Pubdate: Tue, 15 Mar 2016
Source: Toronto Star (CN ON)
Copyright: 2016 The Toronto Star
Page: A10
Bookmark: (Supervised Injection Sites)


The evidence is in: supervised sites allowing users to inject illegal 
drugs save lives. But they do much more than that.

Providing a secure place for people to use heroin and other injection 
drugs leads to cleaner, safer neighbourhoods. It boosts overall 
public health by reducing the spread of blood-borne infections, such 
as HIV and hepatitis C. And it saves money by lowering the huge cost 
associated with treating such conditions.

In short, there's every reason to proceed with a plan to open three 
supervised injection sites in Toronto.

"Injection drug users are at exceptionally high risk," Dr. David 
McKeown, the city's medical officer of health, told the Star's 
editorial board on Monday. "This program helps keep them alive long 
enough to get off drugs."

McKeown is seeking approval for community consultations to create a 
site in the Queen West area, another in South Riverdale and a third 
in the city's centre, near Dundas Square. His initiative deserves 
strong support from Toronto board of health when it meets next Monday.

The obvious - and most compelling - reason to proceed is to ease a 
rising tide of accidental overdose deaths. "Preventing overdose must 
be the top public-health priority of our city," says Councillor Joe 
Cressy, chair of the Toronto Drug Strategy Implementation Panel. "We 
have an opportunity to prevent unnecessary loss of life."

The numbers are indeed stark. Overdose deaths in Toronto increased by 
41 per cent between 2004, when 146 people died, and 2013, when there 
where 206 such fatalities. But these figures, the most recent 
available, include death by suicide. Setting aside cases where people 
intentionally killed themselves, an even more disturbing jump in 
overdose fatalities emerges.

Deaths from accidental overdose are up by more than 80 per cent, 
going from 82 in 2004 to 149 fatalities in 2013. That's almost three 
people dying every week in this city from a cause that is largely preventable.

Supervised injection sites help reduce this toll by giving people a 
clean place to inject their drug, using sterile needles, without fear 
of arrest. Oversight is provided by trained nurses able to respond 
quickly to an overdose by administering a dose of naloxone, which 
works as an antidote to excess opioids in a person's system.

It's not hard to see how this saves lives, said McKeown. "Injection 
under the supervision of a health professional is safer than 
injecting in a washroom or alley."

It's better for the community, too. As many as one-third of people 
injecting illegal drugs do so in public places. Supervised sites 
"move drug use and needles from our streets, our parks, our backyards 
and our coffee shops," said Cressy.

A further benefit is that staff at a supervised site are better 
placed to reach out to drug users, putting them in contact with 
counselling and rehabilitation programs as well as other health and 
social services.

The city's strategy of placing supervised injection sites in existing 
facilities, where people already receive "harm-reduction" services, 
makes eminent sense. About 1.9 million clean needles are distributed 
to injection drug users in Toronto each year, and 75 per cent of them 
are delivered through the three centres where the proposed new sites 
are to be set up. "That's where the drug use is," says Cressy,

Supervised injection sites typically generate community opposition, 
but it's important to remember that people in the habit of taking 
illegal drugs, especially those who are addicted, aren't going away. 
If they are denied a safe, supervised place to inject the drug of 
their choice they'll keep doing what they do now - shooting up in 
neighbourhood parks, washrooms, stairwells and alleys.

They destroy their own health in doing so, and also put others at 
risk through the used needles they leave scattered in public places.

There is a better way. The first supervised injection site opened in 
Bern, Switzerland, 30 years ago. More than 90 are operating 
successfully in countries including Germany, Spain, Denmark, Norway, 
the Netherlands and Australia. Vancouver now has two such centres.

Earlier attempts in Toronto to follow the example of these 
progressive jurisdictions ran up against opposition from the Harper 
government. The new Liberal government has signalled it will not 
block new injection sites, so it's time for Toronto to move ahead. 
It's best for injection drug users, and for the city at large.
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MAP posted-by: Jay Bergstrom