Toronto's medical officer of health is calling on Canada's largest city to move one step closer to opening three safe drug-injection sites.
In the report, Dr. David McKeown calls for three sites to be located at The Works Needle Exchange Program, the Queen West Community Health Centre and the South Riverdale Community Health Centre.
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Federal Health Minister Jane Philpott told the CBC last week that supervised injection sites are among a number of strategies the government has put forward to cope with drug abuse and overdose deaths.
"From a public health point of view it makes a tremendous amount of sense," she said. "Sites like Insite in Vancouver and others like them have the possibility to save countless lives."
There are only two in the country right now, and both are in Vancouver. Insite has existed for years. The other just received approval from Health Canada.
Overdoses on the rise
In 2013, there were 206 overdose related deaths in Toronto, a problem that has been on a steady rise for years. In the last decade alone, the number of reported overdose deaths in the city has risen by 41 per cent.
Toronto Coun. Joe Cressy, chair of the city's drug strategy panel, says the increase in overdoses has been accompanied by rises in the number of drug-related diseases such as HIV and hepatitis C.
Drug use has caused a number of other issues across the city that safe injection sites may be able to address, Cressy said.
"We're hearing frequently from our residents that they have an issue of needles being found in the local coffee shop bathrooms, in the local park, in the local school yard," Cressy said.
Next week McKeown will recommend Toronto hold public consultations about potentially opening the three supervised drug injection sites.
The issue is a contentious one: The union representing Toronto police officers has already come out against the idea.
Toronto Mayor John Tory admits getting unanimous consensus isn't easy.
"These are difficult issues," he said. "They have some emotional aspects to them, they have some substantive aspects to them, some on which even reasonable people can disagree."
There is interest in safe drug injection programs in other cities as well, including Ottawa, Victoria and Montreal. The federal government has to approve their plans, but the new Liberal government is much more open to the concept than its predecessor.
The previous Conservative government fought to close Insite all the way to the Supreme Court of Canada, losing that battle in 2011. Its subsequent legislation laid out several conditions that had to be met before a site could open.
The former health minister, now the interim Conservative leader, Rona Ambrose, says she'll be watching to make sure those rules are respected.
"I would expect that the government would follow the law and make sure that there is wide support in the neighbourhood, and that this is something the people in the neighbourhood support and that there [are] public consultations," she said.
Philpott says for now she will try to work within the Conservative's legislation, pointing out it requires consultation, not consensus.
"One-hundred per cent consensus in many situations is difficult to achieve," Philpott said. "Having said that we are always in favour of consultation … and I think it's the kind of thing that the more people understand about what it actually offers the more people are in favour of it."
Philpott said that officials at the Public Health Agency of Canada who "hadn't had the opportunity to visit" Insite in the past are going there to study it.
If Toronto city council gives the green light to hold public consultations it will still take until the fall at the earliest before the city could formally apply to the government to open three drug-injection sites in the city.
An earlier version of this story reported that Health Minister Jane Philpott backs Toronto's bid for safe injection sites. Philpott's comments supporting safe injection sites were recorded earlier this week, not in reaction to the Toronto announcement.Mar 14, 2016 8:30 PM ET