Toronto’s supervised injection sites might get an extra boost of support in 2019 if a budget increase request is approved.
On Nov. 19, the Toronto Board of Health approved a request from Toronto Public Health to increase spending by $1.32 million, up 2.1 per cent from 2018. If approved, $700,000 of that would be used to fund six outreach workers and one supervisor for the supervised injection sites in downtown Toronto, including the sites on Victoria Street and in the Moss Park area.
The budget request will be presented to city council in the spring.
The request was put forth on Nov. 13 and was approved by the Toronto Board of Health budget committee that same day.
However, some community activists say that allocating more funds to workers is simply not enough. Jen Ko from the Toronto Overdose Prevention Society (TOPS) said that the services and programs themselves are too full to handle the amount of people flowing through.
“Outreach workers cannot do much if there are no, or already very full, services to refer people to, which is the case in Toronto’s downtown. The drop-ins are full, The Works is full, the shelters are full,” Ko said. “It just doesn’t address the actual problems.”
The request comes less than a month after the health ministry revealed the new application guidelines for supervised injection sites in Ontario, standards that advocates say will have serious implications for the future of overdose prevention services.
The guidelines require that at least one designated health professional must be present at an overdose prevention site at all times, a requisition that will be difficult for many locations to meet without additional funding. The application standards also require that the ministry assess the site’s proximity to licensed child-care centres, parks and schools, including post-secondary institutions. If a proposed site is within 600 metres of any of these, the applicant must specify how it is working with the community to assuage concerns.
Ryerson president Mohamed Lachemi said the university, which is located less than 200 metres from The Works on Victoria Street, understands the importance of the supervised injection sites and is supportive of their mission.
“Ryerson University supports the government’s recent call for (Supervised Injection Services) sites to provide overdose prevention, harm reduction and increased wrap-around services,” he stated in an email. “We recognize that this is a complex situation and we are supportive of initiatives that offer help and practical options for at-risk populations.”
Overdose prevention sites must also not be within 600 metres of each other. These requirements make the status of sites in Toronto Centre, which has been designated the centre of Toronto’s opioid epidemic, especially precarious.
Workers and advocates worry that the new guidelines create unnecessary barriers and restrictions that will make it more difficult for communities to effectively respond to the overdose crisis.
Suze Morrison, MPP for Toronto Centre, said the standards will be impossible for community organizations to meet, especially in a riding as small and densely populated as hers.
“We are the smallest geographic and most densely populated electoral district in the entire country,” she said. “It makes it complicated because all of the sites are going to be in conflict, (because they are) within range of other sites or within range of schools, or just in some other way challenged by the weight of these regulations.”
Morrison said she’s deeply concerned about the future of the life-saving overdose prevention sites and is disappointed in how the current government has responded to the opioid crisis.
“We are in a state of crisis in Ontario and across Canada right now when it comes to the opioid crisis,” she said. “I’m very, very concerned about how this service continues to be available at the end of this reapplication process because at the end of the day it’s not just about policy or political ideology, but this is a service that saves lives — and there are no shortcuts around that.”
In a statement, TOPS said the new application process, and the restrictions they impose, impedes their ability to save lives. They added that the goal of the latest restrictions is “clearly intended to force several existing (overdose prevention sites) to close.”
TOPS said the guidelines are a “huge step backwards” for overdose prevention in Ontario. The group also said the restrictions are uninformed by evidence, will bury existing sites in red tape and will result in the end of overdose prevention sites as a “low-barrier model” for addressing the crisis.
In July, the government of Premier Doug Ford announced it will be conducting a review of the province’s supervised consumption services and overdose prevention sites. The review concluded that the services reduced illness and death in areas where they are located, but that changes to the model are necessary to address safety concerns from the public.
Supervised consumption services and overdose prevention sites must be repurposed to emphasize treatment, Health Minister Christine Elliott said at a press conference in October. While the previous Liberal government took steps in the right direction, she said it did not focus on rehabilitation and treatment enough to get people the help they need.
“It’s one thing to save lives through overdose prevention, that is very important, but it’s also really important to make sure that people can connect with the services they need,” she said.