Toronto’s medical officer of health is pushing for the decriminalization of all drugs for personal use as part of a shift to a public health approach to overdose prevention in the midst of a deadly and worsening crisis.

Dr. Eileen de Villa is urging the city’s board of health to call on the federal government to decriminalize possession of drugs for personal use, while scaling up “prevention, harm reduction and treatment services.” She is also recommending Ottawa convene a task force made up of people who use drugs, alongside experts in policy, health care, human rights, mental health and criminal justice experts “to explore options for the legal regulation of all drugs in Canada.”

Those positions are detailed in a new report entitled A Public Health Approach to Drug Policy that will be presented to the city’s board of health next week.

“There is an opioid overdose epidemic that is happening in our city and too many people are dying,” de Villa said Monday. “I believe we have scientific evidence and evidence from other jurisdictions that would suggest this different approach, a more public health approach to drug policy, is at the very least worth trying.”

De Villa has previously called for public conversations around decriminalization of all drugs, but only for personal use, but the spike in deaths across the country has brought new urgency to that position.

Toronto Public Health reported that in 2017, 303 people in the city died from drug overdoses, up 63 per cent from the previous year.

The federal government has already approved the legalization of marijuana, which takes effect Oct. 17.

The basic idea is to move away from treating individual drug use as a crime and viewing it more as a symptom of broader social failures, including a lack of housing and mental health and addiction services, or seeing it first as a health issue. It is an approach supported by more than 60 per cent of the general population, according to a survey conducted by Ipsos Public Affairs on behalf of Toronto Public Health.

Drug use, as outlined in the report, stems from a range of issues, including “genetic, biological and social factors including trauma,” and criminalization forces people to do drugs in unsafe environments, saddles them with criminal records and places a huge financial burden on society through as much as $2 billion in annual costs associated with courts, policing and the justice system.

Maryse Durette, a spokesperson for Health Canada and the Public Health Agency of Canada, said the federal government “is not looking at decriminalizing or legalizing all drugs” at this time and while there has been some success with decriminalization in countries like Portugal, Canada’s criminal justice system is different and more study is required.

“It is very important that we keep working toward our common goals and that we keep talking about any and all evidence-based responses that could help reverse the trend of the opioid crisis in Canada,” said Durette, in an email, noting the federal government has an opioid response team and is piloting a peer-assisted injection program at several safe-injection sites.

Toronto has four safe-injection sites and several overdose-prevention sites, including one at Queen St. E. and Sherbourne St. staffed by the founders of a recently closed and unsanctioned site in Moss Park.

The renegade group worked out of tents, then a donated trailer, and operates on the firm belief that active drug users play a critically important role in harm-reduction services and solutions.

From mid-August to the end of June, that team oversaw 9,062 injections and intervened in 251 overdoses.

Tave Cole, a harm-reduction outreach worker, said the expectation that police will respond to overdose calls is contributing to fatalities, despite federal law stating that bystanders carrying drugs for their own use are entitled to immunity from possession charges.

“It is a public health issue and not a criminal issue,” Cole said.

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In the last bittersweet days in the park, the community gathered for ice cream and speeches, to celebrate and pledge to continue fighting for people they lost and those still in harm’s way.

“The saddest part of all of this is no matter what we do we can’t bring them back,” said harm-reduction worker Zoe Dodd.