October 30, 2023
The Canadian Drugs +
Substances Strategy
The Government of Canada’s approach
to substance use related harms and
the overdose crisis
Health Canada is committed to improving the lives of all
of Canada’s people and to making this country’s population among the healthiest in the world
as measured by longevity, lifestyle and eective use of the public health care system.
Prepared by the Controlled Substances and Cannabis Branch, Health Canada.
Également disponible en français sous le titre :
La stratégie canadienne sur les drogues et autres substances : l’approche du gouvernement du canada à l’égard des méfaits
liés à la consommation de substances et de la crise des surdoses
To obtain additional information, please contact:
Health Canada
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Toll free: 1-866-225-0709
Fax: 613-941-5366
TTY: 1-800-465-7735
E-mail: publications-publications@hc-sc.gc.ca
© His Majesty the King in Right of Canada, as represented by the Minister of Health, 2023
Publication date: October 2023
This publication may be reproduced for personal or internal use only without permission provided the source
is fully acknowledged.
Cat.: H134-35/2023E-PDF
ISBN: 978-0-660-68488-8
Pub.: 230529
The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
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Table of Contents
The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
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The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
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Minister’s Message
Canada is in the midst of one of the most serious and deadly public health
crises in our country’s history—the toxic and illegal drug and overdose
crisis. No community has been left untouched. Since 2016, more than
38,500 people have died of apparent opioid toxicity in Canada.
This crisis is tragic, and I want to recognize and remember the lives of
people in Canada we have lost. Every person who overdoses is somebody
who has a family and people that care about them and that we must do
everything we can to support and protect them.
People who use substances, their families, and the communities around them, need us to use every tool at
our disposal to provide compassionate care and maintain community safety. There is so much to be done
and no one government, community or family can end this crisis alone.
That is why we are launching a renewed Canadian Drugs and Substances Strategy (CDSS) that has been
designed to support a comprehensive and compassionate approach centered on promoting both public
health and public safety. This whole-of-government initiative includes timely access to a full range of
strategies to help people access the prevention, harm reduction, treatment, or recovery services and
supports they need, when and where they need them.
The renewed CDSS is using an integrated approach that brings together prevention and education,
substance use services and supports, evidence, and substance controls. New investments include
supporting a wide range of activities such as community-based supports; streamlining authorizations
for supervised consumption sites and drug checking services; vital data collection on substance-related
harms and lab-based analysis of the illegal drug supply; an overdose monitoring platform for law
enforcement and other first responders; and further action to work with our partners to disrupt illegal
drug production and traicking and stem the global flow of these devastating substances.
By using a wide-range of tools, we have the best opportunity to end this crisis, protect communities
and save lives.
We must continue to work with our partners across all levels of government, communities, people with
lived and living experience, and stakeholders to address the complex factors that contribute to substance
use and related harms, including links with other issues, such as housing, mental health, economic
insecurity, and chronic pain.
That’s the work we are doing, together. Because when people get the right support, there is hope. We are
building a safer, healthier and more caring future for all Canadians. One where we embrace one another in
the journey towards healing.
The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
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The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
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Introduction
Canada is experiencing an unprecedented and unrelenting rate of overdose deaths and harms, largely
due to the toxic illegal drug supply that has continued to worsen since the start of the COVID-19 pandemic.
National data shows that 38,514 apparent opioid toxicity deaths occurred between January 2016 and March
2023 (see Figure 1). The overdose crisis is complex and caused by many factors (see Box 1). In particular,
drug traickers and criminal organizations are seeking to maximize their profits by contaminating the illegal
drug supply with inexpensive fentanyl and other opioids at a cost to Canadian lives. While in 2017 Canada
saw a spike in fentanyl detected in the illegal drug supply, the overdose crisis continues to evolve and
increasing amounts of other toxic substances are now present. This impacts the ability of first responders
to reverse overdoses through the use of Naloxone and makes the treatment of substance use disorders
more complicated. Just under half (48%) of accidental apparent opioid toxicity deaths in 2023 also involved
a stimulant, reflecting the role that the mixing of substances (polysubstance use) plays in this crisis.
Federal, provincial, and territorial Special Advisory Committee on the Epidemic of Opioid Overdoses. Opioid- and Stimulant-
related Harms in Canada. Ottawa: Public Health Agency of Canada; September 2023. https://health-infobase.canada.ca/substance-
related-harms/opioids-stimulants/
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The Government of Canada’s approach to substance use related harms and the overdose crisis
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The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
The increasing toxicity and unpredictability of the illegal drug supply means that anyone is at risk for an
overdose, whether they are trying drugs for the first time, or have been using drugs frequently. While anyone
is at risk of a drug overdose, some populations in Canada have been disproportionately impacted by the
crisis. Males accounted for the majority of apparent opioid toxicity deaths in Canada (70 to 75% since 2016).
People living with co-occurring health conditions are also at increased risk of an overdose, including those
with mental health conditions and chronic pain.
Approximately 20% of Canadians with a substance
use disorder (SUD) also have a co-occurring mental
health disorder. Meanwhile, up to 55% of people
who use drugs are also living with chronic pain.
Indigenous populations in Canada also face
an increased risk of overdose death and other
substance related harms. According to the First
Nations Health Authority, First Nations people
died of opioid toxicity deaths at 5.9 times the rate
of other residents in British Columbia in 2022; a
disproportionate impact on Indigenous populations
that has also been seen across other provinces and territories. Historical and intergenerational trauma,
including the impact of colonization, loss of traditional culture and language, and experiences with Indian
Residential Schools, have contributed significantly to the elevated risk of overdose death and broader
substance use related harms amongst Indigenous Peoples. Systemic racism arising from Canada’s colonial
history has also created inequities for African, Caribbean and Black populations, which has resulted in
higher rates of poverty, unemployment, and precarious housing among these populations, placing them
at greater risk of substance use harms.
In addition to the overdose crisis, Canada continues to see harms from other substances, such as tobacco
and alcohol. According to the Canadian Costs of Substance Use and Harms 2007–2020 report, substance
use and its related harms from all substances cost Canadians more than $49 billion and led to the loss
of nearly 74,000 lives or 200 lives per day in 2020. In 2020, tobacco use was the leading cause of substance
attributable deaths with 46,366 deaths in 2020, followed by alcohol use with 17,098 deaths and opioid use with
6,491 deaths (see Figure 2).
The harms related to substance use are not limited to the loss of lives alone, but also include increased costs
to our health care system, from hospitalizations, emergency visits and specialized treatment for substance
use disorders, which amounted to $13.4 billion in
2020. Substance use also has economic impacts due
to lost productivity from premature deaths and time
o work due to disability, which cost $22.4 billion in
2020. The enforcement of substance use laws cost
Canada’s criminal justice system $10.0 billion in 2020.
The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
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Canadian Substance Use Costs and Harms Scientific Working Group. (2023). Canada Profile: Canadian Substance Use Costs and
Harms (2007–2020). (Prepared by the Canadian Institute for Substance Use Research and the Canadian Centre on Substance Use and
Addiction.) Ottawa, Ont.: Canadian Centre on Substance Use and Addiction. Information generated by the online data visualization tool at
www.csuch.ca/explore-the-data
People use substances for many dierent reasons, such as medical purposes, personal enjoyment, religious
or ceremonial purposes, or to cope with stress, trauma or pain. Substance use looks dierent for everyone
and has varying stages of benefits and harms. Substance use related harms occur when substances are
used in a manner, situation, amount, or frequency that harms the person using the substance or those
around them. Examples of substance use related harms can include infection, hospitalization, risk of
mental health disorders including risk of substance use disorder, and loss of income or housing. Harms
may also occur in the illegal production, processing, and
distribution of those substances such as community violence
that disproportionately aects marginalized populations. Social
and economic factors also impact a person’s substance use,
such as unemployment, housing insecurity or homelessness,
poverty, trauma, colonialism, systemic racism, and stigma and
can contribute to their marginalization from society.
Addressing this crisis therefore requires a holistic approach,
centered on promoting public health and protecting public
safety. People who use substances, their families and
communities around them are counting on us to use every tool
at our disposal to provide compassionate care and maintain
community safety. We also cannot end this crisis alone. It requires all levels of government, Indigenous
communities and people with lived and living experience and partners from law and border enforcement and
health and social systems to come together to save lives. Our collective work to address this crisis will
guided by our world leading renewed Canadian Drugs and Substances Strategy (CDSS).
The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
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About the Strategy
The CDSS is the federal government’s comprehensive response to substance related harms and the
overdose crisis in Canada. The CDSS is an all-substances, public health and public safety strategy that
covers a broad range of legal and illegal substances, such as tobacco, cannabis, alcohol, and opioids
and stimulants. The goal of the CDSS is to improve the health and safety of all Canadians by minimizing
substance-related harms for individuals, families, and communities. In particular, it prioritizes children
and youth who are more susceptible to negative impacts of substance use as they are still growing and
developing and focuses on providing them the supports, tools and help they need to prevent, delay and
lower the rates of substance use related harms. It also focuses on connecting people to evidence based
substance use services and supports, while also keeping communities safe by taking action against criminal
organizations who are traicking and producing illegal drugs.
The CDSS is a horizontal initiative that is led by the Minister of Mental Health and Addictions and Associate
Minister of Health, who is supported by Health Canada and over 15 federal government departments and
agencies. As addressing substance use related harms is a shared responsibility between federal, provincial
and territorial governments, the CDSS focuses on areas of federal jurisdiction, such as:
+
legislation and regulation
+
funding to support the adoption of innovative approaches
+
national surveillance and research
+
services and supports for populations served by the federal government
Budget 2023 provided $359.2 million in new funding to support the implementation of the renewed CDSS.
The renewal of the CDSS has been informed by national public consultations in 2018 and on-going
stakeholder roundtable discussions where we have heard from communities, provinces and territories,
Indigenous leaders, people with lived and living experience, professional and regulatory bodies and health
care providers. It has also been informed by the findings and
recommendations of the Expert Task Force on Substance Use
(see appendix for membership list), which focused on how we
could strengthen the CDSS moving forward as well as potential
alternatives to criminal penalties for personal possession of
controlled substances. The renewal of our strategy also reflects
the findings and recommendations of the Canadian Pain Task
Force, which examined how pain could be better understood and
eectively prevented and treated in Canada. It has also been
guided by our on-going analysis of data and evidence that we
have collected since the strategy was first introduced in 2016.
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The Government of Canada’s approach to substance use related harms and the overdose crisis
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The Foundational Elements
The CDSS has four integrated priority areas for action called foundational elements, including:
+
initiatives to increase awareness and knowledge
about the eects and risks of substances, and initiatives to prevent,
reduce or delay substance use harms.
+
that support the full
continuum of care, including treatment, harm reduction and
recovery options as well as other social services and supports
to help people reduce their substance use and related harms.
+
through data and research to help inform
substance related policies and decision-making.
+
are activities that allow for the use of
controlled substances and precursor chemicals for legitimate
purposes, such as clinical trials or medical uses, while also
giving health inspectors, law enforcement and border control
authorities the tools that they need to enforce the laws and
regulations that keep Canadians safe and address the harms
of the illegal drug market.
Guiding Principles
The CDSS is led by four guiding principles. It is:
+
by treating substance use as a health issue and people who use substances with
compassion and respect, and recognizing stigma as a barrier to accessing health and other services.
+
by recognizing the distinct impacts that substance use policies and interventions can have
on Indigenous Peoples, African, Caribbean, Black and other racialized and marginalized populations.
+
by engaging all levels of government, Indigenous Peoples, communities, stakeholders,
people with lived and living experience, law and border enforcement and international partners.
+
by recognizing that substance use is dierent for everyone and requires a range
of policies, services and supports to promote overall wellbeing and that many substance use related
harms arise from the toxic illegal drug supply and illegal drug market more broadly.
The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
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Our Priorities for Action Under the
Canadian Drugs + Substances Strategy
Prevention + Education
Prevention and education initiatives support communities, and raise awareness to influence the health
and wellbeing of people living in Canada. They aim to:
+
educate people living in Canada by providing factual information that helps them make informed choices
around substance use and where to get help;
+
prevent, delay or reduce substance use related harms by reducing the factors that increase their risk,
while increasing those that help protect against them; and
+
reduce healthcare, social, economic and criminal justice costs by preventing substance use related harms.
Addressing known risk and protective factors, especially early in life, is key in reversing the current trends
of substance-related harms (see Figure 3). Risk factors are characteristics or experiences that increase the
likelihood of a negative health outcome or harm due to substance use, whereas protective factors promote
an person’s overall health and well-being and decrease their likelihood of experiencing harms related to their
substance use.
United Nations Oice of Drugs and Crime, “Drugs and Age; Drugs and Associated Issues Among Young People,” World Drug
Report, 2018.
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The Government of Canada’s approach to substance use related harms and the overdose crisis
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Factors like sex, gender, age, race, pre-existing health conditions, socioeconomic status, ability, sexual
orientation, migration status, and geography, may also interact with each other to create multiple experiences
of stigma, discrimination and marginalization for some individuals and population groups, such as
2SLGBTQIA+ populations, placing them at greater risk for negative mental health and substance use
outcomes, while also limiting their access to health-related resources that could prevent substance use
harms. Experiences of discrimination, racism and intergenerational trauma arising from Canada’s history
of colonialism are also important determinants of health for certain groups in Canada such as Indigenous
Peoples and Black Canadians.
What is the Government of Canada doing?
To prevent substance use related harms among youth, at risk and other marginalized populations and
disproportionately impacted populations, we are:
+
A new Youth Substance Use Prevention Program based upon the Icelandic Prevention Model will provide
funding to communities to build their capacity to support data-driven community-led approaches to
prevent and delay substance use in youth.
+
Harm Reduction Fund provides funding to time-limited projects across Canada that help reduce HIV
and hepatitis C among people who share injection and inhalation drug-use equipment.
+
Mental Wellness Program to support First Nations and Inuit access to mental wellness services.
+
National Crime Prevention Strategy provides funding to communities to address known risk and
protective factors to prevent at risk, vulnerable youth from participating in crime.
We are raising awareness of substance use related harms and ways to reduce them, and the importance of
reducing stigma, through public education, outreach activities and awareness campaigns. Stigma leads
people to hide their substance use and prevents them from getting help for fear of reprisals, being labelled or
judged. Examples of our campaigns include:
+
Know More Opioids youth awareness program that educates teens and youth on the risks of opioids and
substance use and ways to reduce harms.
+
Ease the Burden Campaign that promotes resources and supports for men working in physically
demanding jobs who are at higher risk of substance use harms.
+
Multi-year campaign to raise awareness of opioids, how to respond to an overdose, the Good Samaritan
Drug Overdose Act and the impacts of stigma on people who use drugs.
+
Drug Stigma Awareness Training for the law enforcement community to help support frontline oicers
in their interactions with people who use substances.
+
Resources and information for people who need help with substance use.
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The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
The Substance Use and Addictions Program (SUAP) supports projects that aim to reduce stigma
associated with substance use disorders through public education, capacity building and research.
With support from SUAP, the Sinai Health System redeveloped the Eective Prescribing of Opioids for
Chronic Pain (EPOCH), a training program for primary health care providers to improve competencies in
treating opioid use disorder. Beyond Stigma is a public and professional education program focused on
stigma. It complemented the EPOCH training program and included the creation of two videos:
The Treating Pain in Opioid Use Disorder
video which explores the impact of stigma
on all aspects of treatment for people living
with a opioid use disorder.
The Nurturing Circle of Care video which
explores the impact of colonialism and
institutional racism on stigma for Indigenous
peoples with opioid use disorders.
We will work with our partners to leverage existing federal initiatives to address underlying inequities that are
the root causes of substance use related harms and support the provision of a range of social services and
supports, such as:
+
reducing homelessness with the implementation of Reaching Home: Canada’s Homelessness Strategy;
+
reducing poverty by implementing initiatives under the Opportunity for All—Canada’s First Poverty
Reduction Strategy; and
+
promoting programs that focus on mental health and preventing family and gender-based violence.
To address the role that unmanaged chronic pain plays in substance use related harms, we will also continue
to work across all levels of government and with professional organizations and other key stakeholders to
advance the priorities identified by the Canadian Pain Task Force, including ensuring that people living in
Canada, including those who use substances, have better access to pain management services. Since 2018,
there have been over 25 pain related projects funded through the Substance Use and Addictions Program to
support the mental health and wellbeing of people who live with chronic pain in Canada.
The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
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Substance Use
Substance use is dierent for each person and there is no single service that will meet the needs of
everyone. The Government of Canada is therefore focusing on supporting equitable access to a continuum
of eective, culturally appropriate and trauma informed evidence-based health services and supports to
meet the diverse needs of individuals who use substances, including:
+
a range of approaches to help reduce, or cease, substance use related harms by managing
withdrawal and cravings, such as psychological and behavioural interventions like talk-based therapy and
counselling that provide practical advice and support on abstinence or reduced use and other behavior
therapies to treat addiction, peer support from people with lived and living experience who oer emotional
support, and pharmacological interventions that reduce cravings and withdrawal symptoms.
+
an evidence-based, public health approach that aims to reduce the negative health,
social, and economic impacts of substance use, without requiring or promoting abstinence. Examples
of harm reduction services could include providing drug
checking services so that an individual can make informed
decisions about the drugs that they are consuming or
providing someone a naloxone kit in case of an overdose.
+
a process or lifestyle change where people who
struggle with substance use related harms work to improve
their health and well being, which could include accessing
services and supports that have complete abstinence as a goal
or a variety of harm reduction and treatment services, as well
as broader social services and supports to meet employment,
vocational training, housing, income and cultural needs.
People who use substances need a range of integrated health and social services to support their health
and wellbeing. Funded through the Substance Use and Addictions Program, the Eastside Movement
for Business and Economic Renewal Society’s Addictions Support and Employment Program provides
rapid access, long-term substance use care to people who have gained employment and are now ready
to address their substance use in order to maintain their employment and stabilize their overall lives.
Evaluations of this program found that achieving employment goals was positively correlated with reduced
risk of substance use related harms and improvements in physical and mental health.
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The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
What is the Government of Canada doing?
Though the delivery of substance use services and supports is primarily the responsibility of the provinces
and territories, we are playing a critical role by improving equitable access to these services through
investments, such as:
+
, including in new funding through the Canada Health Transfer
and other mechanisms, for provinces and territories to improve health care services for Canadians.
This funding includes:
+
to provinces and territories for bilateral agreements to address unique
needs in four shared health priorities, including access to quality mental health and substance
use services.
In addition, we are investing to address unique challenges Indigenous Peoples face
when it comes to fair and equitable access to quality and culturally safe health care services.
The Substance Use and Addictions Program (SUAP) also provides grant and contribution funding to
other levels of government, community-led and not-for-profit organizations, for innovative evidence-based
harm reduction, treatment and recovery projects that focus on at risk and disproportionately impacted
populations, such as young and middle-aged men, Indigenous Peoples, people experiencing chronic pain,
2SLGBTQIA+ populations and Black Canadians. This program has also supported building the evidence
base for innovative approaches to harm reduction such as safer supply. SUAP is currently funding 29 safer
supply pilot projects across the country. Safer supply is a promising harm reduction practice that involves
health care practitioners providing prescription drugs as an alternative to highly toxic street drugs, with the
goal of helping to reduce overdose deaths for those most at risk.
Somerset West Community Health Centre’s Drug Overdose Prevention and Education (DOPE) Project
provides peer outreach to isolated people who use drugs in Ottawa, who otherwise may not have access
to services and supports. This peer based program employes the knowledge, expertise and social
networks of people who use drugs or have used drugs to provide support, resources and training on
overdose prevention and response, including the use of Naloxone, a medication that can be used to
reverse an opioid overdose. Since 2019, this Substance Use and Addictions Program funded project has:
Conducted 441 injectable
+ 401 nasal naloxone
training sessions
Provided 1296 injectable
+ 1789 nasal naloxone kits
Administered naloxone
to community members
75times
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The Government of Canada’s approach to substance use related harms and the overdose crisis
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We will also streamline authorizations for Supervised Consumption Sites, Urgent Public Health Need Sites
and Drug Checking Services, to create a process with clear public health and public safety requirements
for organizations seeking to provide these evidence-based life saving services to Canadians.
We support the provision of substance use services and supports to some populations both directly
and indirectly served by the federal government, such as:
+
culturally appropriate and trauma-informed substance use services and supports within
Indigenous communities;
+
Opioid Agonist Treatment, psychosocial and peer supports and harm reduction services to people
in federal correctional institutions;
+
court-monitored treatment and community services for non-violent oenders with a substance use
disorder through the Drug Treatment Court Funding Program;
+
youth interacting with the criminal justice system who are struggling with complex needs,
including trauma and mental health and substance use disorders through the Youth Justice Fund.
+
veterans, including those experiencing or at risk of homelessness through the Veteran Homelessness
Program.
Indigenous Services Canada (ISC) recognizes that accessibility of quality federally funded health services
is key to achieving physical and mental wellness for Indigenous Peoples. ISC continues to prioritize the
implementation of distinctions-based mental wellness initiatives. The department works collaboratively
with partners to improve access to high quality culturally grounded community based mental health and
substance use services and supports for First Nations, Inuit and Métis, including: life promotion and suicide
prevention programs, including on-the-land activities; mental wellness teams; the Hope for Wellness
Help Line; as well as funding for a network of 45 treatment centres and drug and alcohol use prevention
services. ISC also supports the provision of essential cultural, emotional and mental health supports to
Survivors of Indian Residential Schools and Federal Indian Day Schools and families of former students,
as well as those aected by the issue of Missing and Murdered Indigenous Women, Girls, and 2SLGBTQIA+
people. These initiatives are guided by the First Nations Mental Wellness Continuum Framework, and the
National Inuit Suicide Prevention Strategy, which are holistic frameworks developed by and with
Indigenous partners.
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The Government of Canada’s approach to substance use related harms and the overdose crisis
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Evidence
Accurate, timely, reliable data and research are essential to policy development and decision making.
They allow us to:
+
assess the current situation
+
identify trends
+
set policy priorities
+
respond to emerging drug issues
+
measure our impact
What is the Government of Canada doing?
We are building our capacity to collect, analyze and disseminate disaggregated data in a timely manner and
conduct research to support equity informed, evidence-based decision making to address the overdose
crisis and substance use related harms. The new CDSS Data and Evidence Framework will guide these
eorts by prioritizing the following activities:
+
Conducting and updating our general population surveys to include sex and gender-based analysis
plus data to better understand substance use trends among dierent population groups in Canada.
Examples include:
+
Canadian Alcohol and Drugs Survey
+
Canadian Student Tobacco, Alcohol and Drugs Survey
+
Canadian Postsecondary Education Alcohol and Drug Use Survey
+
Developing new targeted surveys and research to identify trends among and needs of. at-risk,
marginalized, Indigenous and racially diverse populations to support the development of programs and
initiatives that better meet their needs.
+
Strengthening current innovative approaches to surveillance to support public health and law
enforcement’s timely response to the overdose crisis and emerging trends in the illegal drug market by:
+
Working with provinces and territories to collect and report data on opioid- and stimulant- related
deaths and harms;
+
Providing bi-annual simulation models of opioid-related deaths during the overdose crisis;
+
Laboratory analysis of drugs seized by law enforcement by Health Canada’s Drug Analysis Service
to support investigations and prosecutions involving illegal drugs, as well as better understand trends
in the illegal drug supply including the emergence of new harmful substances;
+
Gathering data from supervised consumption sites to understand demand for harm reduction
services, types of drugs consumed and the impact these services have on reducing overdose deaths
and supporting access to other substance use services and supports.
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The Government of Canada’s approach to substance use related harms and the overdose crisis
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+
Monitoring the impact of our policies and programs through activities such as:
+
supporting the Canadian Research Initiative in Substance Misuse (CRISM)’s five-year independent,
scientific evaluation of the impacts of the subsection 56(1) exemption for adults (18 years of age and
older) in the province of British Columbia to remove criminal penalties for people who possess a small
amount of certain illegal substances for personal use; and
+
supporting a four year CRISM led evaluation of the implementation and impact of safer supply
pilot projects.
+
Supporting the evaluation of data and research to develop evidence-based guidance to prevent and
address substance use related harms and support treatment, such as British Columbia Centre on
Substance Use’s National Guideline for the Clinical Management of High-Risk Drinking and Alcohol
Use Disorder.
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The Government of Canada’s approach to substance use related harms and the overdose crisis
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Substance Controls
The Government of Canada has various laws in place that regulate access to controlled substances,
precursor chemicals, cannabis, alcohol and tobacco and vaping products to mitigate their public health
and safety risks while supporting access to them for legitimate purposes. These include:
+
the Controlled Drugs and Substances Act (CDSA) is the federal law that prohibits the possession,
production, distribution, and sale of controlled substances, unless authorized through the regulations
or an exemption, to protect public health and public safety. Controlled substances are those that can
alter mental process and may harm a person’s health or society when used inappropriately or diverted
to an illegal market.
+
the Cannabis Act creates a strict legal framework for controlling the production, distribution,
sale and possession of cannabis across Canada.
+
the Tobacco and Vaping Products Act regulates the manufacture, sale, labelling and promotion
of tobacco products and vaping products sold in Canada.
+
the Food and Drugs Act applies to food, drugs, medical devices and cosmetics.
The Government of Canada also has obligations under international drug control conventions, including
measures to ensure the availability of drugs and substances for medical and scientific purposes while also
preventing their diversion into the illegal market and collaborating with international partners to combat
drug traicking:
+
Single Convention on Narcotic Drugs, 1961
+
Convention on Psychotropic Substances, 1971
+
United Nations Convention against the Illicit Traic in Narcotic Drugs
and Psychotropic Substances, 1988
What is the Government of Canada doing?
To support the administration and enforcement of our substance control laws, we are focusing our eorts
on authorizing activities with controlled substances and precursor chemicals for legitimate purposes, such
as clinical trials or medical uses, while also giving health inspectors, law enforcement and border control
authorities the tools that they need to enforce the laws that keep people living in Canada safe and address
the harms of the illegal drug trade. To achieve this objective, we will:
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The Government of Canada’s approach to substance use related harms and the overdose crisis
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Law enforcement interact daily with people who use substances and have crucial role to play in supporting a
public health approach to substance use related harms. We are supporting law enforcement in this role by:
+
oering training to raise awareness of drug stigma; and
+
piloting an overdose monitoring platform to provide near real-time suspected overdose surveillance data
to support an immediate community-level response to a sudden increase or spike in overdose events and
collect information on organized crime’s drug traicking patterns to support decision-making.
We are working with law and border enforcement partners across the country to address the role of
organized crime in the production, diversion and traicking of toxic illegal drugs. Our activities include:
+
preventing cross-border movement of illegal drugs and precursor chemicals through on-going
enforcement eorts.
+
supporting major drug enforcement operations both domestically and internationally and the dismantling
of illegal drug labs.
+
collecting, assessing and sharing criminal intelligence on the illegal drug supply among law
enforcement partners.
+
working closely with the United States and other countries to identify and disrupt shipments
of illegal drugs destined for Canada.
+
providing forensic accounting services to support law enforcement agencies in conducting complex
and sophisticated organized drug crime investigations; and
+
identifying drugs seized by law enforcement agencies to support police investigation and enforcement
of our drug laws.
To address the harms that people who use substances experience as result of their interactions with
the criminal justice system, such as stigma, loss of income and employment, and loss of housing; and the
over representation of Indigenous, racialized and diverse populations within the criminal justice system,
we have introduced a number of measures:
+
Bill C-5, which repealed mandatory minimum penalties for all drug oences in the Controlled Drugs and
Substances Act; it also requires police and prosecutors to consider diverting people who commit simple
drug possession oences toward health and social services
+
guidance to prosecutors to encourage them to consider alternatives for simple drug possession oences,
except when there are serious public safety concerns
+
the Good Samaritan Drug Overdose Act, which provides some legal protection for people who seek
emergency help during an overdose
19
The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
We will continue to support policies and approaches that divert people who use substances away from
the criminal justice system and towards health and social services by:
+
continuing our engagement and monitoring of the Province of British Columbia’s implementation
of the three-year subsection 56(1) exemption for adults (18 years of age and older) in the province
of British Columbia to remove criminal penalties for people who possess a small amount of certain
illicit substances for personal use.
We will also continue to facilitate the use of controlled substances in scientific research and medical
treatment, or when it is in the public interest, with appropriate controls in place by providing exemptions
under subsection 56(1) of the CDSA.
We are also participating in international forums to advance a coordinated and global approach to substance
use related harms that balances public health and public safety interests through information sharing and
joint action. Key international forums include:
+
Canada-US Opioids Action Plan
+
Cross-Border Crime Forum
+
North American Trilateral Fentanyl Committee
+
North American Drug Dialogue
+
Global Coalition to Address Synthetic Drug Threats
+
United Nations Commission on Narcotic Drugs
Launched in January 2020, the Canada-United States Joint Action Plan on Opioids brings our two countries
together to find solutions to the overdose crisis, which continues to take a tragic toll on families, loved ones
and communities on both sides of the border. Through the Action Plan, Canada and the United States are
taking steps in law enforcement, border security and health to address this tragic crisis. Together, we are:
sharing information
and best practices
collaborating
to stop traicking in opioids,
including fentanyl, and their
precursor chemicals
addressing
the health consequences
of harmful opioid use
The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
20
Implementation: Monitoring +
Our shared goal is to reduce overall rates of substance use related harms and overdose deaths in Canada.
Long-term success will be measured through our ability to decrease substance related deaths and
hospitalizations. Over the next five years, we will evaluate the impact of the activities under the Strategy
by monitoring progress towards:
1. greater awareness, knowledge, skills and resources related to substance use and harms;
2. more equitable access to services and supports to reduce substance use related harms;
3. access to population specific data and evidence on substance use related harms and the illegal drug
supply to make informed decisions; and
4. law enforcement and health authorities have the tools they need to administer and enforce our laws and
regulations related to controlled substances and precursor chemicals.
Our success in achieving these results will depend on our ability to collaborate with many partners and
stakeholders. We are committed to publicly reporting our progress, including impacts on at risk and
marginalized populations, Indigenous Peoples and racialized communities.
The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
21
Appendix: List of Members
Substance Use
The following people were members of the Expert Task Force on Substance Use:
(Co-Chair), CEO of the Thunderbird Partnership Foundation (a division of the National
Native Addictions Partnership Foundation)
(Co-Chair), CEO of Wellesley Institute, Director of Health Equity at the Centre for
Addiction and Mental Health, Full Professor in Psychiatry at the University of Toronto and consultant with
the World Health Organization
(Co-Chair), Chief Constable, Abbotsford Police Department; Chairperson of the Drug Advisory
Committee, Canadian Association of Chiefs of Police (CACP), and Chair of the CACP’s Special Purposes
Committee on the Decriminalization of Illicit Drugs
(Co-Chair, stepped down in April 2021) the Executive Director of the Canadian
Association of People who Use Drugs
, PhD, Professor, École de criminologie at the Université de Montréal
, President and CEO, Shepherds of Good Hope (SGH) and Shepherds of Good Hope
Foundation
, Executive Director, Community Addictions Peer Support Association
, President and CEO, Downtown Vancouver Business Improvement Association
, Executive Director, British Columbia Centre on Substance Use (BCCSU)
, Elder, Advisor and Ambassador, Northern Alcohol Strategy Saskatchewan, Former
Crown Prosecutor
, Chair, Addictions Foundation of Manitoba, and President, Aboriginal Council of Winnipeg
, Spoken Word Poet, Educator, Journalist, and a Community activist living in African Nova Scotia
, Primary Health Care Nurse Practitioner, Thunder Bay and Temagami First Nation
, Chairman of the Executive Board, Canada’s Building Trades Unions
, Communications Oicer, AQPSUD (Association Québécoise pour la promotion de la
santé des personnes utilisatrices de drogues/Québec Association for Drug User Health Promotion)
, Executive Director, Maison Jean Lapointe and Addiction Prevention Centre
, Addiction Forensic Psychiatrist, Clinical Associate Professor, University of British Columbia
The Canadian Drugs + Substances Strategy
The Government of Canada’s approach to substance use related harms and the overdose crisis
22
, Director, Canadian Drug Policy Coalition
, PhD, Assistant professor, Department of Sociology, University of Toronto
, President of BCYADWS (BC/Yukon Association of Drug War Survivors),
Regional Peer Coordinator of the Northern Health Authority in BC
, PhD, Executive Director, Centre on Drug Policy Evaluation, MAP Centre for Urban
Health Solutions, Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Assistant Professor,
University of Toronto Institute of Health Policy, Management and Evaluation, and Assistant Professor,
University of California San Diego Division of Infectious Diseases and Global Public Health
