At the start of 2016, it seemed doubtful Ottawa would ever get a supervised drug injection site.

Mayor Jim Watson adamantly opposed the idea. Police Chief Charles Bordeleau had never been on board, citing public safety concerns. Coun. Shad Qadri, who chairs Ottawa's board of health, was no fan either.

Now the city's on the verge of having three injection sites, maybe four.

At 3 p.m. Tuesday, Ottawa's first sanctioned consumption site will open its doors. Next month a more permanent site is set to open at the Sandy Hill Community Health Centre.

Somerset West Community Health Centre and Ottawa Inner City Health, located at the Shepherds of Good Hope, have applied for federal exemptions to open supervised injection sites. Meanwhile Overdose Prevention Ottawa is already operating an illegal yet well-attended tent offering a similar service to drug users, and appears to have little intention of decamping.

It's a dramatic shift in public health policy that happened without — or maybe in spite of — political leadership.

Mayor distanced himself from issue

The mayor has never supported supervised injection sites, saying he'd prefer scarce public health dollars to go toward drug rehabilitation instead. He's stood by that view for years despite evidence that the sites reduce overdoses, and that regular users of supervised sites are more likely to actually go those rehab programs Watson says he supports.

Mayor Jim Watson reacts to London attacks June 4, 2017

Ottawa Mayor Jim Watson has never supported supervised injection sites, and late last year side-stepped the issue. (Radio-Canada)

But just as the opioid crisis worsened and public opinion on harm reduction appeared to shift late last year, Watson backed away from the issue.

As part of its application, the Sandy Hill Community Health Centre (SHCHC) needed a letter of support from the municipality. Instead of writing that letter himself  — or taking the issue to council as the mayors of other big cities have done — Watson left the decision to the public health board.

It was a have-your-cake-and-eat-it-too political moment. Watson was surely under pressure from local health and social services groups, as well as then minister of health Jane Philpott, to get behind supervised injection services. By leaving it to the health board, which had already voted in favour of the SHCHC application earlier in 2016, Watson didn't have to change his stance. 

Qadri voted against site in 2016

At an emotional meeting in June 2016, where drug users shared their harrowing stories and where our mild-mannered medical officer of health, Dr. Isra Levy, described supervised injection sites "an unquestioned part of the spectrum of health services," health board chair Shad Qadri was one of only two people to vote against the SHCHC bid.

Shad Qadri

Coun. Shad Qadri is the chair of the city's board of health. Last year, he voted against the recommendations of public health officials calling for a supervised injection site. (CBC)

Qadri said he was against the Insite model of harm reduction, where supervised injection is the core service, a view that was hardened during a visit to Vancouver when his taxi driver refused to drop him at the centre. He told CBC he has never been, nor ever will be, in favour of "supervised injection sites without treatment."

But the vote last year was about whether to support injection services at SHCHC, which already has a host of health programs, including counselling services for people struggling with addictions and mental health issues.

It sounds just like the sort of program Qadri said he'd support — but he didn't.

Objections not based on evidence

Ottawa's board of health hastily approved the Clarence Street site last week, a response to Overdose Prevention Ottawa's pop-up tent.

Everyone applauded the decision, including Qadri, who voted in favour of the interim facility. Watson gushed in an emailed statement that "the efforts of the phenomenal staff have not gone unnoticed."

Where was all this support last year when public health officials were making the case for a supervised injection site? It's true that the fentanyl crisis has increased the potential for overdosing, but drug users in Ottawa were overdosing before fentanyl came along.

Many are uncomfortable with the idea of supervised injection sites, that as a society we're somehow sanctioning or even enabling this harmful behaviour. It's an understandable reaction, and there are real and complex issues to be discussed.

But the idea that a drug addict's condition would somehow worsen once they get access to a supervised injection site, or more ludicrously, that they might forgo doing a hit if a supervised injection site isn't around, is to grossly misunderstand this illness. 

No bump in crime near pop-up site

Indeed, it appears there's a lot of misunderstanding around this issue. The evidence that's available has either been ignored, or hasn't been genuinely sought out.

Bordeleau's concerns about public safety around injection sites conflict with what he says actually happened when Overdose Prevention Ottawa set up its illegal tent.

'My personal feelings aside, the evidence is absolutely clear. Absolutely clear.' - Calgary Mayor Naheed Nenshi

"We've been monitoring the site, looking for drug traffickers in the area. We haven't seen any," Bordeleau told CBC.

That's similar to the experience of Vancouver police, who have also reported that the area surrounding Insite, while far from problem-free, has not experienced an increase in crime.

Neither Watson nor Qadri have visited the tent that has been open for more than four weeks now. The reason for the cold shoulder? Because it's illegal and, in the words of Watson's statement, "raises a number of concerns." 

​But to show some interest in the welfare of the people using the site doesn't mean they endorse the site itself. 

Toronto mayor moved by visit

Toronto Mayor John Tory visited an unsanctioned site in that city late last month, even though he was not in favour of it. He later said the visit left him "more mindful" that folks addicted to drugs are real people, and that society has "an obligation to do whatever we can to help save those lives."

Asked for his reaction to Tory's remarks, Qadri replied: "We're not obligated to do what the mayor of Toronto does."

In a little more than four weeks, Ottawa's illegal tent has had more than 1,000 visits. Can there be clearer evidence that there's a need for this service for some of our most vulnerable residents?

Our politicians are people, with all the emotional baggage that that entails. But we ask our leaders to try to rise above their own entrenched worldviews to make decisions for the greater good.

Here's how Calgary Mayor Naheed Nenshi, no fan of supervised injection sites, put it: "I find that they almost feel like an admission that we're not able to solve the problem, but that said, my personal feelings aside, the evidence is absolutely clear. Absolutely clear. They save people's lives, and our job today has to be to save people's lives."

And that, today, is Ottawa's job as well.