The debate about safe-injection sites

Amanda Shendruk considers the players and concerns

by Aaron Wherry

Toronto is talking drugs again, but this time it’s not about their mayor’s recreational habits.

The city’s medical officer of health, Dr. David McKeown, is calling for the development of a safe injection site for illegal drug users. The Toronto Board of Health will discuss the recommendation on July 10 and if approved, the measure will move forward for consideration by city council.

With tomes of academic literature extolling the health and safety benefits of harm reduction facilities (including a reduced number of overdose deaths, greater prevention of HIV, and cost savings), for many the establishment of safe injection site is a no-brainer. For others, though, the thought of assisting addicts and encouraging illegal activity is a significant moral offence.

So where will the issue land? Prepare for the diversity of views on July 10 with our stakeholders reference sheet.

[UPDATE] Wednesday afternoon, Toronto’s Board of Health approved the report recommending supervised injection sites in the city, becoming the first governing body in Ontario to throw support behind the facilities. The report will now go to Toronto City Council for final approval.

Click on the image for a larger version.

Safe Injection Sites

Links to sources used in the above graphic:

“Police Perceptions of Supervised Consumption Sites (SCSs): A qualitative Study” (from Substance Use and Misuse, 2012)

“Supervised Injection Services in Toronto” (Toronto Medical Officer of Health, 2013)

“Summary of Findings from the Evaluation of a Pilot Medically Supervised Safer Injecting Facility” (from Canadian Medical Association Journal, 2006)

“Injection Drug Users’ Perceptions Regarding Use of a Medically Supervised Safer Injecting Facility” (from Addictive Behaviors, 2007)

 ”Report of the Toronto and Ottawa Supervised Consumption Assessment Study, 2012″ (from the University of Toronto Dalla Lana School of Public Health, 2012)




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The debate about safe-injection sites

  1. I hope this gets approved. The research and evidence supporting the benefits of safe injection sites to both drug users, and society, is overwhelming. People opposed either have incorrect information, or are opposed simply for idelogical reasons. These centres save lives, make users more likely to seek treatment, and save society millions in health related costs. Drug use exists. Criminalization is a dismal failure. Time for a new approach.

    • Agreed about the inability to control it. But governemtn never wanted it eradicated in the first place. Drugs justifies a huge police, judicial and prison bloat. Gets you and I to pay for far more police state than we need. So when G20 protests happen, they have lots of blue soldiers to crack peoples heads that are protesting statism.

      Yes, I just said illegal drug trade is not effective by design and police state.

      Also, these addicts fuel organized crime and the people they kill. Why not make it legal, let street drugs go to prices no organized crime type can make money on and orgaized crime and the deaths they make go away. Let the dopers live with death, and the whole mess goes away.

      So lets legalize it. The problem will take care of itself without the tax sheep police state bloat. I am all for making all illegal drugs legal.

  2. Better solution: don’t use drugs.

    If you’re not willing to have drug users around your children everyday, then you’re not willing to have these clinics in your city. I know I am certainly not. It doesn’t matter what the “costs” are. If it costs more to help these people after they’ve used their drugs then so be it. But it should never ever be condonable.

    And yes, people will break the laws all the time but that doesn’t mean we get rid of the laws. We don’t decriminalize murder because there are murders. Laws exist for a reason, to keep society civil. Drug use is simply not civil. No.

    Just don’t do drugs.

    • This is a recipe for dirty needles on playgrounds. We need to move past the facile sloganeering from the 1980s. The drug war is an utter failure. We need to treat addiction as a public health problem and use strategies that actually work to get users into treatment. We’ve tried the other way for 40 years; it doesn’t work.

      • Then we clean up the playgrounds. There will always be lawbreakers, no matter what the laws are, but that never inherently means we lax the laws. It’s the same argument with abortion, that it will mean “back-alley” murders will take place. To that my response is I don’t care, murder is murder.

        Laws exist for a reason. Drug use is not healthy for a society. If I live next to a crack user at least there will be legal recourse to fix that in my neighbourhood. I won’t have to subject my child to it. But we start condoning it and what are we to do then? Why, move away from it all.

        So that will be fun, having ghettos everywhere because no one wants to live near crack users, especially those with families.

        • “If I live next to a crack user at least there will be a legal recourse to fix that in my neighborhood.”
          I am all ears about that legal recourse to fix it….what is it? I live on the same street as a “drug salesman”. Children in the playground have seen his clients shooting up in their cars next to the playground. The alderman is aware and “working on the problem’. All of us call the police EVERY time a car goes into the back alley to the house. The head of the community association lives on the street and is the heading up the drive to get the house shut down. Exactly, what recourse do you think you have?
          Now my daughter has had a lady across the street from her retire and move south. Her son rented the house to a drug sales person and they are experiencing the same things we are. Recourse indeed.

        • Drug use has been illegal for decades, with no impact of usage. Alcohol prohibition was tried and abandoned as a dismal failure that triggered huge increases in criminality and violence. We tried your way, it doesn’t work. I also think we should deal with the world as it is, not how you think it ought to be. That’s the difference between living in reality and living in an ideological fantasy.

        • And what is your response to the child who develops HIV/Hepatitus/etc. because they stepped on a dirty needle before the playground was cleaned up? Drug addiction is a public health issue – the health of the addicts as well as the health of the innocent bystanders & the so-called “war on drugs” has been a spectacular failure at protecting the health of both. Reducing the risk to public health is in no way condoning drug abuse. Please get your head out of the ideological sand.

      • I am not sure that they get many people into treatment but they do try. Harm-reduction really is all about less dirty needles on the street and fewer over-dosing. It is about accepting that people are going to use no matter what so you are going to make it safer for them and for the public. It is a realistic approach.

    • Look Ryan, these safe injection sites are not providing drugs for people to inject. They are removing the people who are injecting from doing so on the sidewalk, in playgrounds and in other places that pose a risk to the public and themselves. It is like giving condoms to people so they won’t spread STI’s. Chances are in YOUR city, they already hand out clean needles so they aren’t spreading diseases like HIV. This is just one step further.

    • Sometimes you have to deal with a problem by trying what is most likely to work and not what we wish would work.

    • I guess if it was that simple people wouldn’t lie, cheat, thieve, commit fraud, get drunk, over weight, beat their spouse, bully, how long do you want me to make this list.

      People have been using drugs for thousands of years and that includes animals. I’m not suggesting we should all run out and get intoxicated. Does your belief in an ideal world, consist of a world where everyone does what someone else says they should do?

      • I too advocate safe injection sites for Toronto’s dog population!

    • That’s like saying we don’t like the rain, so we should make sure nobody has raincoats.

      There’s a difference between making something legal and providing assistance for people who are suffering because of their illegal activities.

      There’s room enough in the law, and society, for both to coexist.

    • You do realize that you just said ” don’t do drugs” and then said ” there will always be law breakers” good job insinuating that no one will listen to your first statement, making your argument invalid

  3. My bet — city council won’t approve. The folks who are in the “drug use is a sin” camp will make sure of that. Logic has no place in this debate – it will be decided on emotion..

  4. Nothing in the article, and in fact nothing in any of the research I have seen, gives any indication of a detectable, much less substantial, reduction in the harm the needle junkies inflict on the rest of society.

    The thefts, robbery, extortion, and other criminality employed to buy their drugs carries on unabated.

    And extending the lives of those same junkies just means more junkies around to commit those crimes.

    • Good to see you value people’s property over people’s lives. Lets us know right where you’re coming from.

    • The harm that you’re concerned about could be easily fixed by legalization, or just giving away the drugs for free. The property crime side of things arises solely because of the well-documented problems with prohibition.

    • GlynnMohr….your comment would make one surmise that you do not view addiction to narcotics as an illness. What is your position on addiction to alcohol?

  5. The research and evidence showing the dangers of safe injection sites to both drug users, and society, is overwhelming.

    • What research, what evidence? Sources please.

  6. I was a law student at UBC during the fight to set up Insite in Vancouver. I wrote a legal analysis of the situation, arguing that B.C. had a legal duty to establish safe injection clinics. You can find that, as well as subsequent updates as the case proceeded, at:
    http://perry-bulwer.blogspot.ca/p/safe-injection-sites-bc.html

    I also wrote an analysis of international law regarding that issue, and co-wrote an article arguing that the City of Vancouver also had legal obligations to support setting up such a clinic. You can find those at the same site.

  7. Yes, I know all the arguments in its favour BUT we still give addicts a clear message that ADDICTION IS ACCEPTABLE for solving life’s problems.
    Dr. W. Gutowski
    Retired Psychiatrist,
    Chilliwack, BC.

  8. I hope this gets approved. The research and evidence supporting the benefits of safe injection sites to both drug users, and society, is overwhelming. People opposed either have incorrect information, or are opposed simply for idea logical reasons.
    Regards,
    Doctor in Naperville

  9. Should you not say unsubstantiated mayors habits or has Macleans too jumped the hate people as they are not as corrupt as the left would like. I like Ford, he didn’t bow to back room extortion by crack heads…. And Ford isn’t a career statism tax’e sheep some more politician. Please get off his case until you can get something tangible and real.

    I get a kick out of cost savings. Do the pro-drug needle types factor in if they die sooner it is less heath care burden? Less theft to get illegal drugs? Less panhandling and vagrancy as less dopers doing drugs if mortality is allowed to happen? Less welfare/social system abuse?

    We have disabled, and I mean really disabled like blind people living in poverty yet needles are free, just bring dope. Sorry, I miss the logic.

    Nope. Just more propaganda.

  10. Problems legalizing all illegal drugs solve:

    - less costs, reduces expensive police state and court congestion time to deal with repeat drug offenders and the like.
    - legal, drugs would be so cheap the criminal element would not exist, even home insurance would be cheaper as less B&E would occur.
    - with no organized criminals for drugs, less drug related killings. No 22 bodies in a ditch in Mexico or Columbia from Canadian money. Yes huge a drug types, you do fuel the murder of people.
    - less jail costs
    - all of the above could give the taxpayer a tax break.

    Problems it creates:

    - instead of crime lords killing innocents, police officers and judges, and bribing politicians, the drug abusers can easily OD or kill themselves faster.
    - less government justice employment as the problem takes care of itself

    - might be more stupid people that tries drugs until the novelty wears off. Yes, for many doing illegal stuff is 1/2 the attraction.

    Neutral:

    If the drugs are bad drugs and kill, you still need to charge dope sellers with underage and manslaughter for bad drugs.

    I back this up this way. How many sniff gasoline? And anyone could but almost none of us do. As where is the kicks? Making all illegal drugs legal might be the righ answer to eliminate the organized crime as no organized crime type is going to make money on $10 a bushel for weed or $5 a hit for heroin.

    Fact is we create problems with the current policy on illegal drugs. And just tax people too much for it. Needs to change.

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