Municipal politicians in Canada's two largest cities are optimistic that new legislation aimed at clearing the path for more supervised consumption sites means they will finally be able to offer the harm-reduction service next year.
Ottawa on Monday tabled Bill C-37, which would overturn yet another piece of Conservative-era legislation and advance the Liberal government's plan to approach drug use as a public-health issue.
Toronto recently submitted applications to operate three small-scale sites, and said they have long been needed; Montreal applied almost two years ago to have three supervised injection sites and one mobile unit. Vancouver, which is home to the only two sites sanctioned by Health Canada, recently applied to open two more.
City councillor Joe Cressy, who chairs Toronto's drug strategy implementation panel, called Ottawa's announcement a "good sign" and encouraging news for other cities.
The change would have no effect on Toronto's applications, as they would be covered by the more stringent old rules. Toronto is also awaiting word on whether the Ontario government will fund the three sites.
"We still believe that we will be given [federal] approval imminently. Our challenge is that we need to open these sites yesterday," Mr. Cressy said. "The longer we delay, the more lives with be lost."
Montreal Mayor Denis Coderre said he is "pleased but impatient."
"I hope the bill is adopted quickly because we've been experiencing a veritable public-health crisis," he said in a statement on Monday.
"It's not a question of ideology: We're talking about saving lives."
The bill, which would amend the Controlled Drugs and Substances Act and the Customs Act, is the beginning of a new federal strategy on substance-use disorder, federal Health Minister Jane Philpott said in Ottawa.
"The big picture of the Canadian Drugs and Substances Strategy is that it will replace the National Anti-Drug Strategy," Dr. Philpott said. "It will reframe problematic substance use as the public-health issue that it is. It will return the lead on the Canadian Drugs and Substances Strategy to the Minister of Health, rather than the Minister of Justice."
Ottawa will reinstate harm reduction as a key pillar in this strategy, the Health Minister said.
The bill would repeal the Conservatives' Respect for Communities Act, which critics had called an effort to hamper supervised consumption.
Under the new legislation, agencies that want to open such a facility must meet only five conditions: Proof of the need; community consultations; evidence about its impact on crime; adequate resources to maintain the site; and regulations.
The previous legislation had 26 requirements for prospective operators, including extensive community consultations; collecting data and other information on crime, public nuisance and inappropriately discarded drug paraphernalia nearby; and criminal-record checks for staff members going back 10 years.
In an interview, Dr. Philpott said that while the specifics of the new conditions are still being developed, applying will no longer be onerous. Evidence regarding the impact on crime, for example, could be research that has been done on Insite, Vancouver's 13-year-old public supervised injection site.
Ottawa is working to approve existing applications as soon as possible, Dr. Philpott said.
Bill C-37 would impose a service standard so applicants know how many days the process might take, Dr. Phillpot said. Status updates would also be posted online.
This is not the first piece of Conservative legislation on drug use the Liberal government will undo.
After Health Canada in 2013 granted special access for a few dozen severely addicted heroin users in Vancouver's Downtown Eastside to receive prescription heroin outside a clinical trial, Conservative health minister Rona Ambrose introduced legislation to ban physicians from prescribing "dangerous drugs like heroin, cocaine, ecstasy and LSD."
That was overturned in September, with Health Canada saying a "significant body of evidence" supports heroin-assisted treatment.
Dr. Philpott said on Tuesday she believes the previous government took the wrong approach to drug policy.
"They thought they could solve things with a law-enforcement approach when even law-enforcement officials themselves will tell you you can't arrest your way out of the problem," she said.
"We've seen the escalating number of people dying as a result of opioid overdoses. The previous government, in my opinion, was not adequately recognizing this was a serious public-health problem … that requires a policy approach that will see substance use disorder as a chronic disease and not a moral failing."
In British Columbia, the province hardest hit by the overdose crisis, 622 people had died from illicit drug overdoses by the end of October – the highest death toll in 30 years of record keeping. Fentanyl, a powerful synthetic opioid being cut into street drugs, was detected in about 60 per cent of those deaths.
Carfentanil, a large-animal tranquilizer many times more toxic than fentanyl, has since been detected in four provinces and is beginning to fuel another surge in overdoses.
With reports from Jeff Grey in Toronto and Ingrid Peritz in Montreal