legrandangle-lgm

Article content

The rollback of harm reduction in Ontario begins in earnest. CUPE Local 79 says 33 full- and part-time employees at The Worksa supervised injection site in Toronto’s Yonge-Dundas Square, has received layoff notices ahead of the facility’s upcoming closure in March — along with nine other such facilities closed by Queen’s Park across the province.

Article content

Article content

Article content

The Progressive Conservative government’s reasoning is a mix of perfectly reasonable concerns about public safety and considerably more dubious ideas about what getting rid of it might mean for public safety, and about the prospects of getting addicts into treatment.

“I get endless calls about needles in the parks, about needles at schools and daycares, it’s unacceptable,” Ford said in August, justifying a ban on supervised injection sites within 200 yards of childcare facilities.

“It’s a failed policy, plain and simple,” Ford argued. “We are making a better policy: $378 million to help these people, support them, get them back on their feet and get them a well-paying job. … We don’t have to give them any medicine.”

Ford, like many conservatives, sees it as a simple matter: Major Canadian cities have implemented 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 should be at least partially responsible for this.

Article content

Article content

Proponents of supervised injection sites (like myself) believe they can be a bulwark to prevent the situation from getting worse. And after all, they had been around for years for the massive increase in overdoses we saw in North America in 2020. The fact is that both sides of the argument tend to vastly overestimate the impact of these facilities.

Consider the United States. There are exactly two official supervised injection sites in the country. Both opened in New York City in 2021, where 2023 saw the first decline in opioid overdose deaths since the pandemic. It was a very slight decline, less than one percent, but after a 105 percent increase since 2019, it came as a relief.

But then, overdose deaths in the US outside New York City decreased by four percent, without the help of supervised injection sites.

With supervised injection sites still operating, death rates in Toronto appear to be reaching a plateau: a record high of 592 confirmed opioid overdose deaths in Toronto in 2021 fell to 509 in 2022, but preliminary figures for 2023 indicate that it will resume has risen to 526. In Toronto, the number of deaths in Ontario has unfortunately increased by five percent – ​​also because supervised injection sites are operating in some cities.

Article content

The best that can be said about opioid overdose rates in British Columbia is that they are no longer rising. Unfortunately, they are still rising: 2,594 in 2023, compared to only 806 in 2016.

The death toll is also record high in 2023: Alberta, which has seven supervised injection sites but reconsiders their future; New Brunswick, which has one location in Moncton; Nova Scotia, which has one location in Halifax; and Manitoba and Newfoundland, which have no locations between them. Overall, Canada saw a nine per cent increase in opioid overdose deaths in 2023 compared to 2022 – 128 per cent more than in 2019.

The best argument for supervised injection sites is not that they have a monumental effect on overall numbers. The rate of opioid overdose deaths in Canada and the United States is nearly identical: 24 per 100,000 south of the border, where harm reduction is still considered controversialand 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 many people overdose there and don’t die. There is no doubt that these sites are linked to crime and misery. There really is no other way, given the model we use. Addicts still have to do terrible things to get money; they still have to buy their drugs from criminals; and the criminals will of course go to the supervised injection sites where the customers are… and occasionally shoot each other and kill an innocent passerby.

Article content

But The Works in Toronto is a good example of the central unanswered question. Just as addicts congregate in Yonge-Dundas Square because of The Works, they put The Works in Yonge-Dundas Square because addicts already congregated there.

If you walk past there every evening, you will see a grotesque scene of human misery. They won’t be any less miserable once the supervised injection site closes unless we get them “back on their feet” and find them “well-paying jobs,” as Ford suggests—an undeniable goal, but a much bigger and more complicated one. job, with a much higher failure rate than the Prime Minister suggests. And I suspect the neighborhood won’t be any healthier—unless, I assume, The Works’ clients move to the supervised injection sites.

If we want to stop harm reduction, let’s at least try to seriously measure the results. Obviously, the best way to do that would be an ongoing investigation into what happens to current customers of safe injection sites once the facilities close. Assuming we really want to know, and not just make a problem go away, that’s worth more than a small portion of the $378 million promised.

National Post
[email protected]

Article content