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Toronto Public Health’s Victoria Street site in the Yonge and Dundas area is seen on Oct. 31, 2018.

Christopher Katsarov/The Globe and Mail

Some of Toronto’s supervised drug-use sites could be forced to move or shut down under the province’s new rules, critics warn, even as the city’s opioid overdose crisis mounts.

Doug Ford’s Progressive Conservative government last week quietly released its new reapplication criteria for drug-consumption sites. The existing sites – Toronto has eight – had already been approved by both the federal government and the previous Liberal provincial government.

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But they must now follow a new set of rules: Among them, a provision that could prohibit sites near postsecondary institutions, and a rule that disallows sites from operating within 600 metres of each other.

The first new rule could affect Toronto Public Health’s The Works clinic, which is right next to the downtown campus of Ryerson University. The university has complained of increased vandalism and crime in the area that it blames on the supervised injection site. Public health officials say they have increased street patrols by outreach workers.

Meanwhile, the 600-metre buffer zone would appear to put the east-end Moss Park overdose-prevention site out of business, as its new indoor facility on Sherbourne Street is just a block away from another nearby site. Activists say the sites are both needed in the neighbourhood well-known for homelessness and drug use.

Downtown City Councillor Joe Cressy, chairman of the city’s drug-strategy implementation panel, acknowledges that on paper it appears the sites would have to close. But he said he is optimistic the Ontario government can be convinced to either waive or rewrite its rules, noting that Premier Ford called him personally last week to discuss the government’s announcement that it had decided to keep the sites open.

“The regulations they put forward are onerous, are too restrictive, and would result in Toronto having to close some of its existing life-saving sites,” Mr. Cressy said. “Clearly the regulations will need to change. … But I cannot overstate the significance of the move by the province to fund harm reduction.”

Harm-reduction activists put out a statement on Monday condemning the new rules and reapplication process. Gillian Kolla, a co-ordinator of the Toronto Overdose Prevention Society – which opened a then-illegal supervised drug-use site in the summer of 2017 in tents in Moss Park – said the government’s new regime will result in more overdose deaths, creating more red tape for cash-strapped operators while making it impossible to add needed new sites in other neighbourhoods and communities. There were 1,127 opioid-related deaths in Ontario last year, up from 726 in 2016.

“We are in the middle of a crisis,” Ms. Kolla said. “We don’t need people to be filling out two weeks of paperwork.”

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Mr. Ford had said during the spring election campaign that he was “dead against” the sites, which allow drug users to inject opioids and other drugs under the watchful eye of a nurse who can intervene in the event of an overdose.

But after a review, Ontario Health Minister Christine Elliott announced on Oct. 22 that the sites would be allowed to continue, provided they reapply and sign on to a “new delivery model” that would emphasize funneling drug users into treatment programs – programs, now underfunded, that her government has pledged to expand. However, she said the total number of supervised drug-use sites across the province would also be capped at 21.

A spokeswoman for Toronto Public Health, associate medical officer of health Rita Shahin, said in an e-mail that the agency was in the process of reapplying to operate its site next door to Ryerson. She did not directly address questions about whether the clinic would have to move: “We are committed to working within the new guidelines and criteria in order to continue to serve our clients and the residents of Toronto.”

In an e-mail, Hayley Chazan, Ms. Elliott’s press secretary, did not directly address questions about whether sites would be forced to close. She said the new rules were developed after an “extensive evidence-based review” with healthcare providers, police and community groups and “persons with lived experience” and are “entirely consistent with expert input and feedback.”

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