PCs 'playing politics with people's lives' on injection sites, drug policy expert warns

After question period on Thursday, Ontario's health minister was asked about the review her ministry is conducting into supervised injection sites.

"We want to speak with the experts — those in favour —  and there are some people who are against them," Christine Elliott told CBC News.

Elliott says she's heard concerns about supervised injection sites from people living in the areas where they operate, but she wants to look at the evidence on their effectiveness.

"There may be some clinical evidence against it as well; that's why we're conducting the investigation and the review of the evidence."

But health professionals, activists, and those who have been working in the field of harm-reduction for decades say the minister won't find that in her review.

That's because there isn't any scientific evidence that shows supervised injection sites are harmful. There is overwhelming evidence in scientific literature that show they do the opposite: they save lives, help prevent infectious diseases and connect those struggling with addiction with the services they need to get help. 

In 2017, 1,200 people died of an overdose in Ontario. In cities like Toronto, the problem is getting dramatically worse: 303 people died from overdoses last year. That's an increase of more than 60 per cent from the previous year, and a roughly 120 per cent increase from 2015.

Clear consensus

Dr. Ahmed Bayoumi, a physician and researcher at St. Michael's Hospital, has spent years researching the effects of supervised injection sites.

In 2012, he and a team of researchers released a report that looked at what the provincial government is reviewing now — that is, do cities like Toronto and Ottawa need supervised injection facilities. 

The team conducted interviews, focus groups, reviewed existing scientific literature, examined patterns of drug use and did economic modelling to try to forecast the cost-benefit of implementing the sites.

"We found there is good evidence that supervised consumption sites have a number of positive effects, including decreased needle sharing, decreased overdoses in neighbourhoods around supervised consumption sites, and increased referral of people to programs that help them with their drug use," said Bayoumi.

Bayoumi said the consensus among public health practitioners and researchers is the same now as it was then: supervised injection sites save lives and are a cost-effective way to improve the health of people who use drugs.

That finding has been echoed in research conducted elsewhere in Canada, as well as Australia, Switzerland — where the first supervised consumption site opened in 1986 — and other European countries.

Ideology vs. evidence

When asked about supervised injection sites on the campaign trail, Doug Ford told reporters he's "dead against them," saying they encourage more drug use.

"I think in the campaign [the PCs] put forward this kind of ideological position they knew would be appealing to people in their base and in the rural areas," said Robert Drummond, professor emeritus at the York University Department of Politics and School of Public Policy and Administration.

The government has since softened its stance by committing to a review of the evidence before making a decision. But it's unclear how much that will change the mind of the premier who came out swinging against the sites just months ago.

Drummond says it could go either way:

"It may be that they're genuinely unfamiliar with [supervised injection sites] and they want to look at them," said Drummond.

"Or they may be looking at them for the purpose of finding a way of countering them — a way of saying they don't trust the data."

Funding at issue

Vancouver's supervised injection facility Insite has been open for 15 years. Since then, there have been more than 3.6 million visits, and staff have reversed more than 6,400 overdoses. No one has ever died at the facility.

"If there's any clinical evidence against how effective these sites are, it would have surfaced by now," said Donald MacPherson, a drug policy advocate, who has worked in Vancouver's downtown east side since the mid-1980s.

MacPherson says while supervised injection sites alone are not the sole solution — and need to be part of a comprehensive drug policy strategy — he calls it "sad" that Ontario's health minister would question their effectiveness, despite decades worth of evidence.

"It gives to the public the message that she's playing politics with people's lives and that's not taking a medical health care intervention, [that's] evidence based and researched to death."

The Ontario government hasn't committed to a timeline for the review or when it will make a final decision on whether to fund the sites. In the city of Toronto, there are four supervised injection sites that are federally approved but provincially funded. There are also four overdose prevention sites that the province has approved and funded.

"We want to collect all the evidence to be able to present it to the premier," said Elliott.