Chapter One: Introduction to the Toronto Drug Crisis
Before you begin, to help you through the rest of this module, here is a list of keywords and definitions you might find useful:
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Drug Decriminalization: the removal of criminal sanctions (incarceration) for the personal use of drugs. It recognizes addiction and drug use as a health issue rather than a criminal justice one. This does not mean drugs are legalized.
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Harm Reduction: an evidence-based, client-centred approach that aims to reduce the negative social and health consequences associated with drugs. This requires a combination of drug decriminalization and partnerships with a variety of social service networks.
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Safe Supply: Drugs for personal use typically accessible only through the illegal drug market would be checked, monitored, and regulated. The goal is to limit the number of people dying from drug toxicity.
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Addiction: recognized as a complex medical condition in which there is an intense and persistence physical or psychological urge to use a drug. It is a state of dependence that overtakes the resulting negative consequences.
Drug-Related Harms: these consequences have physical (diseases or injury), psychological (addiction or mental health issues), financial (expensive), and social (damage to relationships) harms.
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Stigma: a mark of shame or disgrace that taints the individual as undesirable. Stigma implies social disapproval and can lead to discrimination.
Stimulants: An overarching term that refers to drugs that impact and increase the activity of a person's central nervous system. Tolerance to this grows quickly, creating one of the strongest psychological dependencies (EX/ cocaine, methamphetamine, ecstasy)
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Depressants: An overarching term that refers to drugs that decrease neurotransmission or reduce stimulation in certain parts of the brain. Although not immediately addicting, they are typically used in conjunction with other drugs and if used regularly - both tolerance and dependency can develop. (EX/ Benzos, alcohol)
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Opioids: Typically associated with pain relief, if used properly can be very beneficial medical tools - however if abused they are extremely addictive and pose a significant threat of overdose (EX/ Fentanyl and heroin)
Toronto is considered to be in the midst of a drug crisis because of a surge in drug-related deaths, hospitalizations, and other drug-related harms. This is a result of interconnecting systemic failures that seek to criminalize drug users and hide them in prisons rather than provide the rehabilitative support they truly require.
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Toronto Public Health recognizes this ongoing drug crisis and in 2019 released the Toronto Overdose Plan and in 2022 created a Model of Drug Decriminalization, which is still awaiting approval. If you're interested in learning more about these models, they will be covered in more depth in chapter three.
As you can see, fentanyl and its counterparts contributed to 87% of deaths in Toronto.
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Cocaine is the non-opioid substance directly contributing to the highest percentage of confirmed drug toxicity deaths in Toronto
(Toronto Public Health, 2023)
Did You Know?
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Toronto is home to 20% of Ontario’s population, but in 2017 alone, there were 315 opioid overdose deaths. This means that 1 in 4 overdose deaths in Ontario occurred in Toronto.
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The numbers from 2017 represent a 63% increase compared to the number of people who died in 2016, and a 121% increase compared to 2015 (Toronto Public Health, 2023).
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In 2021, 591 people died due to an overdose in Toronto (Toronto Public Health, 2023)
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The COVID-19 pandemic saw an increase in personal drug use but a limiting of crucial health and social services.
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The Works, a supervised injection service in Toronto, saw visits drop from 3,853 in February 2020 to 127 in April 2020 (Toronto Public Health, 2021).
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Public services have not returned to the same level of traffic since before the pandemic.
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Drug toxicity is the leading cause of death for people experiencing homelessness.
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48% of Toronto’s 961 homeless deaths are the result of drug toxicity (Toronto Public Health, 2023).
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Homelessness in Toronto also intensified by the pandemic
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addiction and substance abuse increases with the time an individual spends homeless, from 19.0% in the first 2 months to 28.2% for those who reported being precariously housed for over 6 months (Government of Canada, 2024).
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