e-3869 (Health)

The toxic illegal drug and overdose crisis is one of the most serious public health threats in Canada’s recent history, which is having devastating impacts on individuals, friends and families, and communities across the country. The Government recognizes that substance use is primarily a health issue, and is committed to a public health approach to address the crisis.

The Government of Canada also recognizes that this crisis has only become more complex due to the ongoing COVID-19 pandemic. This has led to a more uncertain and toxic illegal drug supply, resulting in tragic increases in overdose-related deaths across the country, as well as reduced access to health and social services such as life-saving harm reduction and treatment services. Health Canada and the Public Health Agency of Canada have been working with provinces, territories, municipalities, Indigenous communities, and other partners, including researchers, advocates and people with lived and living experience to ensure that people who use drugs can continue to access the treatment, harm reduction, and other services they need.

Our approach to the overdose crisis has been comprehensive, collaborative, and compassionate, guided by our federal drug strategy – the Canadian Drugs and Substances Strategy (CDSS). The CDSS takes a public-health-focused approach and lays out our framework for evidence-based actions to reduce the harms associated with substance use in Canada.

The federal government is supporting policies and approaches that divert people who use drugs away from the criminal justice system and toward appropriate health service and social supports, when needed. For example:

• The Good Samaritan Drug Overdose Act was passed into law in May 2017, providing some legal protection from simple drug possession charges for individuals who seek emergency help during an overdose.
• In December 2021, the Minister of Justice and Attorney General for Canada reintroduced proposed legislative amendments (Bill C-5) that would encourage the use of diversion measures for personal drug possession offences, such as referral to health and social services, rather than laying a criminal charge. These amendments also propose to repeal mandatory minimum penalties for six offences in the Controlled Drugs and Substances Act (CDSA) to reflect the Government’s public-health-focused approach to substance use.
• These measures are consistent with the August 2020 Guidelines issued by the Public Prosecution Service of Canada directing prosecutors that alternatives to prosecution should be considered for the personal possession of drugs, except where public safety concerns arise.
• Additionally, to help decrease stigma during police interactions with people who use drugs, in September 2020, Public Safety Canada launched an online training module specifically designed for law enforcement members. The training raises awareness of the harms associated with substance use stigma and provides frontline law enforcement members with practical tools to support their interactions with people who use drugs.

The Government of Canada is supporting policies and approaches for greater access to pharmaceutical-grade alternatives to the toxic illegal drug supply – a practice often referred to as safer supply. Since 2020, Health Canada has supported 27 safer supply pilot projects across Canada through the Substance Use and Addictions Program, representing total funding of over $76 million. This includes supporting a range of service delivery projects in British Columbia, Ontario, Quebec and New Brunswick, research/knowledge transfer and exchange projects, and a National Safer Supply Community of Practice to help share knowledge amongst stakeholders. 

We have also made a number of regulatory changes at the federal level to help improve access to drug treatment and safer supply programs, including:

• issuing a class exemption (an exemption for a group of individuals, such as pharmacists, to lead specific activities with controlled substances), which allows each province and territory to establish urgent public health needs sites as required to make it easier for patients to access the medications they need;
• approving injectable hydromorphone as a treatment option for patients with severe opioid use disorder;
• approving injectable diacetylmorphine as a new treatment option for patients with severe opioid use disorder, as well as facilitating the prescribing and dispensing of both methadone and diacetylmorphine; and,
• authorizing nurses who provide health care services at a community health facility to conduct certain activities with controlled substances.

In May 2022, at the request of the Province of British Columbia, the Minister of Mental Health and Addictions granted a time-limited exemption under the CDSA so that adults 18 years of age and older in the province will not be subject to criminal charges for personal possession of small amounts of certain illegal drugs. We have also received a request from Toronto Public Health and we are working with them toward a successful application.

Each request for an exemption under the CDSA is carefully and thoroughly reviewed on a case-by-case basis, taking into account all relevant considerations, including evidence of potential benefits and risks or harms to the health and safety of Canadians.

The Government of Canada remains fully committed to addressing the overdose crisis and working with partners, including provinces, territories and key stakeholders, to save lives.

Under the CDSS, the federal government has collaborated with stakeholders and supported provinces and territories in an effort to address the toxic illegal drug and overdose crisis in a number of ways by investing more than $800M. This includes investing $150 million through the one-time Emergency Treatment Fund to provinces and territories in Budget 2018, which, when cost-matched with the provinces and territories, resulted in an investment over $300 million to improve access to evidence-based treatment services. It also includes nearly $350 million through the Substance Use and Addictions Program (SUAP) to support community-based prevention, harm reduction and treatment initiatives. To date, SUAP has allocated all funds from Budgets 2017 to Budget 2021. In March 2022 the Minister of Mental Health and Addictions also announced a $45 million investment to develop national standards for mental health and substance use services. This effort was made in collaboration with provinces and territories, health organizations and key stakeholders, in order to address long-standing challenges in the delivery of mental health and substance use services and supports across the country.

In response to substance use harms and the opioid overdose crisis, the Government of Canada is consulting regularly with stakeholders and has convened several expert advisory groups, including people directly impacted by substance use.

The Government engages with people with lived and living experience (PWLLE) and organizations that represent them, including: regular bi-lateral meetings with key organizations, participation on projects teams, facilitating PWLLE engagement in government and ministerial events and meaningful consultations in order to better understand their perspectives of substance use and on-the-ground realities (e.g., roundtables, Knowledge Exchange Series, etc.).

Recently, Health Canada has established the PWLLE Council, the Expert Advisory Group on Safer Supply and the Expert Task Force on Substance Use as part of this engagement strategy. We have established federal, provincial and territorial governance tables, including the Special Advisory Committee on the Epidemic of Opioid Overdoses, the Federal/Provincial/Territorial Committee on Substance Use (formerly Problematic Substance Use & Harms), and the Federal/Provincial/Territorial Assistant Deputy Minister Committee on Mental Health and Substance Use to facilitate ongoing collaboration and consultation with provincial and territorial partners.

The Government of Canada is committed to continued collaboration between jurisdictions, health providers, people with lived and living experience, stakeholders and partners, such as community-based organizations, to reduce the harms associated with substance use and provide people with the culturally appropriate and trauma-informed support they need.