Injection Sites

The Ontario is undoubtedly in the midst of an opioid overdose crisis. From January to September 2018, an incredible 1,031 Ontarians died of an overdose. The number of deaths in the province is second only to the 1,155 deaths in British Columbia, dubbed the “ground zero” of the overdose epidemic in North America.

Yet with no signs of the crisis slowing down, the Ontario government announce in April that they would abruptly halt funding for several safe injection sites an unprecedented and dangerous step backwards in curtailing the public health emergency. Opioid use disorder (OUD) is one of the most challenging and dangerous forms of addiction facing the Canadian health-care system.

Stop using opioids

It is a chronic, lifelong illness that leads to severe withdrawal symptoms including vomiting, diarrhea, pain, anxiety and intense cravings when regular users abruptly stop using opioids. Because the symptoms are so intense; so it creates a strong motivation to continue using opioids to prevent withdrawal.

During my training as a family medicine resident they distinctly remember a patient telling me: “No words can describe how excruciating the withdrawal is. With an infiltration of cheaper; so highly potent opioids such as fentanyl and carfentanil into the illicit drug supply; hence patients using these drugs have been dying at unprecedented rates across Canada. The most recent statistics are mind-boggling: 10,300 Canadians have lost their lives between January 2016 and September 2018 alone.

In fact, a landmark 9–0 Supreme Court of Canada decision in 2011 rule; so that barring safe injection sites was unconstitutional as it deprive Canadians of life-saving medical care. With the robust data supporting the utility of SIS as an effective intervention in preventing overdose relate deaths, multiple provinces, including Ontario, have incorporate them as part of an overarching harm reduction strategy.

Proximity to one another

In cities such as Toronto, where many users live in close proximity to one another; so that means several safe injection sites are need within a small radius. In light of this, Doug Ford’s government is misguide in trying to trying to justify; so the elimination of funding simply because there are four sites within a kilometer in one neighborhood. This argument is in direct contravention of the latest evidence base best practise in preventing Canadians from dying.

Equally as important is battling the deep root stigma; so of SIS and supporting the marginalize populations they serve. The misconceptions that they promote drug use and increase criminal activity; so in the surrounding neighborhoods have long been dispelled. Drug users who visit safe injection sites also change their injection behaviors.

Controlling the “defining health crisis of our time” will require public policy makers; hence to understand the complexity of opioid use disorder and ongoing communication with front-line workers and patients caught in the grips of the disease. Currently, there is an isolated, unilateral and non-evidence base approach to harm reduction in Ontario. If this is not rectified, the consequences are clear: more preventable deaths and more devastation for Canadian families.