Item - 2019.HL7.1

The Board of Health recommends that:

1.  City Council endorse the Toronto Overdose Action Plan: 2019 Update - Community Consultation Summary, as outlined in Attachment 1 to the report (May 27, 2019) from the Medical Officer of Health.

The Board of Health:

1.  Endorsed the Toronto Overdose Action Plan: 2019 Update - Community Consultation Summary and requested the Medical Officer of Health to support the implementation of the actions for Toronto Public Health, the Province of Ontario, and the Government of Canada, as outlined in Attachment 1 to the report (May 27, 2019) from the Medical Officer of Health.

2.  Urged the Ministry of Health and Long-Term Care to:

a.  Increase harm reduction funding to community-based organizations to expand overdose prevention and response capacity across Toronto in areas of demonstrated need, including areas with existing services (e.g., downtown);

b.  Remove the limit of 21 Consumption and Treatment Services for Ontario and provide services in all areas of demonstrated need;

c.  Expand the Consumption and Treatment Services model to allow inhalation services;

d.  Reinstate the overdose prevention site model as an agile, low-barrier service option during the opioid poisoning crisis;

e.  Support the implementation of overdose prevention and response strategies across the social housing system;

f.  Fund a range of drug checking programs in diverse settings to meet local needs;

g.  Expand capacity across the treatment sector to eliminate waiting lists and provide more beds sector-wide, including for crisis and withdrawal management, and, further, provide new treatment options based on individual need, such as managed opioid and stimulant programs;

h.  Provide dedicated bereavement and trauma supports for frontline harm reduction workers, family members, and others impacted by the opioid poisoning crisis;

i.  Increase funding to increase the availability of community-based harm reduction services for people using methamphetamine and other stimulants; and

j.  Support enhanced training for service providers on supporting people who use stimulants alone or with other drugs.

3.  Urged Health Canada to:

a.  Increase funding and support for overdose prevention and response strategies at the local level;

b.  Fund a range of drug checking programs in diverse settings to meet local needs;

c.  Explore a range of safer drug supply options and supports for community service providers to implement these initiatives; and

d.  Support evidence-based knowledge exchange and the development of innovative responses to reducing the harms of methamphetamine use.

The Medical Officer of Health gave a presentation on Toronto Overdose Action Plan: Status Report 2019.

The Board of Health considered Items HL7.1 and HL7.2 together.

The opioid poisoning crisis continues unabated in Toronto and elsewhere in Canada. The illicit drug supply has become increasingly toxic with potent opioids and other substances. Too many people in our community are dying from these preventable deaths, and many more experience serious health harms from non-fatal overdoses.

Toronto Public Health (TPH) continues to work with City and community partners on measures to help mitigate the harms of this ongoing crisis. This staff report summarizes key actions taken over the last year to implement recommendations in the Toronto Overdose Action Plan and recommends actions to respond to growing concerns about the harms associated with methamphetamine use, including overdose. This report also identifies additional measures to respond to the opioid poisoning crisis based on the results of a community consultation, as outlined in the attached Toronto Overdose Action Plan: 2019 Update - Community Consultation Summary. These measures include prevention, harm reduction, and treatment actions directed to all levels of government, including TPH.

While action has been taken over the last year to address the opioid poisoning crisis, much more is needed, in particular, strategies to help move people out of the toxic illicit drug market. Fundamentally, drug policy in Canada needs to be reoriented toward addressing drug use as a public health, rather than a criminal issue. TPH remains committed to working with our City and community partners to respond to this ongoing crisis.