Pubdate: Fri, 06 Jan 2017
Source: Globe and Mail (Canada)
Copyright: 2017 The Globe and Mail Company
Author: Kelly Grant
Page: A4


Despite receiving councillors' support, city is still waiting for
formal green light from Ottawa - and funding from the province

As Toronto prepares to respond to more overdoses caused by bootleg
fentanyl, the city's plan to open three supervised-injection sites
remains stuck in limbo.

Six months have elapsed since councillors in Canada's largest city
voted in favour of adding the service to three health centres that
already distribute clean drug paraphernalia and provide support to
drug users.

But the city is still waiting for funding from the Ontario government
and the go-ahead from Ottawa, which received Toronto's completed
application last month.

"We're told it's coming soon," Toronto Councillor Joe Cressy said of
formal approval from Health Canada.

"But we need it now. We needed it yesterday."

Supervised-injection sites allow users who bring their own drugs to
inject or consume them in a sterile environment under the watchful eye
of health-care workers. If clients overdose, workers are there to
revive them.

Toronto wants to offer the controversial service inside The Works,
Toronto Public Health's needle exchange and harm reduction facility,
and inside the South Riverdale and Queen West-Central Toronto
community health centres, both of which are operated by the province.

But such sites need exemptions from federal drug laws - exemptions the
former government of Stephen Harper was loath to hand out. The
Conservatives passed a law, the Respect for Communities Act, that
required applicants for supervised-injection sites to satisfy a long
list of criteria, including garnering the support of police and the
local community.

The country has only two sanctioned supervised drug-consumption sites,
both in Vancouver. Montreal has applied to Health Canada to open three
locations and a mobile supervised-injection unit, while other major
cities, including Ottawa, Edmonton, and London, Ont., are looking at
following suit.

Health officials on Vancouver Island sent an application to Health
Canada for a Victoria site just this week; they have two more
applications in the works.

Although Health Minister Jane Philpott has vowed to scrap the
Harper-era law, Toronto has already completed every step of the
existing process, Mr. Cressy said, meaning Health Canada could grant
the exemption right away.

Funding is another matter. Toronto has asked Queen's Park for about
$400,000 to retrofit the three health centres and $1.8-million a year
to run the trio of supervised-consumption operations, a request the
Ministry of Health and Long-Term Care is still reviewing, according to
a spokesman for Ontario Health Minister Eric Hoskins.

A Health Canada spokesman confirmed the department received
applications for two of Toronto's proposed sites on Dec. 6 and the
application for a third on Dec. 12. The department has asked for more
information on the first two applications and is planning to respond
to the third "very shortly."

"Obviously, I would urge them to move as quickly as possible to give
us the approval," Toronto Mayor John Tory said. "I think in this case
it might be useful to have that approval and have these establishments
in place before we get to any level [like Vancouver]. I hope we never

British Columbia and its largest city are in the grip of an overdose
epidemic that caused 755 deaths in the first 11 months of last year,
up 70 per cent from the same period in 2015. Illicit fentanyl, a
powerful synthetic opioid smuggled in from China and often cut into
heroin or pressed into fake OxyContin tablets, is driving the increase
in overdoses and deaths.

Fentanyl has yet to take the same toll on Canada's largest city, but
the drug is becoming more prevalent on Toronto's streets, according to
police and public-health officials.

Mary Clare Zak, managing director of social policy for the City of
Vancouver, said supervised-injection site operators in her city did
not wait for federal approval, and applicants in other cities
shouldn't either.

Vancouver's Dr. Peter Centre, a renowned HIV/AIDS clinic in the city's
west end, began supervising illegal-drug injections in 2002, one year
before the opening of Insite, the first dedicated supervised-injection
site in North America.

The Dr. Peter Centre did not receive a Section 56 exemption under the
Controlled Drug and Substances Act until last January, one year after
it submitted a formal application to Health Canada.

Last fall, former drug addicts and activists horrified by a string of
fatal overdoses started an impromptu supervised injection site in a
tent in an alley in Vancouver's Downtown Eastside, an unsanctioned
initiative that has saved lives, Ms. Zak said. It now has a warm home
in a donated trailer.

"We cannot afford to wait for the federal government to grant us the
exemptions," Ms. Zak added. "We can't. We're behind as it is. The
response was not fast enough."

- - With a report from The Canadian Press
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