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July 2, 2013
Supervised injection services in Toronto
Toronto Public Health released a report today about supervised injection services for injection drug users in Toronto. The report will be considered by the Board of Health on July 10.

Toronto Public Health supports a proactive, evidence-informed approach to reducing the considerable harms related to injection drug use. Extensive research from Vancouver, Australia and Europe has demonstrated that supervised injection services are effective in addressing a wide range of public health and safety issues. These sites can play an important role in the reduction of harm and disease transmission.

Toronto Public Health supports implementing a pilot of supervised injection services in Toronto. This view is shared in the Toronto and Ottawa Supervised Consumption Assessment Study, which was co-authored by researchers from the University of Toronto and St. Michael's Hospital. This study concluded that Toronto would benefit from supervised injection services integrated into existing health services already serving people who inject drugs, both as a means to help individuals already addicted to reduce their own risk of disease transmission and as part of a continuum of services from prevention to treatment that can minimize the impact of injection drug use on communities as a whole.

"Supervised injection services are part of a range of health services including prevention and access to treatment that we need to help reduce the significant harms associated with injection drug use," said Dr. David McKeown, Toronto's Medical Officer of Health. "These services have been safely and effectively implemented around the world as measures that balance real public health issues such as overdose and HIV and hepatitis C infection prevention as well as addressing public safety concerns such as public drug use."

Toronto Public Health and 35 community agencies deliver needle exchange and other harm reduction services. In 2010, there were 75,000 client visits and 1.1 million needles distributed along with other sterile injection supplies.

The evidence suggests that when implemented carefully, supervised injection sites can actually reduce the level of unsafe, hidden injection drug use in communities.

“Society has made significant advances in the past decade in addressing the denial that surrounds mental health. We need the same honesty and openness regarding injection drug use. The reality is that injection drug use is already happening in neighbourhoods across Toronto, in apartments, in alleyways, in washrooms," said Dr. McKeown.

Toronto Public Health's report recommends that the provincial government fund supervised injection services in Toronto that are integrated into existing provincially-funded clinical health services on a pilot basis and fund the evaluation of these pilots.

The recently tabled Federal Bill C65, the Respect for Communities Act outlines the federal government's proposed requirements for any existing or new health service provider to be exempted from federal drug regulations to provide supervised injection services.

The requirements set out in the proposed Bill C65 are onerous, and create significant unnecessary barriers for health services looking to add supervised injection to the services they provide to people who inject drugs. Toronto Public Health calls for the draft legislation to be withdrawn and consultations to be held with health service providers and others on a more workable exemption process.

“Supervised injection services save lives," said Doris Grinspun, Chief Executive Officer of the Registered Nurses’ Association of Ontario (RNAO). "Nurses know that you can prevent individual deaths by drug overdose and make our communities healthier by decreasing infection. These are proven facts. Putting up barriers to life-saving health-care services is terrible public policy and against human rights.”

Toronto Public Health's Board of Health report on this issue is available at

The Toronto and Ottawa Supervised Consumption Assessment Study is available at

The Canadian Medical Association's position statement is available at

Toronto is Canada's largest city and sixth largest government, and home to a diverse population of about 2.8 million people. Toronto's government is dedicated to delivering customer service excellence, creating a transparent and accountable government, reducing the size and cost of government and building a transportation city. For information on non-emergency City services and programs, Toronto residents, businesses and visitors can dial 311, 24 hours a day, 7 days a week.

Media Contact
Jennifer Veenboer
Toronto Public Health



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