Executive summary

Ontario’s Chief Medical Officer of Health’s 2023 Annual Report, Balancing Act: An All-of-Society Approach to Substance Use and Harms, is a call for an all-of-society approach to reduce substance use harms. An approach that recognizes the complexity of human experience with substances, the factors that drive substance use, and how public health policies may conflict with economic policies, and with public attitudes and perspectives.

Mood altering substances like cannabis, alcohol, opioids, and tobacco and vaping products that contain nicotine are widely used in Ontario. During the COVID-19 pandemic, Ontario saw disturbing trends, including:

  • more people who had not previously smoked tobacco started using vaping products that contain nicotine
  • more adults using cannabis and subsequently more cannabis-related emergency department visits
  • a significant increase in alcohol sales and alcohol toxicity deaths
  • a growing number of youths in grades 7 to 12 who reported using alcohol, cannabis, and vaping products more frequently

The recommendations in this report reflect the best available evidence on interventions that can help to reduce substance use harms. They aim to build healthier families and communities and ensure people in Ontario have the knowledge, skills and supports to live healthy lives and avoid substance use harms.

By working together as a unified society, to advocate for health, social, and economic policies at all levels, Ontario can build stronger communities so that people can enjoy longer and healthier lives.


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