Londoners will have multiple chances this fall to speak their minds about a supervised injection site in the city.
The public consultations will take place in September and October, with a report prepared by the end of November, documents obtained by CBC News reveal.
"Without supervised injection sites, people are not going to refrain from doing drugs. They will continue to shoot up in alleyways and parks and public bathrooms. Safe injection sites are so much better for everyone involved," said Dan, a former drug user who said supervised sites can't come fast enough.
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CBC London has agreed not to use Dan's last name because he is trying to find a job and fears the stigma associated with injection drug use could keep him from getting employment.
"People are suffering now. They've been suffering for years, for decades," Dan said.
This comes a full year after the Middlesex-London Health Unit declared a public health emergency because of spiking HIV, Hepatitis C and other infection rates.
"We have a serious crisis on our hands among people who are extremely vulnerable," said Bruce Rankin, the acting director of Regional HIV/AIDS Connection.
In February, Regional HIV/AIDS Connection released a study of the city's injection drug users, in which 86 per cent of participants said they'd use supervised injection services if they were available.
Health unit seeking public input
The process to get approval for safe injection services is long.
In Ottawa, the Sandy Hill Community Health Centre began the process of getting an injection site almost five years ago. Last week, Health Canada approved a site which could open in October.
"I would inject wherever I could, in bathrooms around the city -- a lot of them have needle drop boxes in the stalls -- in alleys, in my apartment if my girlfriend wasn't home," Dan said. "Ask any drug user where they'd do it, and they'd tell you they'd do it anywhere."
The health unit's public consultation sessions must include:
- At least four town hall-type meetings in different parts of the city, including downtown and east London.
- An online survey.
- Up to 10 focus groups with businesses, residents, local agencies and people who use drugs.
Agencies wanting to lead the public input sessions must apply to the health unit to do so by August 11.
Public health emergency
Dr. Chris Mackie, the medical officer of health for the region, said there's a clear need for a supervised injection program.
The mayor has also spoken out in favour for the services, though some residents have expressed hesitation about locating supervised injection sites in downtown and Old East Village.
But other cities with supervised injection sites have had positive responses, said Rankin.
"We have to be more compassionate and to try to work with people, this is one of the ways to do that, to help engage (drug users) in health care," Rankin said.
"Supervised injection services lead to community health, to less public injection. We feel strongly that this is a public health benefit."
Opioid-related infections a problem
While all this has been happening, Mayor Matt Brown is proposing the establishment of an opioid crisis working group.
The mayor's working group would establish how best to address the opioid crisis in London.
And while high-profile overdoses make big headlines in other cities, London's opioid crisis is one of injections that kill slowly.
"London is definitely in need of a comprehensive response to the opioid crisis," said Dr. Sharon Koivu, who specializes in palliative care and addiction medicine.
"Overdoses get a lot more media attention, but our overdose rate hasn't increased since 2012. But our concern has been infectious complications. We need to have a very comprehensive response that would include people that are suffering from addiction right now."
Rates of HIV, Hep C, Infectious Group A strep and infective endocarditis -- a heart infection linked to injection drug use -- are much higher in London than in other cities, Koivu said.
"We have a crisis of infection in this community and that has put an extremely high burden on our health care system."