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Abdullah Shihipar is a Masters of Public Health candidate at the Brown University School of Public Health. Brandon D.L. Marshall is an associate professor of epidemiology at the Brown University School of Public Health.

From January to June, more than 2,000 Canadians died because of opioids, according to recently released national statistics – bringing the total count to more than 9,000 since the beginning of 2016. But mere numbers don’t capture the full scope of the opioid crisis in Canada. Each digit represents a person who was loved, and is now missed. People like Brad Chapman, who died after overdosing on the streets of Toronto in 2015 – before the city had any supervised consumption sites (SCS) for safer drug use. At a coroner’s inquest into his death last week, family, friends and front-line workers posed questions to Ontario’s Ministry of Health and Long Term Care about the province’s new regulations around supervised consumption sites. According to the activists, the ministry refused to comment.

Those new regulations allow the sites to continue operating but only after reapplying, and the total number of sites is capped at 21 with no new ones permitted. Front-line workers have warned that this will not only create more hurdles to their continued operation, but may also force some sites to shut down completely.

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It’s a move so fraught with problems that the federal government has effectively instituted an end-run around Ontario’s government, allowing sites to apply directly to Ottawa for approval instead.

By making access to such sites more difficult for vulnerable people, Ontario’s regulations could only make those dire statistics worse. These aren’t policies that harm in the abstract. They could actively cost lives.

Politicians may debate the merits of supervised consumption sites, but there is mounting evidence that they save lives. A study published in The Lancet compared overdose-related fatalities for two-year periods before and after the 2003 opening of Vancouver’s Insite – Canada’s first supervised consumption facility – and found a 35-per-cent decrease in fatal overdoses. According to Vancouver Coastal Health, which operates Insite, 2,151 overdoses occurred within their facilities last year, none of which were fatal. These sites do more than just prevent overdose. They also stem the spread of infectious diseases like HIV, and connect people who use drugs with medical and addiction treatment services.

Two of the new Ontario regulations in particular have the potential to cause great harm to existing facilities. One states that an SCS cannot be within 600 meters of another one, while a second states they cannot be in operation near a university.

This would affect two Toronto sites in high-need downtown locations, both of which have prevented hundreds of overdose deaths in the past year. But these facilities have also faced a backlash due to perceived increases in crime and drug-dealing activity – even though police data for the SCS near one of those locations, Toronto’s Moss Park, shows a drop in offences from 713 in 2016 to 680 in 2017, the year the site opened. Similarly, a previous analysis of the Insite facility showed that there was no increase in drug-related crime after the facility opened.

A number of cost-benefit analysis studies have shown Insite has saved B.C. millions due to prevented deaths and infections of HIV and other diseases – not that a dollar amount could ever truly be put on a life.

The federal government’s site-approval workaround is a helpful step, but it also exposes a deeper, systemic problem. Seventeen people a day are hospitalized with opioid-related poisonings. SCS front-line workers – who endure stress and trauma in these volunteer roles – deserve the same benefits and support that other emergency medical personnel receive. Overdose hospitalization rates were 2.5 times higher in towns with 50,000 to 100,000 people than they were in larger cities. If governments want real, lasting solutions that address the sheer scale and growing scope of the crisis, they need to come together to make that happen through concrete government funding.

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This is a time for expansion of life-saving services, not a cap. According to 2017 data, only two of 10 areas with the highest rate of overdose-related fatalities have supervised consumption facilities. In Toronto alone, an unsanctioned site sprung up in the Church-Wellesley Village because of high overdose rates in the area.

No, supervised consumption sites are not a panacea to all opioid-related problems. But it’s difficult to deny their positive impact on those struggling with addiction. Government inaction and infighting has exacerbated the crisis, but that need not – and cannot – be the case going forward.

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