Toronto harm reduction workers are taking matters into their own hands by opening the city's first unregulated pop-up safe-injection site following a spate of deaths in and around the city — three in the last 24 hours.

The Toronto Harm Reduction Alliance is set to open the site Saturday at a "traditionally underserved" location in downtown Toronto, front-line harm reduction worker Matt Johnson told CBC News. 

Johnson declined to give the site's exact location, citing the protection of users and organizers who could potentially be arrested, given that the space is not authorized by the city.

That's a risk Johnson said they simply have to take.

"We just can't wait any longer.… With this many deaths we just can't afford to," he said.

City-sanctioned sites not sufficient, say advocates

The move comes as many harm reduction advocates call for the city to declare a public health emergency along with immediate funding for 24-hour care for drug users until Toronto's official safe-injection sites open later this year. The first of those sites, which would allow for illicit drugs to be used under the supervision of a medical professional, is set to open its doors this fall.  

'You have to put up the tent and then the city will have to come around. It would be bonkers for the city to shut [it] down.' - Sarah Blyth, Vancouver-based community advocate

Although many have lauded the sites approved by Health Canada as a life-saving move, many harm reduction advocates have said they simply aren't enough to address what they see as a growing crisis.

"They were opened to deal with the overdose problem that we had — not the increase that we're dealing with. So they can't handle the overflow that we're seeing now," Johnson said, citing a rash of drug overdose deaths in the past month that prompted police to issue a public alert. 

'We have to stop sort of viewing them as the answer," Leigh Chapman, whose brother died of an overdose on a downtown street in 2015, told CBC News on Friday.

Vancouver's response to pop-ups a model

Police did not respond to requests for comment on Friday. But Toronto isn't the first to see a pop-up injection site in Canada.

Sarah Blyth, a community advocate with the Overdose Prevention Society, opened up a tent in September in the alley behind the market that she manages in Vancouver's Downtown Eastside — out of what she says was desperation. 

The group offered clean needles, food and basic care to anyone in need — and within months, the city got on board, bringing the clinic under the funding umbrella of Vancouver Coastal Health. 

"It takes a fiscally smart government with an open mind," Blyth told CBC News on Friday.

Sarah Blyth

Sarah Blyth helped set up a safe-injection tent out of desperation in the Downtown Eastside of Vancouver. The city eventually supported it. (Rafal Gerszak/Boreal Collective)

Johnson said harm reduction advocates met with Mayor John Tory on Thursday to ask for assurances that police and city staff would not try to dismantle the site, should the group choose to go ahead with it. 

"They couldn't give us those assurances," said Johnson, saying the group is now going forward without city backing and hoping for the best, with lawyers on hand in case arrests are made.

Johnson couldn't guarantee that a nurse will be present on-site at all times, but at least two people trained in advanced first-aid and naloxone administration will be inside. 

Councillor won't condemn sites

"We're really really hoping that the police and city recognize the value of what we're trying to do, recognize that we're just trying to save lives."

And while the site will technically be illegal, Coun. Joe Cressy said he understands the frustration among harm-reduction advocates who are losing friends and colleagues to overdoses awaiting the construction of the city-run safe-injection sites.

 Joe Cressy

The pop-up safe-injection site will technically be illegal, but Coun. Joe Cressy says he can't condemn it. (CBC)

"We wish our sites were open yesterday, and frankly they would have been if it didn't take nine months for the provincial and federal government to give us the funding to do it.… The City of Toronto cannot open a site which is illegal, I certainly cannot as a city councillor and as a harm reduction advocate, cannot condemn it."

Not all agree. Board of health chair Joe Mihevc stressed to CBC News Friday that without the proper exemption from the federal government, pop-up injection sites would be illegal, saying the city is working as fast as it can to open the city-sanctioned sites, while also equipping more staff with naloxone and providing more training on how to use it.

The hope, said Johnson, is that Toronto responds to the site in the same way that Vancouver did to Blyth's. 

Meanwhile, Blyth has a message for her Toronto counterparts.

"I do believe you have to put up the tent and then the city will have to come around. It would be bonkers for the city to shut [it] down."

With files from Nick Boisvert and John Rieti