Update: a number of petitions have sprung up in support of safe injection sites in Toronto, like this Change.org petition for Toronto city council and this Leslieville-specific petition.
Overdose deaths, at levels in Toronto which surpass even motor vehicle deaths, are an epidemic: 206 in 2013, and growing every year. And we are responsible. All of us.
Counterproductive laws, inaccurate information, misguided leadership, institutional stigmatization, fear … all play roles in keeping drug overdose deaths high in all populations, not just street persons.
Safe injection services is one important way of addressing the problem. This morning, the Toronto Board of Health will issue a report recommending the establishment of safe injection sites. The issue will be considered at the Board of Health’s next meeting March 21. They are not a new idea.
In the mid 1990s, the Goethe Institut brought a large delegation from Frankfurt, Toronto’s sister city, to share its success in addressing its open intravenous drug scene, one of the most deadly in all Europe.
One tactic they employed was to set up sites where people could inject their drugs in a clean, well-lighted place, with new equipment and a knowledgeable staff to help out in case of emergencies. Alas, Toronto wasn’t ready to do anything different about its drug problem, and we have seen the results of that missed opportunity year in and year out.
We cannot miss the opportunity now. There is too much need and too much evidence that these services are successful.
There are more than 90 supervised injection service facilities around the world, including two in Vancouver. More in Canada are coming. The research is clear they improve the health of those who use drugs and the quality of life of the surrounding community.
As an ethnographer, I have had the opportunity to observe people in Toronto injecting crack cocaine. Remaining an objective observer was impossible. I struggled to keep tears and anger at bay.
Using drugs desperately, covertly and under duress is a matter for people without homes or safe places to use, and shooting up in laneways, abandoned building, parks, garages, janitors’ cupboards, washrooms, etc., does not provide safety. No wonder there are so many illnesses and deaths. That said, the people I observed wanted to be safe, and they did their best to protect the safety of their partners and friends.
Not everyone who uses drugs is addicted, but many feel they cannot live without them. They use them for a variety of reasons. However, as long as the drugs they use have questionable levels of strength and purity, overdoses and damage to health are inevitable. The war no drugs has failed. It has, in fact, made things worse for everyone. It’s time for another approach, and supervised safe injection services offer us that opportunity.
Will they increase drug use, crime, illnesses? No. They have not done this anywhere else they have been tried. What they can offer is a place where people who have been pushed to the edges can connect with dedicated healthcare workers.
In the mid 1980s, I had the opportunity to accompany a street outreach worker in Calgary handing out condoms to women working in the sex trade. We struck up a conversation with a local minister who was helping out. Alas, my inner wise-ass asserted itself. I decided to ask how he, a man of the cloth, could be openly condoning a “sinful” activity. He told me it was more important to him to keep the women alive now so he could save their souls later. He had given me my first real lesson in harm reduction, one which has guided me ever since. Harm reduction is not just about the now but about the future.
Safe injection services in Toronto can save lives now. Working to help the living is full of possibilities, but it is impossible to help those who are dead.
Walter Cavalieri is director of the Canadian Harm Reduction Network.
