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Dr. Gigi Osler, president of the Canadian Medical Association, in Winnipeg, Manitoba, on Aug. 19, 2018.LYLE STAFFORD/The Globe and Mail

The Ontario government should immediately declare a state of emergency to combat the worsening opioid crisis, according to health leaders and harm-reduction workers who say the province’s current approach risks making a bad situation worse.

The province has not backed away from plans to limit the number of supervised drug-use sites to 21, which experts say will leave many hard-hit communities without important tools to stop the rising rate of opioid-related overdoses.

“If we want to save lives and we want to improve health, then not limiting the number of sites helps to achieve that goal,” Gigi Osler, president of the Canadian Medical Association, said in an interview on Monday.

Ontario Health Minister Christine Elliott announced in October that the government would create a new model to replace overdose-prevention sites and supervised drug-use sites, called consumption and treatment services. She pledged to approve 21 sites under the new model and have them up and running by the spring. The cap means many communities with the highest rates of opioid-related deaths, hospitalizations and emergency room visits won’t get a supervised drug-use site.

“The cap is the exact opposite of a proper response to the current crisis,” said Sarah Ovens, an organizer with the Toronto Overdose Prevention Society (TOPS). “It’s so disheartening.”

TOPS issued a call on Monday for the province to declare a state of emergency, which would help public-health officials track information in real time and respond to problems as they emerge. The group also says the government should reconvene its opioid emergency task force, which hasn’t met in months.

"It is like nobody is steering this ship, nobody is in charge of co-ordinating this response at a higher level,” Ms. Ovens said.

The permits for several overdose-prevention sites are set to expire on Thursday, which is creating uncertainty in the community. In an e-mail, Hayley Chazan, a spokeswoman for Ms. Elliott, said existing sites will be allowed to continue operating while they await the transition to the new consumption and treatment services model. It’s unclear when the sites will get formal extensions, which are required in order for people to use illegal drugs there.

“I’m hoping that we’ll get some positive news out of the government. We’re still waiting,” said Glen Walker, executive director of Positive Living Niagara, which operates an overdose-prevention site in St. Catharines.

Raechelle Devereaux, executive director of the Guelph Community Health Centre, which operates an overdose-prevention site, said she’s confident that existing sites will be allowed to remain open. She said her site’s permit expired on Oct. 31 and they were only notified that they would be able to continue providing services on Nov. 1. While the paperwork to support the programs’ continuation can sometimes take a long time, she said she would be very surprised if the government abruptly shut down an active service providing support to a community in need.

Alexander Caudarella, a member of the opioid task force and an addiction physician at Toronto’s St. Michael’s Hospital, said it is “unacceptable” that some communities won’t have access to supervised drug-use sites and that better co-ordination is needed from the government to lead the response to the crisis.

The Health Minister’s office did not respond to questions about the opioid task force or whether the province would consider declaring a state of emergency.

Dr. Osler said the opioid crisis is “not abating,” and that in order to make a difference, provinces must dedicate as many resources as possible.

“Now is not the time to hold back,” she said.

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