Any solution to the numerous problems associated with the injection of illegal drugs is bound to be imperfect. In a perfect world, no one would be abusing intravenous drugs. But in the messier reality we inhabit, people are overdosing and dying in disturbing numbers while communities are degraded by the consequences of a look-away, not-my-problem approach to drug use.
Three health centres across downtown Toronto are planning to open supervised injection programs, providing what is described as a safe and hygienic environment where addicts can inject powerful, illegally obtained drugs such as heroin and fentanyl under a nurse's watchful eye. The City's medical officer of health is strongly supportive. So are others across the country. So is the federal government.
There is bound to be opposition to any health strategy that seems to condone and enable illicit drug use, particularly when integrated into a storefront neighbourhood setting. Supervised injections sites won't make drug abuse disappear. They may not even cut addiction rates. But they promise to cut the number of overdoses and deaths while reducing broader social and medical problems created by a more half-hearted engagement. They are harm reduction, which is possible, not harm elimination, which is not.
In 2013 in Toronto, 123 people died from accidental overdoses of opiates, a 300-per-cent increase since 2004. These numbers are likely to fall when drugs are taken in a controlled health-care environment. Once again, you needn't like the fact that people addicted to drugs are shooting heroin in a publicly supported setting to prefer a solution where they continue to live rather than die an unneeded death. The goal is not to normalize or celebrate heroin addiction. It is to keep users alive so they at least have a shot at treatment and overcoming their condition.
Supervised injection sites may also offer significant public benefits. New, sterile needles prevent the spread of hepatitis C and HIV, both of which are prevalent among intravenous drug users. It will also limit the danger of discarded needles in public places.
Last year in Toronto, 80 clinics gave out 1.9 million needles to addicts – and then told them to find somewhere else to shoot up. Does that sound like the best approach? A supervised injection site means fewer users discarding dirty syringes in restaurant washrooms, parks and alleyways. That's better for addicts and for society. This public health initiative deserves public support.