Political will around these parts shifts at roughly the speed of sludge in the Don River. Slower when it comes to the issue of drugs and harm reduction.Still, when the feds let it be known last fall that they were open to cities setting up their own safe injection sites for addicts, it was hoped that there would be more than a few takers. So far, only Vancouver is known to have signed on to the pilot project.
Local advocates of supervised drug injection, like the Toronto Harm Reduction Task Force, say the need is just as great here, where the estimate of 18,000 addicts rivals the number in Canada's drug capital.
A study by the Centre for Addiction and Mental Health showed that 10 per cent of Toronto's heroin addicts are HIV-positive. Problems are especially serious when it comes to homeless drug addicts.
According to the mayor's task force on homelessness, 50 per cent of street drug users surveyed tested positive for hepatitis C. These numbers are so alarming that the city's public health department, which currently administers needle exchange programs, supported the idea of safe injection sites in principle a few years ago.
"It's something we support as a concept," says Shaun Hopkins, manager of The Works. Hopkins says informal groundwork, including surveying addicts and getting legal advice on how the sites could be administered, is already being done.
Valerie Cartledge, an adviser to the Toronto Harm Reduction Task Force, says supervised sites could attract addicts to other assistance programs.
"I think you'd see a drop in hospital use. You'd see a drop in ODs. You'd see people connecting," she says.
The clinics would be small and located in existing outreach centres. Clients would go through a registration process, and their names would be kept confidential from the police. No one would be allowed to sell drugs on the premises.
Health Canada has signalled that the government would be willing to exempt staff and clients from anti-drug laws. People have talked about safe injection sites for years. They have long been reality in Amsterdam, Frankfurt, Zurich and other European cities. Barbara Hall floated the idea when she was mayor.
But more than a decade later, "There's no solid movement at City Hall to get it to happen," laments Cartledge.
Indeed, city council seems unlikely to touch the issue soon. Even lefty councillors behind the idea in principle offer only lukewarm support.
"I believe in harm reduction," says mayoral hopeful David Miller cautiously.
"If there's a need, we should do it," adds councillor Olivia Chow. "The research seems to say it's good."
So why isn't anything happening? "It's too hot an issue for council to handle," thinks councillor Chris Korwin-Kuczynski, an opponent of the supervised-injection approach.
A pilot project could happen if Toronto's public health department determines that addicts would use it and if city council approves it. But it would also need financial backing, and the provincial government is reluctant to chip in.
Last fall, Health Minister Tony Clement spoke out vehemently against the idea, insisting that it would never happen in his province. That would leave the ever cash-strapped city to pay for the whole project.
"The focus here is how do you stop people from this altogether," says John Letherby, a spokesperson for the provincial ministry.
Letherby insists that supervised drug injection sites don't work and that the only way to fight the effects of drugs is to keep educating children about them. "It's better to put in funding for prevention," he says.
Toronto police are also far from comfortable with the idea. While police don't make decisions on things like supervised drug sites, they would need to agree not to arrest addicts and medical staff at the clinics. According to Constable Shehara Valles, police are skeptical that supervised injection sites reduce crime and drug use -- even while they have come to support methadone clinics and needle exchanges.
Raffi Balian, an ex-heroin user now on methadone and the coordinator of COUNTERfit, a program that works to get drug addicts off the streets, says safe injection sites are inevitable.
"Not because there's any love for illicit drug use, but because it's necessary," he says. With mounting health care costs associated with addiction, Balian thinks the city soon won't be able to afford not to build the sites.
Politically, though, the idea of helping to reduce the spread of disease and the number of overdoses and to keep drug users alive long enough to get clean still has some way to go.