Should We Really Be Moving Towards Safe Injection Sites in Ontario?

According to the Canadian Press, Toronto is the latest Canadian city poised to set up safe injection sites for drug users.

Toronto’s Medical Officer for Health, Dr. David McKeown, will be holding a press conference next week, where he will promote a new Board of Health report on the services for supervised injection.

With a liberal government in power, advocates of the scheme are confident that getting permission from the federal government should not be too difficult, as they have already sanctioned one site in the past and voiced their support.


But is this an idea that the rest of us should be sanctioning? Are we facilitating a dangerous habit and failing to find a suitable solution to a big problem? Or are we just making an existing situation more transparent in an attempt to lessen the fatal nature of the issue?

The top aim of supervised injection sites is of course to save people’s lives. And judging by Insite, the drug injection site in Vancouver that was founded in 2003, that has definitely been achieved. As of 2015 there were no deaths from overdose on the site despite 600 injections each day as Insite staff intervened to provide oxygen or naloxone in the event of heroin or other opioid overdoses.

The site was introduced after the Downtown Eastside neighbourhood of the city had 4,700 chronic drug users in 2000 and was considered to be at the centre an injection drug pandemic.

Unlike European sites, which in the past have found it hard to create strong research, the site in Vancouver was set up with the understanding that its impact would be thoroughly evaluated. Numerous studies and journals published have suggested that public injecting, syringe sharing, and neighbourhood litter have all been reduced since the clinic opened. It has also prevented 35 cases of HIV and 3 deaths per year.

A study published in the Lancet in 2011 said that fatal overdoses decreased by 35 per cent within 500 metres of Insite, while a 9 per cent decrease for the whole of Vancouver was recorded after the facility opened.

It’s even been deemed a success economically. In 2008, the Canadian Medical Association Journal recorded net savings of $18 million and an increase in 1175 life years over a decade. Back in November the Toronto Star reported on a study that bolstered the case for safe injection sites after an increase in the cost of treating Hepatitis C — a virus that is spread primarily through blood to blood contact associated with intravenous drug use — made a much better case for introducing the safe injection sites that would prevent the spread of the sometimes deadly disease.

However, a big thorn in Insite’s side has been the debate of how comprehensive the findings are. Some have claimed that the research is flawed, as those scientists who undertook it were the same ones who lobbied for the clinic to be set up in the first place, and thus had a vested interest. The RCMP have criticized Insite, as did Colin Mangham, director for research at the Drug Prevention Network of Canada, who said that the clinic downplayed the negative aspects and ignored findings that did not contribute to its successful image. Despite Insite claiming to have referred many users to nearby detox facilities, Mangham claimed that interviews with treatment centres revealed no referrals.

And when the very problem itself is addiction, is handing a drug user a needle (albeit a clean one) helping? Stephen Harper’s opposition to the use of safe injection sites was well documented, and in 2008 Health Minister Tony Clement compared Insite to “a doctor holding a cigarette to make sure a smoker doesn’t burn his lips, or watching a woman with cardiac problems eat fatty French fries to ensure she swallows them properly.”

Many believe that the taxpayer-funded $3 million per year could be better spent on treatment for those in recovery. And while it’s great that lives are being saved, the site is doing nothing to deter drug users or to help drug addicts, who could even be put off from quitting by the invitation of a safe non-judgmental haven to do it in.

The harm reduction element is the easiest defense to use for the issue of safe injection sites — because the harsh truth is that many clinic users may never get off drugs. However, by keeping them connected with welfare services and entitling them to healthcare, we are giving them a realistic chance of staying alive. Showing them tough love and asking for the cure instead of a band-aid may seem like the right thing to do. But by treating them like criminals, and not addicts, we’re keeping that underbelly in society hidden.

And it’s usually in the shadows that bad things tend to happen.