Toronto asking Ottawa's permission to operate supervised injection sites

In recognition of World AIDS Day, which falls on Thursday, Toronto is making its case to Ottawa for supervised injection services.

Last July, the city approved three locations to assist drug users in the downtown core, but Health Canada still has to sign off.

• Toronto city councillors vote in favour of safe injection sites

Canada's Controlled Drugs and Substances Act prohibits the possession of illicit drugs.That means health centres can only allow them through their doors if an exemption is approved.

Right now, the three sites that have the green light from the city; the South Riverdale Community Health Centre, Queen West Central Community Health and Toronto Public Health can only hand out clean needles to addicts who must then inject the drugs off site.

"About 75 per cent of the needles being distributed in the city of Toronto are going out through these three sites," said Rita Shahin, an associate medical officer with Toronto Public Health.

They aresubmitting their respective exemption applications Thursday.

The applications include everything from the proposed site plans to policies and procedures, community consultations and letters of opinion from various levels of government.

Overdose deaths on the rise

Shahin said the number of overdose related deaths in Toronto is climbing at an alarming rate. "Between 2004 and 2014, we saw a 77 per cent increase in the reported number of deaths, many of those are related to opioids."

• Fentanyl deaths on the rise in Ontario, chief coroner says
• Fentanyl crisis coming to Ontario, police and community groups warn

There is currently no way for health centres to test what's in drugs. Shahin is seeing a spike in cases where heroin and other drugs have been laced with Fentanyl, which can be deadly.

Though they won't be able to detect it beforehand, she said having nurses monitor users after they inject their drugs will be the key to saving lives when it comes to the opioid.

"We know people that overdose within supervised injection sites do not die," Shahin said. "They're able to be treated right away medically with all the supports that are necessary."

Demand from drug users

Shaun Hopkins, who manages the needle exchange program at Toronto Public Health, said there is a demand for these services from users.

"People are injecting in very unsafe locations right now. In alleyways, in bathrooms with the door locked, which is not safe from an overdose intervention point of view," she said. "People want to be able to come in where it's well lit, where they know that they'll be safer, where someone will intervene and save their lives if they need to."

She said the plan at Toronto Public Health is to install five cubicle-like booths for the supervised injections. "People will come in with their pre-obtained drugs and they'll inject under the supervision of one of the staff."

There will also be a "chill-out" room when users will be monitored after injecting. It will be open 12 hours a day, seven days a week.

These services will be offered in addition to the current harm reduction supports such as clean supplies, naloxonekits for treatment of opioid overdoses, and treatment referrals.

Hopkins said she hopes to start offering the supervised injection services next year, but the three health centres are also waiting on provincial funding. A request was made in August, but there has been no word yet.

There are currently two supervised injection sites operating in Canada both in Vancouver. Montreal is also taking steps towards opening them.