Create safe-injection sites in Ottawa, Toronto: Study

BY DON BUTLER AND TOM BLACKWELL

OTTAWA — A team of researchers Wednesday recommended the creation of two supervised injection facilities in Ottawa and three in Toronto.

After what is thought to be the broadest study of its kind, the researchers concluded that such facilities would improve the health and reduce harm among drug users. They could also reduce public drug use and save money for the health system, they said.

"We projected that supervised injection facilities would prevent HIV and hepatitis C infections and result in multiple benefits for people who use drugs in Toronto and Ottawa," said the University of Toronto's Carol Strike, who led the research with Dr. Ahmed Bayoumi of St. Michael's Hospital in Toronto.

Such facilities "are likely to represent good investments of health-care dollars," added Bayoumi, an HIV specialist.

The report of the Toronto and Ottawa Supervised Consumption Assessment said multiple sites are preferable to a single, central location like Vancouver's Insite clinic.

Drug use in Toronto is widely distributed throughout the city, while in Ottawa it is concentrated in a few distinct neighbourhoods, the report said. Drug users say a single facility would be inconvenient for many of them, the report said, adding that multiple locations "may also reduce community concerns."

The report recommends the creation of supervised drug injection sites only, saying there is insufficient evidence to recommend the creation of supervised drug-smoking facilities for users who smoke drugs such as crack cocaine.

According to the report, Ottawa has the highest new rate of HIV infections in Ontario among people who inject drugs. Among drug users, HIV prevalence was 11 per cent in Ottawa and four per cent in Toronto. As well, 60 per cent of drug users in Ottawa and 52 per cent in Toronto have hepatitis C.

While Vancouver's Insite remains the only supervised drug injection clinic in North America, a decision last October by the Supreme Court of Canada opened the door for more supervised injection sites. In a unanimous decision, the court rejected efforts by the federal government to shut down the Vancouver clinic, ruling that its refusal to extend Insite's exemption to the Controlled Drug and Substances Act violated the Charter of Rights and Freedoms.

Clinics such as Insite allow drug users to inject or use illegal drugs such as heroin under the supervision of trained staff.

Supporters of the concept point to scientific studies that suggest it has reduced the number of fatal overdoses and curbed the spread of infectious disease through shared needles.

A study published earlier this year, on the other hand, indicated the idea will meet some opposition among police officers in the two cities, reporting that officers feared the sites will increase crime and harm the neighbourhoods where they're situated.

The wide range of officers surveyed by the University of Toronto team almost unanimously indicated they thought it was illogical to help addicts do something that is illegal.

"We're keeping them as addicts, as opposed to trying to get them to be former addicts, where they can once again contribute, maybe do some of the things that they've always wanted to do, as opposed to being stuck in a vicious circle," said one Ottawa officer quoted in the study published in the journal Substance Use & Misuse.

The city of Montreal indicated last October it was also in favour of setting up supervised injection sites for addicts, though it is looking at setting up sites at existing medical facilities, rather than a single, stand-alone centre.

And the exact location of those injection sites has been hotly debated, with residents around proposed locations warning of an influx of addicts.

Montreal's public health department released a report last December, however, that concluded the evidence indicates such facilities will not increase crime or drug problems in their vicinity.

Ottawa has an estimated 6,000 intravenous drug users.

But Ottawa Mayor Jim Watson has already made it clear that he opposes such a clinic in the city. Former police chief Vern White, now in the Senate, has also spoken out against the idea.

While funding for a supervised sites would likely come from the provincial ministry of health, Ottawa city council would first have to zone a property for that use.

The authors of Wednesday's report embarked on the four-year research project after Toronto city council approved a drug strategy in 2005 that recommended an assessment of the need for and feasibility of supervised consumption sites in Toronto. The project was later expanded to include Ottawa.

Ottawa Citizen and National Post