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A new recommendation from Toronto's top medical professional is calling for the opening of safe injection sites at multiple locations in the city.
Dr. David McKeown, Toronto's medical officer of health, told reporters Monday he believes supervised injection sites should be opened at three locations in the city's most at-risk areas—Queen Street West, Downtown, and Queen Street East.
A safe injection site provides intravenous drug users with clean injection equipment and medical supervision while they get high.
"[Safe injection sites] save lives and limit the spread of diseases like HIV and Hepatitis C by reducing unsafe injection practices such as the sharing of previously used needles," McKeown said.
"Research has also shown that there are benefits for the community, that they reduce the public drug use and discarded needles associated with injection drug use and in fact they do not increase criminal activity in areas where they are located."
The three proposed locations—South Riverdale Community Health Center, the Toronto Public Health facility, and Queen West-Central Toronto Community Health Center—already have existing medical programs for drug users including needle exchanges and methadone clinics, which McKeown's report says would make the transition easy.
Dr. Philip Berger, medical director of the Inner City Health Program at St. Michael's Hospital, says the recommendation was "a long time coming."
"This is incredibly welcome," he told VICE. "If people are going to do drugs, they should have a safe and clean place to do them. That is the kind of platform [one] needs to have to be able to seek other services."
Berger notes the success of facilities like Vancouver's Insite—North America's first and, until recently, only safe injection site—in reducing overdose deaths and infectious disease rates, which he says proves the service is both effective and necessary in cities with high drug-using populations.
He also told VICE that while Insite has been very effective in Vancouver's Downtown Eastside, the service doesn't exist in the rest of the metro Vancouver area, which leaves "huge portions of the population" neglected. Berger says that wouldn't be an issue with McKeown's plan.
"This is a plan that was exhaustingly researched and talked about for the last decade. It was an inevitability," Berger said.
McKeown's report notes that, in 2013, 206 people died from drug overdoses in Toronto, up 41 percent from 2004. The overdoses align with the huge spike in province-wide deaths from opioids; more than 5,000 people died between 2000 and 2013 alone.
McKeown is set to present the idea to Toronto Public Health on March 21, after which the federal government can choose to green-light the plan or not. According to Berger, it's likely the plan will go through given the government's recent approval of a second safe injection site in Vancouver.
Among local politicians, the idea of safe injection has support. Councillor Joe Cressy, who has been leading the charge on harm reduction initiatives in Toronto, told reporters Monday the implementation of safe injection services is a "top public health priority."
"These programs will save lives. They will provide comprehensive health services to those who need it. These programs will also make our communities safer. They will move drug use and needles from streets, our parks, our backyards, and our coffee shops, and into a supportive and safe environment," Cressy said.
But not all agree. Brash conservative Councillor Giorgio Mammoliti told VICE News he will fight the safe injection sites "tooth and nail" and thinks the service should only be done in "hospital settings," rather than in clinics open to the public.
"I don't disagree with the fact that we need to learn how to do things better, but you cannot mix heroin and residential communities in any way," he said. "You've got to figure out a process that gets professional services for addictions... but in hospitals, not in local communities. It becomes a disaster," Mammoliti said.
Mayor John Tory told reporters Monday that he is "carefully reviewing" McKeown's proposal, but added the implementation of the plan needs to be sensitive to the public.
"My priority is the safety of the public and that means working to prevent drug-related deaths and keeping needles and drug paraphernalia out of schoolyards and other public places across Toronto. This is a difficult issue, and it is important that we listen to the experts, review the facts, and hear the views of local communities during the public consultation process," Tory said.
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