Pubdate: Tue, 10 Jan 2017
Source: Globe and Mail (Canada)
Copyright: 2017 The Globe and Mail Company
Author: Kelly Grant
Page: A1


The Ontario government has agreed to help fund three supervised
drug-injection sites in Toronto and one in Ottawa as part of an effort to
better prepare Canada's most populous province for the eastward spread of
illicit fentanyl.

Ontario said it is creating a framework to smooth the way for other
communities to open supervised-consumption services of their own, while
the federal Liberals have promised to knock down legislative barriers
erected by Stephen Harper's government, which opposed letting users inject
their drugs legally as health-care workers watched.

The upshot is that several more supervised-injection sites could open in
Canada later this year. Health Canada is already reviewing a dozen
applications for exemptions from federal drug laws, which the sites need
to protect their clients from criminal charges for bringing their own
illegal drugs to the facilities.

Aside from Toronto, Health Canada has received applications for four sites
in Montreal, two in Vancouver, two in Surrey and one in Victoria. The
applications from Surrey and Victoria arrived just last week, a Health
Canada spokesman said.

Vancouver is already home to the only two sanctioned supervised-injection
sites in the country.

Ontario Health Minister Eric Hoskins told Toronto Mayor John Tory on
Monday that his government plans to support and pay for, at least partly,
the three smallscale supervised-injection facilities that Toronto city
council endorsed last summer.

Dr. Hoskins did the same for a supervised-injection proposal from the
Sandy Hill Community Health Centre in Ottawa, which is preparing to submit
an application to Health Canada but has not done so yet.

"I believe these initiatives around supervised-injection services are an
opportunity to bring together all jurisdictions to tackle addictions and
narcotics misuse," Dr. Hoskins wrote in his letters.

In Toronto, the service will be offered inside two community health
centres and a harm-reduction facility, all of which already hand out clean
drug paraphernalia.

The city asked the province for about $400,000 to renovate the three
clinics and $1.8-million annually to run the supervisedinjection sites,
where health-care workers would be trained to revive drug users who

The province didn't specify how much it would cover. The news from Queen's
Park came as Mr. Tory and representatives from more than 20 organizations
met to discuss how Canada's largest city can tackle an increase in
overdoses caused in part by fentanyl, a powerful synthetic opioid that has
already taken a significant toll in other Canadian cities, particularly

"Our [overdose numbers] are already unacceptable," Mr. Tory said. "The
fact that our numbers are not anywhere near what they are in Vancouver is
no reason for comfort in this city. This is a crisis."

Of the 253 overdose deaths Toronto had in 2015, 42 were linked to
fentanyl. The year before, the overall overdose fatality figure was
similar - 258 - but only 23 of those deaths were linked to fentanyl,
according to Toronto Public Health. (The overall overdose figures also
include poisonings caused by other drugs, by alcohol and by substances
such as cleaning products.)

As of Nov. 30, there were 164 overdose deaths in the city of Vancouver,
compared with 134 in all of 2015. Across the Vancouver region's two main
health authorities, Vancouver Coastal Health and Fraser Health, there were
452 fatal overdoses as of Nov. 30, compared with 362 in 2015. About
two-thirds of fatal overdoses across B.C. last year were linked to
fentanyl, according to the province's coroner.

The Office of the Chief Coroner of Ontario has not yet published figures
for 2016, but Toronto Public Health says that outreach workers are seeing
more overdoses caused by illicit fentanyl, often mixed in with cocaine or
heroin or pressed into fake OxyContin tablets.

"Fentanyl is ... 50 to 100 times stronger than morphine," said Barbara
Yaffe, Toronto's acting chief medical officer of health. "So it can easily
kill you. Oftentimes, drug users don't know what they're taking."

Dr. Yaffe set up Monday's meeting of police, paramedics, hospital
emergency-room staff, harm-reduction advocates and other front-line
workers in a bid to share information and guide the city's response to the
overdose crisis.

Members of the newly established Toronto Overdose Early Warning and Alert
Partnership plan to meet monthly, she said.

Dr. Yaffe said the group discussed the need for real-time information
about overdoses so that workers can "target interventions" to the right
corners of the city. Others at the closeddoor meeting advocated for the
overdose-reversing drug naloxone to be made more widely available in
Toronto, especially at pharmacies and among drug users.

As for Toronto's supervisedinjection sites, Dr. Yaffe said it would be at
least a few months before they open.

The clinics have to be renovated before Health Canada can do the on-site
inspection necessary to approve the sites under the existing Harper-era
rules, Dr. Yaffe said.

Toronto Liberal MP Adam Vaughan said last week that foot-dragging by the
province was partly to blame for the fact that Health Canada has not yet
given Toronto's sites the green light.

"We have staff standing by in Ottawa, ready to attend any single request
[from] the city to meet the requirements and the tests of the legislation
.. The staff is literally on standby," Mr. Vaughan said. "There is no
higher priority in the Health Ministry. We want to get these open as
quickly as possible. It's just up to the other levels of government to get
their ducks in a row."

A Health Canada spokesman confirmed the department received applications
for two of Toronto's proposed sites on Dec. 6 and an 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

- - With reports from Jeff Gray and James Keller
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