2 weeks Ago By Chris Selley
Ontario’s harm-reduction rollback is beginning in earnest. CUPE Local 79 says 33 full- and part-time employees at The Works , a supervised-injection site at Yonge-Dundas Square in Toronto, have received layoff notices in advance of the facility’s forthcoming closure in March — along with nine other such facilities ordered shut by Queen’s Park across the province. The Progressive Conservative government’s reasoning is a mixture of perfectly reasonable public-safety concerns and considerably more dubious ideas about what getting rid of them might do for public safety, and about the prospects for getting addicts into treatment.
“I get endless phone calls about needles being in the parks, needles being by the schools and the daycares, that’s unacceptable,” Ford said in August, justifying a ban on supervised injection sites within 200 metres of child-care facilities. “It’s a failed policy, simple as that” Ford argued. “We are making a better policy — $378 million to help these people, support them, get them back on their feet, get them a good-paying job.
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We don’t need to feed them drugs.” Ford, like many conservatives, sees it as a simple matter: Major Canadian cities adopted harm-reduction measures including supervised-injection sites; then, opioid overdoses and deaths, and the urban blight that comes with them, went through the roof; therefore harm-reduction measures must be at least partly responsible for it. Proponents of supervised-injection sites (such as myself) believe they can be a bulwark keeping things from getting even worse.
And they were around, after all, for years before the enormous rise in overdoses we saw across North America in 2020. The fact is, both sides of the argument tend to wildly overestimate the impact of these facilities. Consider the United States.
There are precisely two official supervised-injection sites operating in the country. Both opened in 2021 in New York City , which in 2023 saw the first decline in opioid-overdose deaths since the pandemic . It was a very slight decline, less than one per cent, but after a 105-per-cent increase since 2019, it came as a relief.
But then, overdose deaths in the U.S. outside New York City fell by four per cent, with no help from supervised-injection sites.
With supervised-injection sites still in action, Toronto’s mortality numbers seem to be plateauing: A record-high 592 confirmed opioid-overdose deaths in Toronto in 2021 dropped to 509 in 2022, but provisional numbers for 2023 suggest it rose again to 526. Outside of Toronto, alas, deaths rose in Ontario by five per cent — also with supervised-injection sites running in some cities. The best that can be said about British Columbia’s opioid-overdose numbers is that they’ve stopped spiking.
Alas, they’re still climbing: 2,594 in 2023, compared to just 806 in 2016. Also seeing record-high death tolls in 2023: Alberta, which has seven supervised-injection sites but is reconsidering their future ; New Brunswick, which has a single site in Moncton ; Nova Scotia, which has a single site in Halifax ; and Manitoba and Newfoundland, which have zero sites between them. Overall, Canada saw a nine per cent increase in opioid-overdose deaths in 2023 relative to 2022 — 128-per-cent more than in 2019.
The best argument for supervised-injection sites isn’t that they have a monumental effect on overall numbers. Canada’s and the United States’ rates of opioid overdose deaths are nearly identical: 24 per 100,000 south of the border, where harm reduction is still considered controversial , and 21 per 100,000 north of the border, where harm reduction is relatively well established. The best argument for supervised-injection sites is simply that lots of people overdose in them and don’t die.
There is no question these sites are correlated with crime and misery. It couldn’t really be otherwise, considering the model we use. Addicts still have to do horrible things to get money; they still have to buy their drugs from criminals; and the criminals will naturally go to the supervised-injection sites where the customers are .
.. and occasionally shoot at each other and kill an innocent passerby .
But The Works, in Toronto, is a great example of the central unanswered question. As much as addicts congregate at Yonge-Dundas Square because of The Works, they put The Works at Yonge-Dundas Square because addicts already congregated there. Walk past there any night and you will see a grotesque tableau of human misery.
They will be no less miserable, once the supervised-injection site closes, unless we haul them “back on their feet” and find them “good-paying jobs,” as Ford suggests — an unimpeachable goal, but a far bigger and more complicated job, with a much bigger failure rate, than the premier suggests. And I suspect the neighbourhood will be no more salubrious — unless, I suppose, The Works’ clients relocate to the supervised-injection sites that remain. If we’re going to back off harm reduction, let’s at least resolve to try to measure the results seriously.
The best way to do that would obviously be an ongoing study of what happens to safe-injection sites’ current clients once the facilities close. Assuming we actually want to know, not just make a problem disappear, that’s more than worth a tiny chunk of the promised $378 million. National Post cselley@postmedia.
com.
