This is the second of two reports prepared by the Health Canada Expert Task Force on Substance Use, established to provide Health Canada with independent, expert advice and recommendations on:
- potential alternatives to criminal penalties for the simple possession of controlled substances, with the goals of reducing the impacts of criminal sanctions on people who use drugs, while maintaining support for community and public safety; and
- the federal government’s drug policy, as articulated in a draft Canadian Drugs and Substances Strategy (CDSS), with the objectives of further strengthening the government’s approach to substance use.
The Task Force convened for the first time on March 10, 2021 and submitted its first report to the Associate Assistant Deputy Minister, Controlled Substances and Cannabis Branch of Health Canada on May 6, 2021. Key findings and recommendations highlighted in the first report of the Task Force should particularly be kept in mind when reading this second report. Specifically, the Task Force found that criminalization of simple possession causes harms to Canadians and needs to end. The Task Force was mindful of five core issues when making recommendations: stigma; disproportionate harms to populations experiencing structural inequity; harms from the illegal drug market; the financial burden on the health and criminal justice systems; and unaddressed underlying conditions.
The Task Force also considered Canada’s obligations under international treaties, lessons learned in other jurisdictions, the important issue of safety, supports for community, recent developments under the Controlled Drugs and Substances Act (CDSA), and the broader Canadian legal framework. The Task Force made four recommendations related to decriminalization and regulation, and four related recommendations.
In addition to recommending an end to criminal penalties and coercive measures for simple possession and consumption of substances, the Task Force recommended that all substances – including substances currently under the CDSA, tobacco, cannabis, and alcohol – be integrated under a single public health framework of legally regulated substances. This recommendation has profound implications for a new CDSS, which will be examined further in this report. This second report presents the recommendations and advice of the Task Force to strengthen the government’s approach to substance use. Although it can be read independently, it builds on the first report and should be interpreted within the context of that first report.
- Provide more context on policy-related harms, the impacts of social determinants of health, and historical harms and their persistent, intergenerational effects.
- Describe the impact of inadequate regulation of pharmaceuticals, tobacco, alcohol, cannabis, and illegal substances on Canada’s substance issue, and acknowledge that alcohol currently causes more harms than the substances covered by the CDSA.
- Broaden the definition of substance-related harms.
- Acknowledge and describe the disproportionate and distinct harms experienced by Black people and Black communities.
- Consider and describe the full spectrum of substance use to provide a more complete and nuanced understanding of the situation.
- Recognize the many profiles of people who use substances and avoid language that reinforces stigma.
- Acknowledge and describe the lack of resources and services for people who use substances or who have a substance use disorder.
- Include as a core priority of the CDSS to immediately develop and implement a single public health framework with specific regulations for all psychoactive substances, including currently illegal drugs as well as alcohol, tobacco, and cannabis. This framework should aim to minimize the scale of the illegal market, bring stability and predictability to regulated markets for substances, and provide access to safer substances for those at risk of injury or death from toxic illegal substances.
- Include as an urgent priority of the CDSS developing, implementing, and evaluating a comprehensive emergency response strategy to scale up access to safer alternatives to the toxic illegal drug market in partnership with people with lived and living experience and the organizations that represent them.
- Provide sufficient and ongoing funding for the strategy.
- Include an objective related to reducing stigma.
- Define the role of enforcement as a means to clearly support the aims of the public health framework and legal regulation by focussing on criminal organizations and the illegal toxic drug supply.
- Make equity a core principle and equity, anti-racism and anti-colonialism a priority area in the new CDSS.
- Include as an objective the implementation of national standards for providing supports to people who use substances, including harm reduction services, and describing the role of Provinces and Territories in our system and how Health Canada will work to ensure supports meet national standards across the country.
- Include an objective related to assessing, acknowledging, reducing, and addressing policy-related harms.
- Remove the notion of “pillars” from the strategy and replace it with a more holistic and integrated approach that better represents the interconnectedness of the different areas for action.
- Frame the overall aim of the strategy as a health promotion approach to substance use and minimizing harms.
- Articulate harm reduction as an effective, evidence-based, non-judgemental public health approach for individuals who use substances, integrated into a full continuum of health and social services including housing.
- Include a full continuum of harm reduction, treatment and recovery care and services.
- Include labour-market measures as part of an integrated approach to support certain populations.
- Align and integrate Canada’s international policy with its domestic policy on substances.