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People wait outside Insite, North America's only supervised injection site run by the Portland Hotel Society, in the Downtown Eastside in Vancouver, British Columbia.Rafal Gerszak/The Globe and Mail

Toronto Mayor John Tory and Police Chief Mark Saunders are not opposing a proposal that would see three existing harm-reduction clinics in the city set up supervised drug-injection sites, where addicts can shoot up with a nurse looking on.

For months, Mr. Tory and Chief Saunders were non-committal about the plans, which were announced in March by Medical Officer of Health David McKeown as a response to an alarming increase in overdose deaths in Toronto.

But on Friday, after Dr. McKeown released the results of public consultations on the three proposed small-scale sites, Mr. Tory issued a statement cautiously supporting the move.

"Supervised injection services have been effective in other communities in preventing death, illicit drug use and in reducing health risks, but in accepting their initiation in Toronto, we must recognize they are only one part of the solution," the mayor said, calling for more health-care resources for treatment programs from the province and the federal government.

He said the city's rising toll of overdose deaths was "a human tragedy" that "cannot be acceptable to anyone in a caring city such as ours."

Meanwhile, in a letter to Dr. McKeown provided to The Globe and Mail on Friday, Chief Saunders also expresses support for the proposal, which is expected to be approved by the board of health and City Council in July but must also be authorized by the provincial and federal governments. The chief says he will work with health officials on public-safety plans for the clinics.

"I am supportive of measures that reduce the incidence of overdoses and death," his letter reads, adding that he hopes that users of the sites "will be given meaningful opportunities to be treated and reintegrated into society."

But Chief Saunders also warns that police will be on guard: "While your report indicates that you anticipate no increase in crime around the three proposed sites, I will remain vigilant in monitoring criminal activity in the areas as the project rolls out to ensure the communities continue to enjoy a high level of public safety."

Last year, a spokesman for Chief Saunders warned that supervised injection sites can "damage" neighbourhoods. After the most recent proposal was released in March, the chief's office said only that he needed more details to make a decision. Chief Saunders also met with advocates to discuss his concerns.

Councillor Joe Cressy, a champion of the idea and chairman of the city's drug strategy implementation panel, met with both the mayor and the chief to convince them of the idea's merits. He said both listened and studied the issue intently, and came to the same conclusion. So has the public, he said, noting that consultation sessions in his ward were dominated by residents in favour of the proposal.

"There's been a tipping point in our country, and certainly in Toronto, on this," Mr. Cressy said.

The proposal comes as overdose deaths have soared in Toronto. According to Toronto Public Health, there was a record 258 overdose deaths in the city in 2014, up from 206 in 2013 and much higher than the 146 counted in 2004. Health officials blame the rise of the new and dangerously more potent opioid fentanyl for much of the increase.

The three selected clinics, which already hand out clean needles to addicts under a city program, are the Works, which is Toronto Public Health's main harm-reduction clinic near Yonge-Dundas Square; Queen West Central Toronto Community Health Centre, near Queen Street West and Bathurst Streets; and South Riverdale Community Health Centre, on Queen Street East near Carlaw Avenue in Leslieville.

Advocates and health experts say supervised injection sites make fatal overdoses much less likely. They allow addicts to use their drugs, obtained by themselves elsewhere, under the watchful eye of a nurse, who can intervene in the event of an overdose. Drug users also receive clean needles, to avoid transmitting disease, and potentially other treatment.

Vancouver has long had supervised injection sites, although its well-known Insite clinic is much larger than the ones proposed for Toronto. Other cities in Canada are discussing the issue, and Victoria and Montreal have both applied for permission from the federal government to open similar clinics.

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