Safe drug injection sites recommended for Toronto and Ottawa

Toronto and Ottawa would both benefit from having supervised drug injection facilities, a new report suggests.

Toronto and Ottawa would both benefit from having supervised drug injection facilities, a new report suggests.

Four years in the making, the study recommends three safe injection sites for Toronto and two for Ottawa. But it says there isn’t enough evidence to recommend a supervised drug smoking facility and suggested more research be done on that issue.

Dr. Carol Strike said she and co-author Dr. Ahmed Bayoumi hope the communities will take the advice to heart.

“I think we have strong evidence to suggest that there’s a benefit for both cities and we hope that both cities use the evidence to move forward,” said Strike, an associate professor at the Dalla Lana School of Public Health at the University of Toronto.

Bayoumi is a scientist in the Centre for Research on Inner City Health at the Keenan Research Centre at St. Michael’s Hospital.

Currently Vancouver is the only city in Canada that has supervised drug injection sites. One is a stand-alone facility known as Insite; as well, the Dr. Peter AIDS Foundation offers a safe injection service for clients of the agency.

Other cities including Victoria, Montreal and Quebec City have expressed interest in setting up similar sites.

In fact, a growing number of studies — studies used by Bayoumi and Strike to write their report — suggest supervised injection sites are beneficial both to injection drug users and the cities in which they live.

This report estimates opening facilities in Toronto and Ottawa would reduce new HIV and hepatitis C infections, though the numbers of potentially averted infections per year are not enormous.

The current federal government is philosophically opposed to supervised injection sites. It tried repeatedly to shut down Insite until the Supreme Court of Canada ruled in 2011 that the exemption the site needed to operate could not be denied if there was a demonstrated need for the facility.

This new report says demand for facilities is high in the two cities, which have an estimated 9,000 (Toronto) and 3,000 injection drug users.

And it suggests there is support for the facilities within the public, though it acknowledges that even those who are supportive of the concept raise concerns about where the facilities would be located.

“It seems to me there is a shift — movement towards acceptance. And I think there’s a broader understanding in the public that addiction problems are complicated. And the model that we currently have addresses some needs but not all and perhaps we need to explore other options,” Strike said.

She acknowledged, though, that the police departments in both cities object to the idea. Toronto Mayor Rob Ford is also on the record opposing the idea.

The report’s recommendations are only that; the researchers say it will be up to the cities to decide if they want the facilities and how and when to proceed if they do.

For his part, Ontario Premier Dalton McGuinty indicated that he’ll study the report, but made no commitments.

McGuinty, who last fall said he was opposed to supervised injection sites, did not repeat his earlier position when asked Wednesday about the report.

“Who was it that said ’A foolish consistency is the hobgoblin of small minds?”’ McGuinty asked.

“I think I have a responsibility at all times to be alive to the best advice, so I’ll be open to the best advice that we have.”

Added Ontario Health Minister Deb Matthews: “We have no plans to pursue supervised sites at this time.”

The researchers were not asked to recommend specific neighbourhoods in which to locate the facilities and the report does not make suggestions. Selecting appropriate locations will be a challenge, they suggest.

They recommend more than one site per city because neither Ottawa nor Toronto has a single neighbourhood in which drug use is concentrated. In Vancouver, injection drug use is heavily focused on the Downtown Eastside, the neighbourhood where Insite is located.

Drug users surveyed by the researchers said they didn’t want a single facility that could become a focus of community opposition.

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