As a specialty hospital in Toronto providing care for people living with and at risk of HIV, Casey House serves people who face multiple barriers to having their basic needs met. We acknowledge that systemic inequities have a profound effect on people’s lives, and believe that everyone deserves judgment-free care – both within and beyond our hospital. With the continuing drug poisoning crisis, housing crisis, and rising cost of living, the need to address the social factors that determine health and well-being is beyond urgent; and tackling these challenges requires thoughtful, transparent, accountable, and compassionate leadership that views people for their humanity amidst the challenges they face.
With less than a month until the mayoral by-election, we are sharing three principles that the next Mayor of Toronto must champion to improve health care and outcomes for people in high need:
1. Housing is a human right, and stable housing and safe living conditions are essential to health and well-being
It is well known that homelessness and precarious housing are at crisis points in Toronto; in fact, Toronto City Council recently declared homelessness an emergency. In addition to a lack of affordable housing options for all income levels, there is a constant lack of emergency shelter spaces to accommodate the volume of people experiencing homelessness – a population in which Black, Indigenous, and other racialized groups continue to be over-represented. Given this reality, many people are sleeping outdoors, including in homeless encampments. The absence of a safe, stable place to sleep and access to the necessities of life makes it difficult to attain stability and adhere to a daily routine, which negatively impacts people’s physical and mental health, particularly during periods of inclement weather. As one Casey House nurse expressed, “For people without housing, managing their health requires so many things they just don’t have access to.”
The city’s housing charter and action plan recognize that housing is essential to the inherent dignity and well-being of the person, however this human right to housing is far from realized. While progress has been made, and while other orders of government have a role to play, there is much more work to do. The next Mayor of Toronto must exercise their power and responsibility to uphold and fulfill the human right to housing for all Torontonians. This entails allocating the maximum available resources, and using all appropriate means, to provide equitable, low-barrier access to adequate housing; and heeding the recommendations of Toronto’s Ombudsman to ensure a fair, consistent, transparent, and accountable response to homeless encampments.
2. Substance use is a health issue, not a criminal justice issue, and people who use drugs should not be criminalized
Despite substance use being a health issue it is treated as a criminal justice issue in Canada, which creates barriers to health services, particularly for people living in deep poverty. It leads health care providers to require that people stop using drugs in order to receive care; deters people from accessing services and supports which would build their resilience and improve their well-being; and drives the inevitable market of illegal drugs which have become increasingly toxic. Moreover, the criminalization of drugs is rooted in colonialism and racism, not in science or public health, and disproportionately impacts Black and Indigenous communities.
In Toronto, promising work is underway to address this systemic barrier: Toronto Public Health’s request to Health Canada to decriminalize illicit drug possession is a decisive policy action. Allowing the possession of drugs for personal use is imperative for decreasing stigma, creating pathways to health care, and improving health outcomes. Equally critical is how this policy change is implemented: it must be supported by a wide range of health and social services that respond to the diverse needs of people who use drugs, including harm reduction – a people-centred and evidence-based approach that aims to reduce the risks of substance use without judgment or preconditions of support. The next Mayor of Toronto must continue to lead and support the critical work underway to help protect people from a toxic drug supply; reduce the harms of substance use, including stigma and discrimination; and respect the health, dignity and human rights of people who use drugs.
3. Everyone deserves to be treated with dignity, compassion, and respect amidst the challenges they face, when interacting with local government
The city’s community safety and well-being plan strives for Toronto to “Become a Trauma-Informed and Responsive City”, one that is “grounded and directed by a thorough understanding of the complete impacts of trauma, adversity, racism and violence on people, families and neighbourhoods.”
A trauma-informed approach accepts and understands the impact of trauma on someone’s life; provides an opportunity for people to express their needs and experiences without feeling judged; and cultivates safety in every interaction to build trusting relationships. In our city, this means providing supports and infrastructure that are accessible and responsive to people’s circumstances and reflect the lived experiences of people from all walks of life, so that everyone feels safe, supported, and respected. The next Mayor of Toronto must champion Toronto’s commitment to becoming a trauma-informed and responsive city by acknowledging the profound effects of systemic inequities on people’s lives; ensuring that city services are delivered to help people to achieve stability in their lives and address the barriers they face; and espouse the fundamental notion that everyone deserves judgment-free care and support.
Leading with unequivocal compassion
All levels of government have a vital role to play in addressing the social factors that determine health and well-being, and in improving health care and outcomes for people in high need. As Toronto embarks on a new chapter of municipal political leadership, thoughtfulness, transparency, accountability, and compassion are imperative to promoting the health, dignity, and human rights of all Torontonians.
Casey House recognizes and acknowledges that systemic inequities deeply affect our clients, and believes it is our responsibility to advocate for compassionate and socially-just health care. Our advocacy seeks to address the structural barriers that prevent optimal health, and improve the well-being of all people living with or at risk of HIV. To learn more, visit Advocacy.
Black History Month is an opportunity to honour Black Canadians and the contributions they make to this country, which span hundreds of years, back to the early 1600s. As a hospital with HIV expertise, it is also an opportunity to call attention to the reality that Black communities are over-represented in rates of HIV, and to consider this population’s distinct health care needs. Statistics show that African, Caribbean and Black (ACB) communities are disproportionately affected by the virus: although these communties made up less than 5% of Ontario’s population in 2015, they accounted for 25% of all new HIV diagnoses.
Barriers to accessing education and employment opportunities, and systemic racism, contribute to the ACB population in Ontario being at higher risk of acquiring HIV, and all too frequently stigma prevents people from accessing prevention, testing and treatment.
A recent study of HIV prevalence and risk factors among ACB people in Ontario¹ suggests that addressing social determinants of health, in particular income and employment related factors, might help lower their risk of acquiring HIV. As a hospital that embraces a holistic approach to health care, we are committed to considering these social factors that determine health and well-being when planning an individual’s care and to providing opportunities to address those factors through our services and programming. We also help reduce barriers to accessing health care by meeting clients where they are on their individual journeys of health and wellness, and taking time to partner with them to reach their health goals.
Another part of our hospital’s approach is to provide culturally-sensitive care without judgement. Creating an inclusive environment takes time, and trust, and in addition to refining our own service offerings, we build partnerships in the community to learn, share knowledge and make connections.
While Casey House’s philosophy and model of care helps support this population, having a team of staff, peers and volunteers that is reflective of the people we serve is also important; providers with lived experience is integral to delivering equitable health care. Casey House is committed to building such a team; one that reflects the diversity of the community in which we live and serve, and encourages learners, job seekers, and those wishing to volunteer, to explore opportunities to join our team.
In addition to highlighting the health needs of the ACB population during Black History Month, we are committed to celebrating Black achievement by continuing to build internal knowledge and by hosting month-specific programming. At the same time, we are also taking the opportunity to look at how Casey House as an organization, and how each team member, is contributing to anti-Black racism and re-committing ourselves to dismantling the structures and behaviours that perpetuate racism. This is critical to the health of our team, our organization, and the clients we serve.
- A cross-sectional investigation of HIV prevalence and risk factors among African, Caribbean and Black people in Ontario: The A/C Study, October 2022. Lawrence Mbuagbaw, Winston Husbands, Shamara Baidoobonso, Daeria Lawson, Muna Aden, Josephine Etowa, LaRon Nelson, Wangari Tharao
As a specialty hospital in Toronto that provides care for people who face multiple barriers to having their basic needs met, Casey House was pleased to share our recommendations for the 2023 Ontario Budget, as part of the public consultation process.
Casey House is committed to understanding our clients’ health concerns in the broader context of their lives. With the continuing drug poisoning crisis, housing crisis, and rising cost of living, the need to address the social factors that determine health and well-being is beyond urgent.
Casey House’s recommendations at a glance
While progress has been made in communities across the province, there is much more work to do – particularly to support people in high need for housing, mental health, and substance use supports. As a hospital, Casey House encourages the Ontario government to increase and improve access to:
- Supportive housing for people coping with mental health and substance use challenges
- Mental health and addictions care that doesn’t require abstinence from substance use
- Wide-ranging harm reduction services and supports as part of overall health care
The provincial government will table its 2023 Budget this spring.
Casey House recognizes and acknowledges that systemic inequities deeply affect our clients, and believes it is our responsibility to advocate for compassionate and socially-just health care. Our advocacy seeks to address the structural barriers that prevent optimal health, and improve the well-being of all people living with or at risk of HIV. To learn more, visit Advocacy.
As a specialty hospital in Toronto that provides care for people who face multiple barriers to having their basic needs met, Casey House was pleased to comment on the City of Toronto’s 2023 Budget, as part of the public consultation process.
Casey House is committed to understanding our clients’ health concerns in the broader context of their lives – including their housing and income situations, which continue to be areas of high need. With the continuing drug poisoning crisis, housing crisis, and rising cost of living, the need to address the social factors that determine health and well-being is beyond urgent.
Casey House’s recommendations at a glance
While progress has been made to improve the health and well-being of people in Toronto, there is much more work to do – particularly to support the estimated 18,000 people experiencing homelessness in our city, while they continue to wait for more safe, affordable, and supportive housing. As a hospital, Casey House encourages the City of Toronto to increase and improve access to:
- Emergency shelter spaces with citywide locations that enable people to remain geographically close to their support systems and networks.
- Low-barrier 24-hour drop-in spaces, respite sites, warming centres during winter months, and fixed-site cooling centres during summer months.
- Storage services for personal belongings, such as medications and critical documentation.
- Income tax clinics and identification clinics to enable more people to apply for long-term housing and income support programs.
The Budget Committee wraps up its review process January 24, Mayor John Tory releases proposed budget by February 1, City Council votes on the budget February 14.
Toronto residents and businesses are encouraged to participate in the process, and can provide written comments and feedback to the Budget Committee by email: buc@toronto.ca. Learn more at the City of Toronto’s website.
Casey House recognizes and acknowledges that systemic inequities deeply affect our clients, and believes it is our responsibility to advocate for compassionate and socially-just health care. Our advocacy seeks to address the structural barriers that prevent optimal health, and improve the well-being of all people living with or at risk of HIV. To learn more, visit Advocacy.
In celebration of the 12 Days of Casey House Christmas
1st day: One Inhalation SCS booth. Casey House was proud to open the first indoor supervised inhalation space for substance use in the province. Adding the option to smoke illicit drugs to our other supervised consumption services (SCS), allows people to use safely with privacy and dignity, and helps prevent overdose deaths. SCS is open to inpatient clients 24 hours a day, and from 10 a.m. – 4 p.m. on weekdays for outpatient clients.
2nd day: Two streams of service (inpatient/outpatient). Our hospital provides care to the community in two different ways. Our traditional 14 inpatient rooms are for those needing 24/7 nursing care and daily access to a physician. Outpatient clients can access the nursing clinic, supervised consumption services, individual appointments with a range of clinicians, and group programming.
3rd day: Three pressing issues for Toronto. Casey House is advocating for the City of Toronto to address three pressing issues that impact people in high need: deep poverty; toxic supply of unregulated drugs; and criminalization of drugs and the people who use them. Learn more about these issues and our recommendations here.
4th day: Four Intro to Harm Reduction Education videos. Our four-part Harm Reduction Capacity Building Training series helps health care and support service providers caring for people affected by HIV contextualize unique lived experiences. Originally created as an internal learning resource for staff , the limited series was repurposed to share our principles of trauma-informed care and harm reduction widely. The series features members of Casey House’s network of community organizations.
5th day: Five episodes of Positively Speaking. Our audio podcast Positively Speaking launched in 2020 and shares first-person accounts of life with HIV. Each episode discusses how living with HIV impacts other facets of one’s life, like relationships or mental health. We’re excited to announce that season 2 is set to release in early 2023, making now the perfect time to catch up and relisten to season 1. Positively Speaking is available wherever you listen to podcasts, including Spotify, Apple Podcasts, or on our website.
6th day: Six real stories of stigma. Alongside our release of Others, the dramatic short film, we created six short documentaries featuring real people recounting real stigma. Peter, Alphonso, Amutha, Ower, Brenden, and Alex shared their experiences in dealing with HIV stigma and overcoming it. Watch them all here at SmashStigma.ca
7th day: Seventh local hospital to receive a sacred Indigenous hand drum. In April, Casey House was grateful to receive a sacred drum for clients, staff, peers, volunteers and families to use for ceremonies and spiritual practices. The drum was gifted by The Toronto Central Regional Indigenous Cancer Program (TCR-ICP) in recognition of Casey House’s ongoing work and commitment to build relationships and improve the care and experience of Indigenous staff and community members.
8th day: Eight featured storytellers at Voices for World AIDS Day. On World AIDS Day, we were honoured to hear from eight incredible Black women who have made strides in the HIV sector. Artists, advocates, and community health leaders, we were moved by stories from d’bi.young anitafrika, Jully Black, Racquel Bremmer, Sane Dube, Muluba Habanyama, Molly Johnson, Marvelous Muchenje, and Lena Soje.
9th day: Nine new outpatient group offerings: Pantry builders, Housing Information, Navigating Grief, The Heart of Art, Winter Warm-up, Pet Therapy, Indigenous Cultural Fridays, Indigenous Grief and Healing, and Indigenous Drumming Circle are nine new programs being offered in our Winter season. We applaud the day health team for continually creating new and exciting programs for our clients.
10th day: Ten co-authors on the MRAT poster: This summer, the Casey House research team presented their Multipurpose Resilience Assessment Tool at the AIDS 2022 conference in Montreal. This integrated client engagement, assessment and follow-up tool that also generates holistic health data was designed by an interdisciplinary working group.
11th day: Eleven o’clock healing drum circle on Tuesdays: Each Tuesday afternoon from 11 a.m. – 1 p.m. Rod Michano, Spiritual Advisor from PWA, hosts a circle for learning about Indigenous identity and to support our Indigenous clients’ health. Check out our Winter DHP schedule for more info!
12th day: Twelve o’clock lunch program: Every weekday at noon, staff and volunteers provide hundreds of hot meals for our client to provide nourishment and an opportunity for socialization. In the first six months of this fiscal year, we provided 7,911 lunches!
As a specialty hospital that provides care for people living with and at risk of HIV, Casey House was pleased to comment on federal Bill C-22 – Canada Disability Benefit Act, which seeks to establish the Canada Disability Benefit (CDB) to reduce poverty and support the financial security of working-age persons with disabilities.
Casey House serves clients with disabilities, particularly those with illnesses or conditions that are “episodic” – meaning, they vary in severity and duration and can include periods of wellness. Most clients are HIV+ and contend with multiple chronic conditions – many of which are exacerbated by the overdose crisis, housing crisis, and rising cost of living. Our hospital is committed to understanding our clients’ health concerns in the broader context of their lives – including their income and financial situation, which is an area of high need.
Casey House’s brief at a glance
With the rising cost of living and risk of a recession, the need for the CDB is urgent. Casey House calls for the swift passage of Bill C-22 so that this disability benefit can be designed and delivered as quickly as possible to:
1. Support people with episodic disabilities living in poverty: examples of episodic disabilities include chronic conditions and diseases such as HIV, mental illness, and substance use disorder. People with episodic disabilities face unique barriers to financial security and require supports that enable them to meet their basic needs.
2. Reach people with disabilities living in poverty who face barriers to filing income tax returns: the CDB would be based on annual income tax returns, however for people living in deep poverty, such as those without housing, it can be difficult to file their taxes regularly. If barriers to tax filing are not addressed, we risk the CDB not reaching those who need it most.
3. Ensure that people with disabilities living in poverty continue to have uninterrupted access to health benefits through provincial disability support programs: most Casey House clients receive income support from the Ontario Disability Support Program (ODSP), which also provides coverage for life-saving medications. Implementing the CDB will require coordination between different levels of government to ensure people have continued, uninterrupted access to provincial health benefits to meet their health care needs.
This bill is currently being studied by a Parliamentary Committee in the House of Commons, and must pass both the House and Senate in order to become law. The faster Bill C-22 is passed, the faster the Canada Disability Benefit can be designed and delivered to reach all working-age people with disabilities living in poverty, to improve their financial security and health and wellbeing.
You can learn more about Bill C-22 and follow its progress at the Parliament of Canada website.
Casey House recognizes and acknowledges that systemic inequities deeply affect our clients, and believes it is our responsibility to advocate for compassionate and socially-just health care. Our advocacy seeks to address the structural barriers that prevent optimal health, and improve the well-being of all people living with or at risk of HIV. To learn more, visit Advocacy.
TORONTO, ON (November 16, 2022) – Today, Casey House clients are able to smoke substances on-site as part of its hospital-based supervised consumption services (SCS). This development makes Casey House the first site in the province to offer indoor supervised inhalation.
Adding this form of consumption, in addition to injection, snorting or eating, as an option for clients makes safer drug use and overdose prevention more accessible. Smoking is an increasingly common method of drug consumption and will make Casey House’s SCS accessible for even more people. Having a safe indoor space allows people to safely use substances with privacy and dignity.
Additionally, research from the Office of the Chief Coroner for Ontario shows that there has been a significant shift towards inhalation-related deaths during the pandemic. In 2020 in Ontario, just over one-third of deaths were inhalation-related – an 11% increase from pre-pandemic times. The report points to the need for more harm reduction services tailored specifically to this mode of drug use, including supervised inhalation services.
Supervised inhalation is also highly recommended by community stakeholders. Recently, inhalation was endorsed in the toolkit Twelve characteristics of client-centred supervised consumption services (SCS), developed by the Engage with Harm Reduction study that featured input from Casey House staff, peers and community members.
Casey House’s SCS are open to registered clients 24 hours a day on the inpatient unit and 10 a.m.-4 p.m. for outpatients, and are integrated into its regular health services. Clients use their own drugs while being monitored by trained staff who can provide emergency medical care in case of overdose. Drug testing and supervision at an SCS substantially reduce the risk of overdose and death, and increase access to sterile equipment, education on safer use, and health and social services. Supervised inhalation is for unregulated substances only; neither tobacco nor cannabis can be smoked in the SCS.
Casey House CEO Joanne Simons is proud to be expanding the supervised consumption services for the hospital’s clients, and says, “We were able to do this in a cost-effective manner, and believe this is a critical health care investment for organizations and governments to improve health care outcomes for people who use drugs.”
Simons goes on to say how much the hospital acknowledges and is grateful for the ground-breaking work of the harm reduction community across the country, such as sites like Prairie Harm Reduction in Saskatchewan and Blood Ties in Yukon. She looks forward to other organizations being able to also offer this much-needed service.
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Casey House is unlike any other hospital. We are a specialty hospital in Toronto providing ground-breaking care to people living with and at risk of HIV. Together with our clients, staff, peers and volunteers, we strive to create an inclusive environment where everyone feels safe. We offer a growing mix of inpatient, outpatient and community-based services that meet clients where they are in their individual journeys of health and wellness. Building on a legacy of advocacy and social justice, we actively dismantle barriers to care and safe living. We provide a community and sense of belonging that connects people to care. The humanity of each client is at the heart of everything we do.
To book an interview with Casey House chief executive officer Joanne Simons, or for more information, contact:
Cole Douglas
Narrative on behalf of Casey House
Cole.douglas@narrative.ca
416.460.5480
Learn more:
See where and how Casey House offers its hospital-based SCS in a short video here.
Casey House becomes first Ontario hospital to provide safe, supervised space for substance use, April 2022
Compassionate Care: Increasing access to supervised consumption services, April 2022
Cinematic short marks the first time an actor is cast specifically because of their HIV status
TORONTO, Oct. 26, 2022 (GLOBE NEWSWIRE) — Casey House – a hospital unlike any other providing care to those living with and at risk of HIV – is utilizing cinematic horror to bring attention to HIV stigma. Others – directed by renowned filmmaker and screenwriter Paul Shkordoff – sets out to highlight the impact of judgement and what it can feel like to be haunted by stigma. This film marks the first time a professional actor living with HIV was intentionally cast to play an HIV+ lead protagonist.
“As a hospital that strives to create an inclusive environment where everyone feels safe, we’re also tackling the deeply ingrained stigma associated with HIV,” says Joanne Simons, Casey House CEO. “Others will spark needed conversation on the impacts of stigma that people living with HIV face every day. Horror is a genre that allows for complex social issues to be presented in a compelling way. An evolution of the hospital’s ongoing #SmashStigma initiative, the Others campaign looks to harness the power of fear – which fuels stigma – to spark conversations around outdated misconceptions about HIV.”
“There are various reasons why horror films are capable of triggering strong emotional reactions related to fear,” says Dr. Joseph LeDoux, Professor of Neuroscience at New York University. “Research shows that both traditional fight-or-flight responses, and an individual’s personal and prior experiences, contribute to how one will respond to horror films. I believe that the unique power of horror films is that they bring on an immediate response in a relatable and engaging way in a safe setting.”
Despite medical advances in effective treatment for people living with HIV, the disease is still shrouded by prejudice and discrimination lingering from the AIDS crisis of the 1980s. According to data from UNAIDS, “across nearly all regions there are countries where large proportions of adults continue to hold discriminatory attitudes towards people living with HIV.” And, according to The Positive Effect, 80% of those living with HIV in Canada have concerns about disclosing their HIV status due to stigma.
“When I first read the Others casting call for an HIV+ actor I thought this sounded like an interesting project I wanted to be a part of,” says Peter McPherson, UK-based actor and lead protagonist of the film. “But when I read the script, I instantly felt an intimate connection to the character. I get what the character has gone through,” he continues. “I’ve experienced the fear that stigma creates.”
Representation in film helps open people’s eyes to the experiences and challenges of others. While this film is a work of fiction, Others was inspired by the lived experiences of HIV+ individuals, six of whose stories are featured at the end of the film.
“The effects of discrimination are felt by the HIV+ community every day,” says Alex, a documentary participant involved in the project. “This film is a powerful tool in showing audiences the repercussions of discrimination while sharing stories from HIV+ individuals who continue to overcome stigma.”
Visit SmashStigma.ca to watch the film and learn more and follow on social: #smashstigma.
To access the campaign film trailer and high-res images, please visit: here.
To book an interview with any of our following spokespeople or for more information about Others please contact:
Samantha Sartor
samantha.sartor@narrative.ca
647-409-8466
Spokespeople available for interviews include:
- Joanne Simons, CEO of Casey House
- Peter McPherson, lead actor of film, Others
- Our HIV+ documentary participants
- Paul Shkordoff, director
- Joseph LeDoux, Professor of Psychology/Neuroscience at New York University.
- Dr. Trevor Hart, Director of the HIV Prevention Lab and Psychology Professor at Toronto Metropolitan University
About Casey House:
Casey House is unlike any other hospital. We are a specialty hospital in Toronto providing ground-breaking care to people living with and at risk of HIV. Together with our clients, staff, peers and volunteers, we strive to create an inclusive environment where everyone feels safe. We offer a growing mix of inpatient, outpatient and community-based services that meet clients where they are in their individual journeys of health and wellness. Building on a legacy of advocacy and social justice, we actively dismantle barriers to care and safe living. We provide a community and sense of belonging that connects people to care. The humanity of each client is at the heart of everything we do.
A photo accompanying this announcement is available at https://www.globenewswire.com/NewsRoom/AttachmentNg/3c5054ca-adfb-47fe-9435-9a5a1b86b042
For many people, substance use is a way to cope with intersecting challenges such as trauma, poverty, homelessness and mental health concerns, which can create multiple barriers to having one’s basic needs met. At Casey House, our clients face many of these hurdles, which have an impact on their health and well-being. Our hospital is committed to understanding our clients’ health concerns in the broader context of their lives, and to actively dismantling barriers to care and safe living. All levels of government have a vital role to play in addressing the social factors that determine health and well-being, and in improving health care and outcomes for people in high need. While considerable progress has been made in recent years, there is much more work to do.
In Toronto, three pressing issues that any municipal policy or program must consider and address are:
1. Deep poverty: inadequate income and chronic homelessness
For many of our clients, an extremely low income creates barriers to safe and healthy living. For those who qualify for income support programs, the amount of money a single person receives is not nearly enough to cover basic needs and shelter. For instance, many clients receive support from the Ontario Disability Support Program (ODSP) or Ontario Works (OW) – the maximum monthly rates for which are $1,228 and $733 respectively. Even in stronger economic times, these rates are far below the poverty line, let alone during this period of high inflation, when even higher income earners struggle to make ends meet.
Unsurprisingly, a related challenge is access to safe, affordable, and supportive housing – the demand for which far exceeds supply. The constant lack of emergency shelter spaces affects the ability of hospitals like Casey House to safely discharge unhoused patients so they can manage their health beyond their stay. As one long-time Casey House nurse expressed, “We call Central Intake [for emergency shelter space], and no beds are available…I’ve never seen it worse.” The situation is further aggravated by obstacles to obtaining required documentation to apply for potential housing. Our team of social workers see these roadblocks far too often: “getting ID is a nightmare for people” because of the limited services available, and “it can be difficult for people without housing to get their taxes done regularly”.
Even when people are housed and have access to programs like ODSP, it is still not enough to pay for food, transportation, and other basic needs.
2. Toxic supply of unregulated drugs and growing risk of drug-related harms
Since 2016 there have been more than 30,000 opioid toxicity deaths in Canada, an accelerating crisis that is claiming lives in communities across the country. In 2021 , Toronto Public Health reported 574 opioid-related deaths. As recent research from the Office of the Chief Coroner for Ontario shows, there has been an increase in stimulants contributing to opioid-related deaths, the circumstances surrounding drug-related harms have been changing significantly, and there is an urgent need for harm reduction services that respond to the diverse needs of people who use drugs.
In Toronto, many harm reduction services are available, but limited. Supervised consumption services (SCS) are contained to the downtown core; don’t always accommodate the range of drugs used and varying effects they have on the mind and body; and often don’t include vital drug checking services, which help people make more informed decisions about their drug use. The few options for safer supply (prescribed alternatives to the illicit drug market) have long waitlists and are limited to opioids.
In addition, many people providing support do not have lived experience of drug use, which can limit the full potential of these services. As one Casey House client expressed, “you want someone who ‘speaks your language’” when accessing care.
3. Criminalization of drugs and the people who use them
While substance use is a health issue, it is treated as a criminal justice issue in Canada which creates barriers to health services, particularly for people living in deep poverty. It leads health care providers to require that people stop using drugs in order to receive care; deters people from accessing services and supports which would build their resilience and improve their well-being; and drives the inevitable market of illegal drugs which have become increasingly toxic. Moreover, federal drug policy is rooted in colonialism and racism, not in science or public health, and disproportionately impacts Black and Indigenous communities.
In Toronto, promising work is underway to address this systemic barrier: Toronto Public Health’s request to Health Canada to decriminalize illicit drug possession is a decisive policy action. Allowing the possession of drugs for personal use is imperative for decreasing stigma, creating pathways to health care, and improving health outcomes for people who use drugs. Equally critical is how policy change is implemented: people who use substances need to feel safe, supported, and respected, and all front-line service providers and first responders must be well-equipped to operate in a new environment that allows for personal drug possession.
Casey House recognizes and acknowledges that systemic inequities deeply affect our clients, and believes it is our responsibility to advocate for compassionate and socially-just health care. Our advocacy seeks to address the structural barriers that prevent optimal health, and improve the well-being of all people living with or at risk of HIV. To learn more, visit Advocacy.