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A health specialist demonstrates how opiate users would draw drugs through a filter into a syringe before injecting drugs.Fred Lum/The Globe and Mail

Toronto city council has approved three supervised injection sites at existing downtown health-care facilities.

Council voted 36-3 Thursday to support the services aimed at providing a safe and hygienic environment where people can inject pre-obtained drugs under a nurse's supervision.

There are about 90 supervised injection sites worldwide, and Vancouver is the only other city in Canada with the service.

Earlier this month, Toronto's board of health unanimously accepted a recommendation for three small-scale supervised injection sites.

The report cites a 2012 study called the Toronto and Ottawa Supervised Consumption Assessment, which concluded that Toronto would benefit from supervised injection services that are integrated into existing health-care services.

Joe Cressy, city councillor for Toronto's Ward 20 and the chair of the Toronto Drug Strategy, welcomed the support for the sites as a "critical tool" in addressing deaths from overdoses.

"Toronto as the first municipality in Ontario and the largest city in Canada to step forward and say, 'We're ready, it's time' will hopefully tip the dominoes for more evidence-based policy across the country," he said.

Between 2004 and 2014, there was a 77 per cent increase in the reported number of people dying from overdoses in Toronto, according to a report presented to the city's board of health. There were 258 overdose deaths in 2014, the highest reported number to date.

The three sites have been approved for Toronto Public Health's The Works needle exchange program, the Queen West-Central Toronto Community Health Centre and the South Riverdale Community Health Centre.

Angela Robertson, the executive director of the Queen West-Central Toronto Community Health Centre, said providing supervised injection services could save lives.

"We have also seen the need for such a service based on our own experience, whereby we have seen a number of clients who have had instances of overdose and clients who have passed — who have died — as a result of that overdose," she said.

In addition to preventing deaths from overdoses, Robertson said supervised injection services could help prevent the spread of diseases such as HIV.

"From a research, evidence standpoint, we've seen the need. And from our own lived experience as service providers, we've seen the impact of not having this service in place," she said.

Robertson said the community response to plans for supervised injection sites has been mostly positive, but some people have raised concerns that the sites could bring more crime to the neighbourhood. She noted that evidence from other supervised injection sites, including the ones in Vancouver, have shown that isn't the case.

Cressy said neighbourhood residents' associations and business improvement associations around the planned sites supported the programs.

"They were saying yes because drug use is already in concentrated neighbourhoods in the city of Toronto," he said. "And we know that not only is supervised injection good policy from a public health standpoint, but it also improves public safety by taking discarded needles and public drug use out of alleys and playgrounds and washrooms, and into a safe and supportive environment."

Before the sites can be established, they need provincial approval and a federal exemption from Section 56 of the Controlled Drugs and Substances Act. Toronto Public Health spokeswoman Susan Shepherd said she anticipates supervised injection services will be available some time in 2017.

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