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Across the country, calls for the federal government to decriminalize illicit drugs for personal use continue to ramp up. This week, the Toronto board of health and Kingston-area health officials added their voices to the fray.

Health-care advocates want to refocus Canada’s approach to drug use so it’s treated as a health issue rather than a criminal one, especially in light of the country’s raging opioid crisis. Deaths from opioid overdoses hit a record high last year: nearly 4,000.

But even with Portugal serving as a model for successful decriminalization, some experts say politics and entrenched tough-on-drugs approaches mean decriminalization in Canada could be a long way off.

“People have a lot of political capital invested in calls to be tough on drugs,” says Eugene Oscapella, an Ottawa lawyer who’s taught drug policy for two decades.

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“It appeals to a certain simplistic notion,” he says. “It’s this problem of simplistic solutions for complex problems.”

Portugal decriminalized possession of all drugs in 2001, making it so anyone caught with a small amount with no evidence of trafficking faces possible fines or referral to treatment programs — not jail. The results are encouraging: Portugal averages three drug-related overdoses per million people, considerably lower than the average of 17.3 per million people across the European Union.

“It became essentially an administrative offence,” Oscapella says. Even if a person was brought before a drug dissuasion committee, the focus was on health care: is your use problematic? Is there an underlying condition that can be treated?

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In addition to decriminalization, Portugal also took the responsibility for drug policy away from the ministry of justice and into the hands of the ministry of health. For Canada to make a similar shift, he says, would require a change in thinking.

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“We’ve had basically 110 years of prohibition in this country,” Oscapella says.

“There’s been an enormous amount of propaganda about the supposed successes of law enforcement and the need to rely on law enforcement as the principal vehicle for dealing with drugs in society.” Tweet This

But the pending legalization of marijuana could be changing that.

“I know people described it as political suicide but I don’t think those days are here anymore,” says Jordan Westfall, president of The Canadian Association of People Who Use Drugs.

It isn’t just about marijuana, he notes. Safe consumption sites mean there are already pockets of space where drug use is decriminalized across the country.

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“It obviously works very well.” Westfall says, “so think about it geographically, it’s just extending it.”

Harm reduction has been a big impetus for health organizations of varying levels speaking out in support of decriminalization.

Last fall, the Canadian Public Health Association released a position statement making it clear that current attempts to curtail Canadian drug consumption aren’t working and alternative approaches are needed.

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The association is advocating for the decriminalization of possession of small quantities of drugs as well as the sale and trafficking of small quantities by young offenders. It called on the government to provide amnesty to those who’ve previously been convicted for such offences.

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The Canadian Mental Health Association echoed those calls for decriminalization in its own position paper released earlier this year.

“There is strong evidence to suggest that a public-health approach to managing problematic substance use is much more effective than policies that punish and criminalize people who use substances, as failed anti-drug and ‘war on drugs’ policies have shown,” the paper reads.

But even with support from Prime Minister Justin Trudeau’s own backbenchers, the federal government doesn’t seem inclined to decriminalize drug possession. In April, Health Minister Ginette Petitpas Taylor said that what works for Portugal wouldn’t work in a larger country like Canada, where the governments share responsibility for health-care delivery with 10 different provinces.

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The lack of political will can be at least partly attributed to the numerous other policy issues the government is currently grappling with, says Rosalie Wyonch, a policy analyst with The C.D. Howe Institute. Trade and border security are likely more top of mind.

Could pressure from health organizations coupled with the Oct. 17 legalization of marijuana change that?

“I think that both the skeptical public and politicians will want to see how that plays out before they tackle the challenge of decriminalization for drugs more generally,” Wyonch says.

But could pressure from health organizations coupled with the Oct. 17 legalization of marijuana change that?

“People are going to find that the sky does not fall when we legalize marijuana,” Oscapella says.

But while that might make people more receptive to the conversation, Wyonch isn’t convinced that health organizations’ appeals for the decriminalization of other drugs will move the needle right now.

“In the current climate, it’s unlikely to be a top-of-the-agenda item,” she says, “but there is the potential that it could become an election issue in the coming year.”

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It needs to be, Westfall says, and every level of government needs to be at the table to make sure federal decriminalization isn’t undercut by provincial or local policies.

“We need an open, frank dialogue,” he says. “So many people are dying right now.”

— with a file from The Canadian Press