Analysis

PCs 'playing politics with people's lives' on injection sites, drug policy expert warns

Ontario Health Minister Christine Elliott says her government needs to review the evidence before deciding on whether to support supervised injection sites. But health practitioners, drug policy advocates and those on the front lines say the evidence is perfectly clear: they save lives.

There may be clinical evidence against supervised injection sites, Heath Minister Christine Elliott says

Christine Elliott was sworn-in as the PC government's health minister and deputy premier last month. (Mark Blinch/Canadian Press)

After question period on Thursday, Ontario's health minister was asked about the review her ministry is conducting into supervised injection sites.

"We want to speak with the experts — those in favour —  and there are some people who are against them," Christine Elliott told CBC News.

Elliott says she's heard concerns about supervised injection sites from people living in the areas where they operate, but she wants to look at the evidence on their effectiveness.

"There may be some clinical evidence against it as well; that's why we're conducting the investigation and the review of the evidence."

But health professionals, activists, and those who have been working in the field of harm-reduction for decades say the minister won't find that in her review.

That's because there isn't any scientific evidence that shows supervised injection sites are harmful. There is overwhelming evidence in scientific literature that show they do the opposite: they save lives, help prevent infectious diseases and connect those struggling with addiction with the services they need to get help. 

This is an example of the type of drug injection kit that would be used at a supervised injection site. (Darryl Dyck/Canadian Press)

In 2017, 1,200 people died of an overdose in Ontario. In cities like Toronto, the problem is getting dramatically worse: 303 people died from overdoses last year. That's an increase of more than 60 per cent from the previous year, and a roughly 120 per cent increase from 2015.

Clear consensus

Dr. Ahmed Bayoumi, a physician and researcher at St. Michael's Hospital, has spent years researching the effects of supervised injection sites.

In 2012, he and a team of researchers released a report that looked at what the provincial government is reviewing now — that is, do cities like Toronto and Ottawa need supervised injection facilities. 

The team conducted interviews, focus groups, reviewed existing scientific literature, examined patterns of drug use and did economic modelling to try to forecast the cost-benefit of implementing the sites.

Dr. Ahmed Bayoumi was part of a team that looked at whether the cities of Toronto and Ottawa would benefit from the implementation of supervised injection facilities. He says the scientific consensus is clear on their health benefits. (Farrah Merali)

"We found there is good evidence that supervised consumption sites have a number of positive effects, including decreased needle sharing, decreased overdoses in neighbourhoods around supervised consumption sites, and increased referral of people to programs that help them with their drug use," said Bayoumi.

Bayoumi said the consensus among public health practitioners and researchers is the same now as it was then: supervised injection sites save lives and are a cost-effective way to improve the health of people who use drugs.

That finding has been echoed in research conducted elsewhere in Canada, as well as Australia, Switzerland — where the first supervised consumption site opened in 1986 — and other European countries.

Ideology vs. evidence

When asked about supervised injection sites on the campaign trail, Doug Ford told reporters he's "dead against them," saying they encourage more drug use.

"I think in the campaign [the PCs] put forward this kind of ideological position they knew would be appealing to people in their base and in the rural areas," said Robert Drummond, professor emeritus at the York University Department of Politics and School of Public Policy and Administration.

During the provincial election campaign, Doug Ford said he's against supervised injection sites and that the focus should be on drug rehabilitation services. (CBC)

The government has since softened its stance by committing to a review of the evidence before making a decision. But it's unclear how much that will change the mind of the premier who came out swinging against the sites just months ago.

Drummond says it could go either way:

"It may be that they're genuinely unfamiliar with [supervised injection sites] and they want to look at them," said Drummond.

"Or they may be looking at them for the purpose of finding a way of countering them — a way of saying they don't trust the data."

Funding at issue

Vancouver's supervised injection facility Insite has been open for 15 years. Since then, there have been more than 3.6 million visits, and staff have reversed more than 6,400 overdoses. No one has ever died at the facility.

Donald MacPherson, a drug policy advocate, says there's no scientific evidence against supervised injection sites. (Canadian Drug Policy Coalition)

"If there's any clinical evidence against how effective these sites are, it would have surfaced by now," said Donald MacPherson, a drug policy advocate, who has worked in Vancouver's downtown east side since the mid-1980s.

MacPherson says while supervised injection sites alone are not the sole solution — and need to be part of a comprehensive drug policy strategy — he calls it "sad" that Ontario's health minister would question their effectiveness, despite decades worth of evidence.

"It gives to the public the message that she's playing politics with people's lives and that's not taking a medical health care intervention, [that's] evidence based and researched to death."

The Ontario government hasn't committed to a timeline for the review or when it will make a final decision on whether to fund the sites. In the city of Toronto, there are four supervised injection sites that are federally approved but provincially funded. There are also four overdose prevention sites that the province has approved and funded.

Vancouver's Insite clinic in Vancouver's Downtown Eastside was the first supervised injection site in North America. (Darryl Dyck/Canadian Press)

"We want to collect all the evidence to be able to present it to the premier," said Elliott.

About the Author

Farrah Merali

Reporter

Farrah Merali is a reporter with CBC Toronto with a passion for politics and urban health issues. She previously worked as the early morning reporter at CBC Vancouver. Follow her at @FarrahMerali

Comments

To encourage thoughtful and respectful conversations, first and last names will appear with each submission to CBC/Radio-Canada's online communities (except in children and youth-oriented communities). Pseudonyms will no longer be permitted.

By submitting a comment, you accept that CBC has the right to reproduce and publish that comment in whole or in part, in any manner CBC chooses. Please note that CBC does not endorse the opinions expressed in comments. Comments on this story are moderated according to our Submission Guidelines. Comments are welcome while open. We reserve the right to close comments at any time.