A temporary overdose prevention site will open its doors in London, Ont. Monday – the first of what is expected to be many under a new provincial emergency response program that will fill the gap for communities waiting on permanent supervised injection sites.
Thousands of people are dying from overdoses every year across Canada. In Ontario alone, there were 336 opioid-related deaths between May and July last year, up 68 per cent from that same period the year before. Fentanyl, a drug so potent that mere grains of it can be lethal, was a factor in 67 per cent of those deaths – up from 41 per cent in 2016, and 19 per cent in 2015.
The wait for a federal exemption from Health Canada to open a permanent supervised injection site is a lengthy one – and as the death toll continues to climb, harm-reduction experts have long been calling for the federal government to expedite that process.
"There are kind of three ways of [opening a site]. One, you get the federal exemption, a process that takes time and requires you to have a lot of ducks in a row," Dr. Chris Mackie, medical officer of health for the Middlesex London Health Unit, explained Sunday.
"The second is, you do it illegally," he says, referring to locations such as Toronto's pop-up site in Moss Park, which has been operating since last summer with tacit approval from the city and police.
The new "overdose prevention site" (OPS) program – announced by Eric Hoskins, Ontario's Minister of Health and Long Term Care (MOHLTC), in December – now provides a third avenue.
Under the new program, communities or community agencies can apply to the province to host a legal but temporary site for three to six months (with the possibility of renewal), with up to $368,700 in funding for salaries, medical supplies and administrative costs. In addition to providing a space for supervised consumption, the sites will also provide naloxone and clean drug supplies.
The application is far less cumbersome than the paperwork-heavy Health Canada one, Dr. Mackie says, and the MOHLTC promises a response within two weeks.
The London site will operate out of the city's Regional HIV/AIDS Connection program, where a needle exchange program already exists, Dr. Mackie said.
"For us, it was really clear that the way we were doing things – forcing people to inject in the streets and back alleys – was dangerous and harming not only the users but our whole community," he said.
A collaboration of community agencies, including the Canadian Mental Health Association and local housing groups, will be partnering with the health unit at the OPS to ensure other community supports are provided, Dr. Mackie said.
These sites allow supervised consumption – for example, snorting – or injection, but because of the Smoke-Free Ontario Act, smoking is not allowed.
Nick Boyce, who is director of the Ontario HIV and Substance Use Training Program and has spent time volunteering with the Toronto Overdose Prevention Society and the site in Moss Park, says that is a "huge barrier" to a significant population of drug users.
Asked whether the Moss Park site plans to apply for the OPS program, he said the no-smoking issue is one concern that's been raised.
"It is a conversation we're going to think about a little more," he said.
Another potential hurdle for the Moss Park site is that they do not currently have the city's permission to be operating in the park – a requirement for the provincial program.
Michael Parkinson, a harm-reduction advocate and community engagement co-ordinator with the Waterloo Region Crime Prevention Council, is thrilled to see the first OPS come out of the gate.
"It's an appropriate emergency response during the worst drug crisis in Canadian history," he said Sunday.
It's unknown how many other communities have applications in for an OPS, but Dr. Mackie says London has been approached by "a number of other mid-sized communities in Ontario" who he expects will be following suit in the coming weeks and months.
While some advocates in Ontario have expressed concern about the temporary nature of the OPS program – and what happens when you get people used to these supports and then yank them out six months into it – Dr. Mackie says, "That is definitely not the plan."
"This is temporary in the sense that the location is temporary. But we plan to continue to offer these services," he said. "This crisis is not going away soon."