Don’t shutter Ontario’s safe injection sites

While it’s unclear how Ontario Health Minister Christine Elliott intends to tackle this province’s deadly opioid epidemic, her latest actions are as distressing as they are discouraging.

Late last week, Elliott abruptly ordered a halt to the opening of any new temporary facilities to prevent overdoses, including three that were set to start operating in Toronto, St. Catharines and Thunder Bay.

The health minister says the Progressive Conservative government will decide the future of all temporary overdose prevention sites as well as the more permanent supervised injection sites by the end of September, after reviewing how well they work.

But while governments should always rely on science when it comes to protecting public health, there’s already compelling evidence that these overdose prevention facilities reduce the death and damage being caused by opioids.

As for Elliott’s plan to continue studying the matter, her freeze on the three sites that were ready to open will needlessly put lives at risk.

This is hardly a propitious start for the new health minister. The opioid crisis is the most urgent public health issue facing this province today.

Last year alone witnessed more than 1,200 opioid overdose deaths in Ontario — more than three a day.

The statistics were also stark in 2016, when opioid-related overdoses sent 4,427 people into emergency rooms across the province. Despite the best efforts of health-care workers, thousands of Ontarians remain hooked on opioids and need more help to beat their addiction and get their lives back on track.

Opening special sites for people taking opioids is one way — but definitely a proven way — to deliver that assistance. The supervised injection sites are semipermanent locations funded by the province. In contrast, the overdose prevention sites are temporary facilities set up to address a local emergency. Eight such sites currently operate in the province, but they may be shuttered at the end of next month along with existing supervised injection sites.

And that could happen because Health Minister Elliott believes there is “contrary evidence” these sites are not effective.

There’s a long line of experts who disagree. “The scientific literature, along with the experiences from other jurisdictions and our own local ones, have shown that supervised injection sites and overdose prevention sites provide many health benefits, including reversing overdoses and saving lives,” says Toronto Medical Officer of Health Dr. Eileen de Villa.

David Juurlink, the head of clinical pharmacology and toxicology at the University of Toronto, argues that overdose prevention sites should be a part of any government strategy for addressing opioid abuse.

“It’s crazy to halt new overdose prevention sites,” he says, explaining these facilities not only save lives, they connect people to addiction care, reduce the spread of HIV and hepatitis C, and save the health system money.

And consider that since opening a year ago, a single supervised injection site operated by Toronto Public Health has reversed 213 overdoses.

But politics, rather than science, may carry the day here. Many people object to governments giving drug users permission to take illicit substances. Others oppose having one of these sites open in their neighbourhood.

Premier Doug Ford proclaimed he was “dead against” these sites during the election campaign.

Is the current Health Ministry review a cover for Ford to get his way, or could it allow the government a face-saving opportunity to keep these sites open?

We can only hope good science — and compassion — prevail. If they do, Ontarians should look forward to the current sites continuing to operate, more being opened and lives being saved.