoning crisis continues to worsen during the COVID-19 pandemic and, further, to support the immediate scale up of prevention, harm reduction, and treatment services.

 

2.  Urged the Federal Minister of Health to provide additional funding for longer-term safer supply programs, injectable medications, and other safer supply options, including for stimulants.

 

3.  Reiterated its request urging the Provincial Minister of Health to:

 

a.  convene a multi-sectoral opioid overdose task force comprised of public health officials, community-based service providers, people with lived and living experience of drug use, and family members;

 

b.  support and fund the implementation of a spectrum of safer supply options, including listing high-dose injectable formulations of hydromorphone on the Ontario Drug Benefit Formulary; and

 

c.  dedicate funding for overdose-related grief and trauma supports for frontline workers, people who use drugs, and family members.

 

4.  Urged the Provincial Minister of Health to:

 

a.  create and fund an Urgent Public Health Need Site (UPHNS) program for Ontario to facilitate the implementation of these lifesaving services in a variety of settings;

 

b.  provide funding to pilot and evaluate virtual and/or telephone-based supervised consumption services as well as in-person peer supervision in congregate or residential settings to complement the current service options;

 

c.  allocate some of the new treatment funding recently announced to evidence-based, on-demand treatment services in Toronto; and

 

d.  designate harm reduction and treatment services as essential services and provide funding to ensure that these services can effectively operate and meet the needs of people who use drugs during the COVID-19 pandemic.

 

5.  Requested the Provincial Minister of Health to reinstate funding for the Overdose Prevention Sites operated by Street Health and St. Stephen's Community House given the urgent and ongoing need for these lifesaving health services.

 

6.  Requested the Provincial Minister of Health to expand the criteria for naloxone distribution to allow service providers to administer naloxone to clients in their programs.

 

7.  Requested the Provincial Minister of Health to collect and provide socio-demographic data, such as sexual orientation, Indigenous identity, race or ethnicity, and income status, on fatal and non-fatal overdoses in Toronto to better understand who is being impacted to inform overdose responses.

 

8.  Urged the Health Professions Regulatory Advisory Council to review the regulatory changes in British Columbia, consult with current safer supply prescribers about the regulatory issues they are facing, and advise the Provincial Ministry of Health and the relevant regulatory colleges on how to address regulatory uncertainties to support the expansion of safer supply initiatives in Ontario.

 

9.  Requested the Medical Officer of Health to report on the status of conversations with the City of Toronto, enforcement agencies, and the Federal and Provincial Governments on decriminalizing the simple possession of drugs for personal use.

 

10.  Requested the Medical Officer of Health to work with the Executive Director, Social Development, Finance and Administration, to include the decriminalization of the simple possession of all drugs for personal use as a key plank in the City of Toronto's Community Safety and Wellbeing Plan in recognition of the differential and negative impacts that this criminal law has on equity-seeking groups in Toronto such as Black and Indigenous peoples.

 

11.  Requested the Medical Officer of Health, in consultation with the General Manager, Shelter, Support and Housing Administration, to continue to work with community partners toward urgently expanding the overdose prevention response and other harm reduction measures in shelters.

  

12.  Requested the Medical Officer of Health to work with community partners and City divisions on options to expand grief and trauma supports for people who use drugs, family members, and service providers who are impacted by the opioid poisoning crisis.

  

13.  Directed that the report (November 5, 2020) from the Medical Officer of Health be forwarded for information and consideration to all Boards of Health in Ontario, the Council of Medical Officers of Health, the Urban Public Health Network, the Canadian Public Health Association, the Ontario Public Health Association, the Ontario Medical Association, the Registered Nurses' Association of Ontario, the Canadian Association of Chiefs of Police, the Ontario Association of Chiefs of Police, the Federation of Canadian Municipalities, and the Association of Municipalities of Ontario.

Decision Advice and Other Information

The Policy Development Officer, Toronto Drug Strategy Secretariat, Toronto Public Health, gave a presentation on Opioid Poisoning Crisis in Toronto.

Origin

(November 5, 2020) Report from the Medical Officer of Health

Summary

The COVID-19 pandemic is worsening the opioid poisoning crisis in Toronto and across Canada. Multiple jurisdictions, including Toronto, have reported spikes in fatal and non-fatal overdoses during the pandemic, which may reflect changes in the unregulated drug supply, as well as service reductions and physical distancing requirements.

 

While there has been a decrease in calls to Toronto Paramedic Services during the pandemic, there has been an overall increase in calls resulting in fatalities. Paramedic data reveals that 132 people died of suspected opioid overdoses between April 1 and September 30, 2020, a near doubling of deaths compared to a two-year average of 67 fatal suspected opioid overdoses for the same period in 2018/2019. July and September 2020 also both saw the highest monthly number of fatal calls (27) attended by paramedics since September 2017.

 

This staff report provides an update on the opioid poisoning crisis and identifies key actions needed urgently to help address the crisis. Crucial to the response is an expansion of the safer supply of regulated drugs in order to provide an alternative to the increasingly toxic unregulated drug supply and the decriminalization of the simple possession of drugs for personal use. Increased access to lifesaving harm reduction, treatment and other services that protect and promote the health and well-being of people who use drugs is also needed, as are grief and trauma supports for people impacted by the opioid poisoning crisis.

Background Information

(November 5, 2020) Report from the Medical Officer of Health on Opioid Poisoning Crisis in Toronto - Update
https://www.toronto.ca/legdocs/mmis/2020/hl/bgrd/backgroundfile-158017.pdf
(November 16, 2020) Presentation from the Policy Development Officer, Toronto Drug Strategy Secretariat, Toronto Public Health on Opioid Poisoning Crisis in Toronto
https://www.toronto.ca/legdocs/mmis/2020/hl/bgrd/backgroundfile-158476.pdf

Communications

(November 2, 2020) Letter from Councillor Gord Perks (HL.Main.HL23.2.1)
https://www.toronto.ca/legdocs/mmis/2020/hl/comm/communicationfile-122718.pdf
(November 12, 2020) Submission from Sandra Ka Hon Chu, HIV Legal Network (HL.New.HL23.2.2)
https://www.toronto.ca/legdocs/mmis/2020/hl/comm/communicationfile-123082.pdf
(November 13, 2020) Letter from 10 organizations, submitted by Robb Johannes, Fred Victor, Factor-Inwentash School of Social Work, University of Toronto, and St. James Town Service Providers' Network (HL.New.HL23.2.3)
https://www.toronto.ca/legdocs/mmis/2020/hl/comm/communicationfile-123090.pdf
(November 12, 2020) Letter from Katie Mayerson, The North End Harm Reduction Network (HL.New.HL23.2.4)
https://www.toronto.ca/legdocs/mmis/2020/hl/comm/communicationfile-123118.pdf
(November 13, 2020) E-mail from Roderick Main (HL.New.HL23.2.5)
(November 16, 2020) E-mail from Jennifer Chambers, Empowerment Council, Centre for Addiction and Mental Health (HL.New.HL23.2.6)
https://www.toronto.ca/legdocs/mmis/2020/hl/comm/communicationfile-123121.pdf
(November 16, 2020) Submission from Melody Alderton-Ballik, Street Health (HL.New.HL23.2.7)
https://www.toronto.ca/legdocs/mmis/2020/hl/comm/communicationfile-123123.pdf
(November 16, 2020) Letter from Amanda Leo (HL.New.HL23.2.8)
(November 16, 2020) Letter from Roxie Danielson, Street Nurses Network (HL.New.HL23.2.9)
https://www.toronto.ca/legdocs/mmis/2020/hl/comm/communicationfile-123125.pdf
(November 16, 2020) E-mail from Roderick Main (HL.New.HL23.2.10)
(November 16, 2020) Submission from Juno Zavitz, Breakaway Addiction Services (HL.New.HL23.2.11)
https://www.toronto.ca/legdocs/mmis/2020/hl/comm/communicationfile-123128.pdf
(November 12, 2020) Submission from Sandi Guignard (HL.New.HL23.2.12)
(November 16, 2020) Submission from Emmet O'Reilly, South Riverdale Community Health Centre and Downtown East Safer Opioid Supply Program (HL.New.HL23.2.13)
https://www.toronto.ca/legdocs/mmis/2020/hl/comm/communicationfile-123136.pdf
(November 16, 2020) Submission from Angela Robertson, Parkdale Queen West Community Health Centre (HL.New.HL23.2.14)
https://www.toronto.ca/legdocs/mmis/2020/hl/comm/communicationfile-123137.pdf
(November 13, 2020) E-mail from Barb Panter, The Neighbourhood Group, St. Stephen's Community House (HL.New.23.2.15)
https://www.toronto.ca/legdocs/mmis/2020/hl/comm/communicationfile-123303.pdf

Speakers

Sandra Ka Hon Chu, HIV Legal Network
Dr. Gillian Kolla, Canadian Institute for Substance Use Research, University of Victoria
Angela Robertson, Parkdale Queen West Community Health Centre
Jason Altenberg, South Riverdale Community Health Centre
Juno Zavitz, Breakaway Addiction Services
Melody Alderton-Ballik, Street Health
Daniel Bingham
Angie Hamilton, Families for Addiction Recovery
ZoŽ Dodd, South Riverdale Community Health Centre
Sarah Greig, Moss Park Consumption and Treatment Service, South Riverdale Community Health Centre
Roderick Main
Kristi Jewell
Jolene Eeuwes, South Riverdale Community Health Centre
Robert Wilson, The Neighbourhood Group, St. Stephen's Community House
Dayn Kent, Moss Park Overdose Prevention Site
Dr. A.J. Withers, Critical Disability Studies, Faculty of Health, York University
Emmet O'Reilly, South Riverdale Community Health Centre
Jessica Demeria, MAP Centre for Urban Health Solutions
Paula Tookey, South Riverdale Community Health Centre

Motions

1 - Motion to Amend Item (Additional) moved by Councillor Kristyn Wong-Tam (Carried)

That:

 

1.  The Board of Health request the Medical Officer of Health to work with community partners and City divisions on options to expand grief and trauma supports for people who use drugs, family members, and service providers who are impacted by the opioid poisoning crisis.


2 - Motion to Amend Item (Additional) moved by Councillor Joe Cressy (Carried)

That:

 

1.  The Board of Health request the Medical Officer of Health to report on the status of conversations with the City of Toronto, enforcement agencies, and the Federal and Provincial Governments on decriminalizing the simple possession of drugs for personal use.

 

2.  The Board of Health request the Medical Officer of Health, in consultation with the General Manager, Shelter, Support and Housing Administration, to continue to work with community partners toward urgently expanding the overdose prevention response and other harm reduction measures in shelters.

 

3.  The Board of Health request the Provincial Minister of Health to reinstate funding for the Overdose Prevention Sites operated by Street Health and St. Stephen's Community House given the urgent and ongoing need for these lifesaving health services.

 

4.  The Board of Health request the Provincial Minister of Health to expand the criteria for naloxone distribution to allow service providers to administer naloxone to clients in their programs.

 

5.  The Board of Health request the Provincial Minister of Health to collect and provide socio-demographic data, such as sexual orientation, Indigenous identity, race or ethnicity, and income status, on fatal and non-fatal overdoses in Toronto to better understand who is being impacted to inform overdose responses.


Motion to Adopt Item as Amended moved by Councillor Joe Cressy (Carried)
Source: Toronto City Clerk at www.toronto.ca/council