It’s time to say hello to safe injection sites in Toronto

It’s the hotly contested drug issue Torontonians are talking about this week – and it’s not about legal ganja. Toronto is considering opening three supervised injection sites for drug users, the city’s chief medical officer of health announced on Monday.

Before we take the plunge (pun intended), perhaps we should first consider how beneficial these sites would be for drug users, as well as for our city at large.

Of the 90 some injection sites that exist worldwide, Vancouver is home to two. Insite, the first to open, is located in the city’s Downtown Eastside, an area notoriously known as “Canada’s poorest postal code.”

At Insite, drug users bring their own substances onto the premises and inject them, while under the watchful eye of trained staff. Staff are on site to intervene in the event of overdose, by administering a dose of naloxone, a drug which blocks the effects of opioids.

And the program works – there is a large body of evidence to back it up. Clients who visit the site feel safer as opposed to injecting in other private or public spaces. Since its opening in 2003, more than 2 million people have visited the site. Its surrounding area has seen a 35 per cent drop in overdose deaths. Those who go to Insite are also more likely than other addicts to sign up for detox and rehab.

The facility was opened after a spike in HIV and hepatitis C infections, an outbreak that one health professional deemed “the most explosive epidemic of HIV infection that had been observed outside of sub-Saharan Africa.” Descriptions of the neighbourhood are dire – addicts die from overdoses in alleyways, and some clean their needles with water from puddles.

Maybe the situation in Toronto is not that extreme. But the need is there. Toronto’s rate of fatal overdose is on the rise, as 2013 saw 206 overdose deaths, a 41 per cent increase from 2004, when 146 people died.

Toronto Public Health, along with 47 community agencies, currently provides harm reduction services, including safer drug use supplies. In 2015, there were 104,952 people who used these programs, and almost 1.9 million needles were distributed.

The proposed injection sites would be set up within existing facilities, where harm reduction services are currently offered.

In addition to providing a clean space and equipment for drug users, these sites would also contribute to the cleanliness of neighbourhoods. Many users inject drugs in public spaces, including washrooms, stairways and alleys, often leaving hazardous waste in their wake. People will likely continue to inject drugs in public spaces, unless provided with an alternative to do so. This puts others at risk.

Should public drug use be in plain view?Do we want to see contaminated needles littering our beaches and parks? This is unsanitary and dangerous for garbage workers, not to mention children. Helping to keep drug use away from the public eye is doing a service to our community.

Would opening these sites be an act of compassion or merely enabling drug activity?

The debate rages on. It is a moral dilemma, as well as a legal one. Toronto police would prefer to see money spent getting people away from drugs to focus on treatment.

And rightly so. It’s true that giving users the green light to inject illegal drugs is a radical idea. Yet like many illegal activities, drug use isn’t something that we can curb altogether. It’s time to view this as a public health issue, and encourage a safe way of using. If it leads to a reduction in deaths due to overdose, then it is worth a try.

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