Studies show the sites could reduce fatal overdoses and the transmission of disease.
Toronto officials on Monday announced the location of three proposed supervised injection sites where drug users will be able to safely inject illicit substances under the watch of medical professionals.
The move marks a long-awaited step forward for harm reduction advocates, who point to extensive research that shows supervised injection sites reduce fatal overdoses and the transmission of diseases.
The injection sites will be located at The Works Needle Exchange Program at Victoria and Dundas, the Queen West Community Health Centre at Bathurst and Queen, and the South Riverdale Community Health Centre at Queen and Carlaw. The three sites currently give out needles, but do not administer drugs.
“Drug overdose is a serious health issue in Toronto,” Dr. David McKeown said at a news conference Monday. “These are, essentially, preventable deaths, and we must do more to save the lives of these vulnerable members of our community.”
There were 206 overdose deaths in Toronto in 2013—the most recent year for which statistics are available—marking a 41 per cent increase from 2004.
There are over 90 supervised injection sites around the world, but just two in Canada—InSite and the Dr. Peter Centre, both in Vancouver—and none in the U.S. They’ve been around for over 30 years and, McKeown says, research proves they are effective in reducing overdose deaths and the transmission of diseases like HIV and Hepatitis C.
Donna May has been waiting a long time for this to happen. Her 35-year-old daughter died of an opiate overdose in 2012, leaving behind three children and a grieving family.
Her daughter’s addiction began when she was prescribed OxyContin after a fall down the stairs. When her doctor cut off her prescription, she turned to street drugs like heroin and fentanyl, which helped ease the social anxiety she suffered from. She had never been addicted to drugs or alcohol before the accident.
“I believe that in her situation, having the facilities and the supervision would have made all the difference in the world,” May said.
“It’s been a long four plus years walking down this road, trying to get facilities established for the other children. It’s too late for my child. It’s not too late for yours, or theirs.”
In the four years since May’s daughter overdosed, heroin and opiate abuse has risen across Canada, though exact numbers are hard to come by.
Canada does not track nation-wide overdose deaths, making it difficult to assess whether this country is experiencing a heroin epidemic like the one currently sweeping through the United States. Provinces are left to cobble together statistics on their own, but since not every province does this, national figures are nonexistent.
But a 2014 report by the Canadian Drug Policy Coalition [PDF] found that overdose deaths were rising across the country, fueled in large part by a drastic reduction in the availability of the painkiller OxyContin in 2012.
This has been the main cause of the opiate epidemic in the U.S. as well, with 80 per cent of heroin users starting with prescription opiates and transitioning to heroin when pills become unavailable or expensive. Heroin overdose deaths have quadrupled in the U.S. since 2002 and some states have declared states of emergency.
At The Works, a Toronto Public Health initiative that has been providing various harm reduction measures since 1994, use of the needle exchange program has skyrocketed in recent years.
In 2012, after OxyContin was discontinued, manager Shaun Hopkins noticed an increase in people coming in addicted to opiates.
“We did find people at that time were moving to something else and there was a big concern about overdose risk then because if you’re using a set dose of something and you go to something else that you’re buying on the street, you don’t know how much that [dose] is,” Hopkins said.
In 2013, The Works gave out just under a million needles. By 2014 that number was 1.6 million and by 2015, it was 1.9 million.
This fast and significant increase in the use of needles in Toronto suggests that the problem of opiate use could be worsening each year, with no signs of abating.
Frank Coburn, an injection drug user, has been using various services at The Works for 15 to 20 years now. He comes for advice, clean equipment, and to see the nurses when he has medical questions. He also sits on The Works Community Advisory Committee, which aims to ensure the needs of users are met.
Coburn says he “knows for a fact” that people will use the proposed supervised injection site.
“This is an idea whose time has come and it’s been long overdue. This is very welcome for people who use drugs and should be welcome news for people who don’t use drugs as well, [as] this is going to keep them a lot safer, keep the community a lot healthier.”
Coburn adds that he thinks the site will go a long way towards reducing the stigma attached to drug use, which has created barriers between users and the public.
With a clean, safe location as opposed to alleyways and public restrooms, users “can use it with dignity and some respect and not feel as if they’re low-lifes,” Coburn says.
Donna May agrees. We need to “bring the human back into the equation,” she says.
“Somewhere along the line, substance users have been regarded as animals, as not deserving of human care or concern. And the only way that we can bring treatment to these individuals is by treating them humanely. Opening the door, letting them walk in, and providing the services that they need in order to stay alive.”