Toronto needs supervised injection sites

Drug overdoses are a serious public health issue in Toronto. There were 206 deaths in 2013, a 41 per cent increase over the past 10 years. Many of these deaths were preventable and we need to do more to save the lives of some of the most vulnerable members of our community. As a city, we need a comprehensive response to the drug problem that includes supervised injection services.

I recently released a report to the Toronto Board of Health that highlights the health benefits of supervised injection services and outlines the next steps that need to be taken to implement these services in Toronto.

Supervised injection is a health service that provides a safer, hygienic environment where people can inject pre- obtained drugs under the supervision of nurses. They have been operating in various locations for more than 30 years and there are now more than 90 worldwide. International research shows that they reduce drug overdoses, save lives and limit the spread of HIV and hepatitis.

An independent needs assessment in 2012 concluded that Toronto would benefit from multiple supervised injection services integrated into existing health agencies that service this population. In 2013, the board of health approved this integrated model and supported the implementation of supervised injection services in Toronto.

There’s little doubt that there’s a population in the city that could benefit from these services. In 2015, there were more than 100,000 client visits to harm reduction services across the city, and almost 1.9 million needles were distributed along with other sterile injection supplies. Providing clean needles is important because rates of HIV and Hepatitis C among people who inject drugs are higher than they are in the general population.

Three health services in Toronto plan to add smallscale supervised injection services to their health programs. People who inject drugs are already coming to these agencies for sterile injection supplies; allowing them to inject on the premises means they will not need to turn to public washrooms or alleyways.

All three agencies serve clients with high rates of injection drug use, and together they distribute almost 75 per cent of all sterile needles in Toronto. Almost a third of these clients report having had an overdose in the pre- vious six months, and 36 per cent inject in public places.

Toronto Public Health is one of the organizations planning to implement this new service. We are in the early stages of this initiative and want to hear from the communities where these services will be provided. We want to ensure that people understand why supervised injection services are needed and how they will work, and address any concerns they may have.

Some will be concerned that supervised injection services will increase drug use and crime. Similar arguments were made over 25 years ago when needle distribution programs were first being set up. Yet, according to research, harm reduction services do not lead to increased drug use or crime rates. Instead, the research indicates that supervised injection services reduce public drug use and the number of discarded needles, and help connect people to treatment and other health services.

Supervised injection will reduce health risks for some of our city’s most vulnerable, as well as reduce the negative neighbourhood impacts of injection drug use. As the medical officer of health for Toronto, I believe it is time for us to join other cities and provide this critical service to the people who need it most.