Toronto’s medical officer of health is recommending officials move ahead with plans to set up supervised injection sites at three existing health centres across the city.
In a report that will be considered on July 4, Dr. David McKeown asks the Board of Health to support the implementation of “small-scale” supervised injection sites at the Queen West-Central Toronto Community Health Centre, the South Riverdale Community Health Centre and the Toronto Public Health facility located at 277 Victoria St.
The cost of setting up the sites is estimated at $100,000 to $150,000 per centre, according to the report.
“These agencies are in locations that have high rates of injection drug use and associated high-risk behaviours in their community and among their service users,” McKeown writes. “At each health care organization, the Supervised Injection Site (SIS) will be added within the existing program space. There will be no visible change to the exterior of the premises.”
Public mostly supportive of idea
McKeown first floated the idea of establishing supervised injection sites in March but the idea had to be put on hold while the city conducted a number of public consultations, as required by Health Canada.
Those consultations were held between March 22 and mid-May and included an online survey that was completed by 1,285 residents as well as several town hall style events in the affected neighbourhoods.
In his report, McKeown points out that 84 to 96 per cent of respondents to the survey identified benefits associated with supervised injection sites (depending on the location) while only 14 per cent to 36 per cent identified concerns (depending on the location).
The most common concerns raised surrounded community safety, the potential for disruptive behavior by those injecting intravenous drugs at the facilities and the potential for an associated impact on the profits of nearby businesses.
In order to address some of those concerns, McKeown’s report recommends setting up community advisory committees to identify and work to rectify ongoing concerns. The report also stresses the need to ensure there is “sufficient waiting space” inside the centres so staff can encourage users to remain on site after their injection.
Furthermore, McKeown says that the facilities must be kept small so they can be properly monitored.
In a letter to McKeown, Toronto Police Chief Mark Saunders says police will “remain vigilant in monitoring criminal activity in the areas” around the three proposed sites.
Saunders says he’s “supportive of measures that reduce the incidence of overdoses and death as the plan for the supervised injection site program indicates.”
“I remain hopeful that the site’s clients will be given meaningful opportunities to be treated and re-integrated into society.”
His report recommends having three injection booths at the Queen West-Central Toronto Community Health Centre, three to four booths at the South Riverdale Community Health Centre and five booths at the Toronto Public Health facility located at 277 Victoria St. The sites would follow the usual operation hours of the facilities they are housed in, however the Toronto Public Health facility would seek to stay open seven days a week from 10 a.m. to 10 p.m.
“Clients would come to the organization with pre-obtained drugs. They would undergo a short assessment to determine the drug being injected, overdose history and/or concerns, injection-related health issues, etc., and then be directed to the supervised injection space,” the report states. “Upon arrival at the injection room, they would be provided with sterile injection equipment. They would then perform their injection under the supervision of a nurse, dispose of all injection equipment in a biohazard container and clean their space.”
Under legislation passed in 2013, municipalities must apply for an exemption to the Controlled Drug and Substances Act (CDSA) in order to open a supervised injection site.
In his report, McKeown asks the Board of Health to provide him with permission to complete an application for that exemption.
City council would, however, have final say.
Currently, there are two supervised-injection sites operating in Vancouver but none elsewhere in Canada.
In a statement issued on Friday afternoon, Trinity-Spadina Coun. Joe Cressy said it is past time for the city to establish safe injection sites as a way to address the rising number of drug overdoses.
“Today's report makes it clear – Toronto is ready to embrace an evidence-based approach to drug policy. An evidence-based approach to reduce harm and save lives,” he said. "The introduction of supervised injection services in Toronto represents our response to the growing overdose crisis, and a bold statement in our ongoing efforts to care for every resident of our city."
