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Syringes, oxygen tanks and other supplies are seen at a supervised-injection site at Moss Park in downtown Toronto on Sept. 13, 2017.Fred Lum/The Globe and Mail

The City of Toronto and the province are asking the federal Minister of Health for the "immediate approval" of a proposed indoor supervised drug-use site at an east-end homeless centre, where an illegal outdoor site has been operating for months.

In a letter to Health Minister Ginette Petitpas Taylor dated Oct. 31, Toronto Mayor John Tory and Ontario Health Minister Eric Hoskins say the illegal site, set up in Moss Park near Sherbourne Street and Queen Street East, has saved many lives since it was launched in August by reversing overdoses in a neighbourhood that had been hit by an increase in such deaths.

"However, operating this type of health service in a park is not sustainable not least because winter is approaching," the letter reads. "The overdose prevention site has clearly demonstrated the need for an SIS [supervised injection service] in the Moss Park neighbourhood."

Ms. Petitpas Taylor, speaking to reporters in Toronto Wednesday, acknowledged she had received the letter from Dr. Hoskins and Mr. Tory but not a formal application, or Dr. Hoskins' approval, for the permanent site that the letter advocates.

She said she has instructed her staff to expedite the application when it arrives, but she could not say how long it would take to approve it. However, she said two to four weeks was not an impossible timeline.

The letter, provided to The Globe and Mail by the mayor's office, says the Fred Victor Centre, an independent charitable agency, is applying this week for an exemption in order to operate a legal, supervised drug-use site at its Queen Street East location near Moss Park. The two politicians said that, while the process usually takes "several weeks," they would like this new site granted a "short-term or conditional exemption to enable the service to open as soon as possible."

The request comes as the activist group currently running the illegal Moss Park site says it intends to stay put in the park. Toronto Harm Reduction Alliance, at a press conference Wednesday, said it may try to bring in a heated trailer, even without a city permit, as the temperature drops – although it hopes the city will co-operate.

The activists, most of whom are harm-reduction workers at other clinics, said they have stopped or reversed 85 overdoses since the pop-up launched Aug. 12, with no deaths while the site was up and running from 4 p.m. to 10 p.m. each day. But they warn that the rate of overdoses is increasing, with 28 at the site in September and 43 in October, as the increasing contamination of the street drug supply with the super-powerful opioid fentanyl fuels the crisis.

"We would like to stay," pop-up site organizer Zoe Dodd said. "We are not going to abandon the people of Moss Park."

Ms. Dodd said that, even if some solution is found to allow for a legal supervised injection site near Moss Park, more pop-up sites, illegal or otherwise, are needed in other places across the city and the entire province as overdose deaths increase.

Governments, she said, should declare a state of emergency and simply allow people to skirt the law to save lives, pointing to moves made by the B.C. government. (The Ontario government has refused to declare a health emergency, saying legislation here is different and that such a declaration would not help.)

Toronto rushed to open its first legally approved supervised drug-use site in the summer near Yonge-Dundas Square, after the activists set up in Moss Park. Two more legal sites, one in a clinic in Leslieville and another near Queen and Bathurst streets, are set to open this fall. Advocates and health officials say the sites help prevent deaths by allowing drug users to shoot up with a nurse on hand who can intervene and administer the anti-overdose drug naloxone in the event of an overdose.

In an e-mailed statement late on Wednesday, Dr. Hoskins said he had already sent his formal approval for the Fred Victor site to Ottawa, and pledged to fully fund the facility.

The federal minister said she recognizes there is a public health crisis around opioids but that her government is not contemplating suspending the application process for the exemptions from drug laws needed to operate supervised drug-use sites.

"‎We are taking this matter extremely seriously," Ms. Petitpas Taylor said. "… We recognize that winter is fast approaching. And we want to ensure that clients, that individuals receive the treatment that they need."

Toronto is opening an interim safe-injection site as the city grapples with a string of overdoses and suspected overdose deaths. Toronto's medical officer of health says the interim site is a response to a need in the community.

The Canadian Press

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