'Unacceptable': Toronto board of health chair slams province for supervised injection site cuts

A set of last-minute federal exemptions means two Toronto overdose injection sites will be able to continue operating —though without provincial funding — after Ontario's newly-revealed overdose prevention strategy nearly saw them shut down.

That's according to the chair of Toronto's board of health Joe Cressy, who on Friday was one of those sounding the alarm over the provincial government's cap on the number of supervised consumption sites, when it appeared three sites were at risk of closing. 

The Ford government announced its new overdose prevention strategy Friday amid an ongoing opioid crisis that shows no sign of abating. In a release, the province announced just six sites have been approved in Toronto. Cities like London, Guelph, Hamilton, Kingston, St. Catharines and Thunder Bay will have just one site each.

In Ottawa, one of four sites currently in operation will no longer receive provincial funding. 

Cressy called the funding cuts "unacceptable," adding the three Toronto sites were told Friday that they would be closing April 1. With the exemptions, two of the sites will stay open but will no longer be funded by the province. 

"In the midst of this deadly crisis, we should be opening new sites, not closing the limited number we already have," he said in a statement. "The overdose crisis is the defining public health issue of our time."

Opioid-related overdose deaths have been steadily climbing in Ontario since 2003. More than 1,200 people died from overdoses in the province in 2017, according to Public Health Ontario. More than 600 died from the same cause in the first half of 2018, the most recent data available shows. 

In its release, the province said it had approved 15 sites across Ontario and "will continue to accept applications from interested organizations."

The aim of the newly approved facilities, to be called "consumption and treatment services" sites, is to ensure those struggling with drug addiction can get supports that include rehabilitation as well as a safe place to use their drugs, it said.

Applications for the sites were reviewed against a number of "program criteria," the release said, including: local needs, evidence of community support and commitment to ongoing community engagement, proximity to child care centres and schools, and meeting accessibility criteria. 

Healthcare professionals, social service providers and community workers had been anxiously awaiting the plan from the province's Progressive Conservative government, which previously announced changes to addictions services last October.

Minister of Health and Long-term Care Christine Elliott said at the time that Ontario would cap the number of supervised injection sites in the province at 21. The move drew criticism from harm reduction workers, who argue that the opioid crisis is too widespread to introduce an arbitrary limit on the vital facilities.

Similarly, those staffing overdose prevention sites in various cities have expressed concern that provincial funding will dry up as the government moves forward with its new prevention strategy.

Opioid use a 'serious public health issue'

Gillian Kolla, with the Toronto Overdose Prevention Society called it a major step backward to be cutting back on sites she said were open.

"This is an absolute disaster for the province of Ontario," Kolla said. "This is a cut, make no mistake, this is a massive
cut." 

Among the sites not approved by the province, Kolla said, was The Works run by Toronto Public Health, which sees 3,000 visits every month — the most used — and other smaller sites that help vulnerable people such as homeless women.

In a statement to CBC News, Toronto's medical officer of health Dr. Eileen de Villa said her office had just received the plan Friday afternoon and was in conversations with the province's ministry of health to have TPH sites approved. 

"In the meantime, TPH will continue to offer its current supervised consumption services (SCS) and other harm reduction services. The overdose emergency in Toronto is a serious public health issue and remains urgent," she said in the statement.

"Since opening in August, 2017, up to March 24, 2019, there have been 40,017 visits to and 748 overdoses reversed at TPH's SCS alone, making it the busiest supervised consumption service in the city... We will continue providing these life-saving services to the community as we look forward to receiving more details from the province."

Mayor plans to voice concern to province

In a statement Friday evening, Mayor John Tory said he was "deeply troubled" by the move. 

"This announcement that leaves Toronto Public Health's Victoria Street site in limbo and appears to close two other sites in the city is extremely disturbing, particularly because it came with no advanced warning or communication from the province," he said.

Tory also said he would have liked to see time extensions for staff and clients, and intends to voice his concern to the province. 

Overdose prevention sites are temporary facilities approved by the province following a federal decision to grant an exemption under the Controlled Drugs and Substances Act. Supervised injection sites, meanwhile, are more permanent locations approved by the federal government after a more extensive application process.