Item - 2026.HL34.7

The Board of Health:

1. Declared the drug toxicity crisis an epidemic in the City of Toronto.

2. Requested the Medical Officer of Health, in consultation with the Deputy City Manager, Community and Emergency Services and the Deputy City Manager, Community Development and Social Services, to continue the work of the interdivisional coordination table which is comprised of representatives from relevant City divisions and agencies for the purpose of developing a strategy with clear deliverables and timelines to present to the Board of Health by Q1 2027, including consideration for the following:

a. Recognizing staff burnout at remaining Supervised Consumption Service sites, shelters, and drop-in centres and supporting as appropriate;

b. Coordinating City services and anti-stigma communication campaigns to increase community safety for all community members, including people who use substances, in residential, educational, and commercial areas;

c. Expand access to overdose response in priority locations through support to impacted service providers and increased access to overdose response tools, including naloxone, overdose detection technology and training in basic life support, first aid care and airway management;

d. Expand access to low-barrier testing for HIV and Hepatitis C;

e. Advocate for drug checking services to remain available across the City; and

f. Engage with key community organizations and people who use drugs through the Our Health Our City, Supervised Consumption Site Closures working group.

3. Requested the Province to fund a healthcare focused response to the drug toxicity epidemic in Toronto through increased funding for:

a. A broader range and increased availability of evidence-based opioid use disorder treatment options, withdrawal management services, and ongoing stabilization supports;

b. Low-barrier community-based health care supports for those who are underhoused (e.g. increased community paramedicine, health-care providers at drop-ins) and people who use drugs; and

c. Additional street outreach and drop-in staff supporting increased needs in the community stemming from the sudden closure of supervised consumption services.

4. Requested the Clerk to forward the Board's decision to the Association of Municipalities of Ontario (AMO), Federation of Canadian Municipalities (FCM), and Ontario's Big City Mayors (OBCM).

Between January and April of this year, the prevalence of calls to Paramedic Services for non-fatal suspected opioid overdoses has been significantly higher compared to 2025. In the month of April there were 485 non-fatal suspected opioid overdoses attended by Paramedic Services, the highest monthly prevalence since 2021. On Friday, June 19th, Toronto Public Health issued a drug alert related to an increased number of overdoses in the downtown core -just one of four alerts that have already been issued this year, compared to just one alert issued in 2025. These alarming figures are the combined result of an unregulated toxic drug supply and the forced closure of nearly all of the safe consumption sites in Toronto.

The remaining supervised consumption sites have experienced a radical increase in the number of clients trying to access their services. With each site only being able to provide a handful of supervised use booths, many people who use drugs have instead been using at other venues where they hope they could be found in the case of an overdose. These locations include shelters, drop-in centres, community health centres, public libraries, the sidewalks outside of these spaces, and public parks.

In my capacity as Chair of the Our Health, Our City Implementation Panel under the Board of Health, I have heard from frontline workers who are experiencing extreme burnout as they respond to several overdoses every day. Responding to these events, in addition to being both emotionally and physically taxing, takes community service workers away from their core job responsibilities.

The serious harm that has already been inflicted both on people who use drugs and the people who support them over the past year and a half is the result of the Provincial enactment of the Community Care and Recovery Act.

When you consider the increased burden on our emergency services, the scope of the harm only grows. The data we have been dutifully collecting and monitoring at the City clearly shows that this is a crisis.

This issue is urgent because indicators are showing that the prevalence of suspected non-fatal overdoses is significantly higher this year compared to 2025. The lives and wellbeing of people who use drugs and frontline workers are at stake. Immediate action is required to prevent further harm.