Pubdate: Thu, 17 Mar 2016
Source: National Post (Canada)
Copyright: 2016 Canwest Publishing Inc.
Author: David McKeown
Page: A10


Drug overdoses are a serious public health issue in Toronto. There
were 206 deaths in 2013, a 41 per cent increase over the past 10
years. Many of these deaths were preventable and we need to do more to
save the lives of some of the most vulnerable members of our
community. As a city, we need a comprehensive response to the drug
problem that includes supervised injection services.

I recently released a report to the Toronto Board of Health that
highlights the health benefits of supervised injection services and
outlines the next steps that need to be taken to implement these
services in Toronto.

Supervised injection is a health service that provides a safer,
hygienic environment where people can inject pre-obtained drugs under
the supervision of nurses. They have been operating in various
locations for more than 30 years and there are now more than 90
worldwide. International research shows that they reduce drug
overdoses, save lives and limit the spread of HIV and hepatitis.

An independent needs assessment in 2012 concluded that Toronto would
benefit from multiple supervised injection services integrated into
existing health agencies that service this population. In 2013, the
board of health approved this integrated model and supported the
implementation of supervised injection services in Toronto.

There's little doubt that there's a population in the city that could
benefit from these services. In 2015, there were more than 100,000
client visits to harm reduction services across the city, and almost
1.9 million needles were distributed along with other sterile
injection supplies. Providing clean needles is important because rates
of HIV and Hepatitis C among people who inject drugs are higher than
they are in the general population.

Three health services in Toronto plan to add small-scale supervised
injection services to their health programs. People who inject drugs
are already coming to these agencies for sterile injection supplies;
allowing them to inject on the premises means they will not need to
turn to public washrooms or alleyways.

All three agencies serve clients with high rates of injection drug
use, and together they distribute almost 75 per cent of all sterile
needles in Toronto. Almost a third of these clients report having had
an overdose in the previous six months, and 36 per cent inject in
public places.

Toronto Public Health is one of the organizations planning to
implement this new service. We are in the early stages of this
initiative and want to hear from the communities where these services
will be provided. We want to ensure that people understand why
supervised injection services are needed and how they will work, and
address any concerns they may have.

Some will be concerned that supervised injection services will
increase drug use and crime. Similar arguments were made over 25 years
ago when needle distribution programs were first being set up. Yet,
according to research, harm reduction services do not lead to
increased drug use or crime rates. Instead, the research indicates
that supervised injection services reduce public drug use and the
number of discarded needles, and help connect people to treatment and
other health services.

Supervised injection will reduce health risks for some of our city's
most vulnerable, as well as reduce the negative neighbourhood impacts
of injection drug use. As the medical officer of health for Toronto, I
believe it is time for us to join other cities and provide this
critical service to the people who need it most.

(Dr. David McKeown is Toronto's medical officer of health.)
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