Toronto will soon be getting more supervised consumption sites for people who use unregulated drugs.

Set to open in the next one to two years, the expanded harm reduction service is the result of a new partnership between Toronto Public Health (TPH), Unity Health Toronto, and University Health Network. The exact locations for the new sites are still being determined.

Specifically, St. Michael’s and Toronto Western hospitals will work with TPH to expand its long-running The Works program, which last year saw more than 21,000 visits for supervised injection and helped prevent more than 500 drug overdoses.

Among other things, The Works provides nursing services, counselling, support and referrals, supervised injection, opioid substitution programming, mobile and street outreach, harm reduction supply and naloxone distribution, overdose response and harm reduction training, and drug checking services. It also produces drug alerts and advisories in collaboration with the Toronto Drug Strategy Secretariat.

“Supervised consumption services are critical medical services that have proven to save lives, especially as opioid overdoses have reached record levels in our city,” Coun. Chris Moise, chair of the Board of Health, said in a Feb. 24 release.

“I am thrilled to see these important services expand through the presence of new hospital partners at the table.”

Naloxone

This new partnership marks the first time in Ontario that acute care hospitals are working in direct partnership with a local public health unit to open supervised consumption services.

It also comes as Toronto grapples with unprecedented numbers of fatal drug overdoses.

According to the coroner’s latest data from 2021, 591 people died of an OD in the city.

This marks the second consecutive year that Toronto saw more than 500 overdose deaths. In 2020, 539 people in Toronto died of a drug overdose.

Toronto’s Medical Officer of Health Dr. Eileen De Villa pointed to the “great need” for more harm reduction and supervised consumption services across the city.

“We are so pleased to announce this historic partnership between Toronto Public Health, Unity Health Toronto and University Health Network, with all of us working together in response to the ongoing drug poisoning crisis,” she said.

Speaking with CP24 on Sunday morning, Dr. Andrew Bond, the medical director of Inner City Health Associates, said every part of the healthcare system needs to work together to drive change when it comes to tackling the drug poisoning crisis.

“The only way to get ahead of this is to have all hands on deck,” he said, adding an “all-approaches strategy to ensure that, at minimum, everybody can be safe and supported and connected” is a good start.

Bond went on to say that while there have been more than 500 reported overdose deaths for the last two years, there are many more than aren’t documented as well as “huge numbers” of non-fatal ODs “that we never hear about.”

“There is a lot of work to do. We need to ensure that our community-based groups are supported to do this, but also have our hospital partners by our side in lockstep working with us,” he said, noting a lot of fatal and non-fatal drug overdoses are happening outside of the downtown core and more of those supports need to be in place to better serve the community.

He also said that it’s important people be educated about what supervised consumption services are all about.

“Taking an evidence-based approach would really, I think, lead almost everybody to say yes in my backyard because what it really means is that those people who are at the moment right now have no one to go except in shadows, in back alleys, and public spaces, now have somewhere safe to go inside,” he said, noting studies have found that supervised consumption sites actually lead to a decrease in public nuisance- and criminal-related related activities.

In a release, the City of Toronto said that a number of factors, including stigma and discrimination, are preventing people from accessing services, which is impacting the health of those who use drugs.

“Overdose deaths are preventable and are due, in large part, to the unregulated drug supply, where the use of highly potent opioids combined with more unexpected and concerning substances are significantly increasing the risk of overdose,” it said.

“Embedding community-based harm reduction services alongside hospital-based health care services provides clients access to a full continuum of care based on their needs.”

Another way the city is working to address the drug poisoning crisis is by applying for an exemption from the Controlled Drugs and Substances Act to decriminalize small-scale drug possession. That application is now in the hands of Health Canada.

Other related initiatives are outlined in the Toronto Overdose Action Plan.