CATIE calls for a hold on closing Ontario supervised consumption sites

August 21, 2024

CATIE, Canada’s source for HIV and hepatitis C information, calls for a pause on the Ontario government’s plan to close 10 supervised consumption sites across the province until a concrete plan is implemented to meet the demand for these life-saving services.

“Seven Ontarians die every day because of the toxic drug supply,” said Jody Jollimore, executive director of CATIE. “These sites are the only places where people can consume their drugs under the supervision of health professionals trained to reverse overdoses.”

On Tuesday, the Government of Ontario issued an ultimatum to 10 supervised consumption sites – five in Toronto and one each in Ottawa, Kitchener, Thunder Bay, Hamilton and Guelph – to either transform these services into abstinence-only treatment facilities with no harm reduction options, or to close their doors.

“If these services close down,” Jollimore added, “people will use their drugs elsewhere – in parks, public washrooms or at home, where they will die if they overdose alone. These closures will lead to more needles in public spaces, more 911 calls, more clogged hospital emergency rooms and increased costs to our health system.”

Supervised consumption services allow people to use their drugs under the supervision of health professionals, who are trained to prevent and respond to overdoses. An estimated 361,000 Canadians visited supervised consumption services 4.3 million times between 2017 and June 2023. During this time, frontline workers reversed about 49,000 overdoses and drug-related medical emergencies on site.

Under the government’s plan, sites that transform themselves into abstinence-only treatment facilities would not be allowed to offer needle exchange programs. Needle exchanges allow people who use drugs to access sterile needles and syringes, preventing the spread of HIV and hepatitis C. They also allow service users to return their used equipment for safe disposal, keeping their communities clean and safe.

All of these harm reduction services have been established in neighbourhoods where the need is high, and where health services for people who use drugs and other marginalized communities have been long established, going back decades.

“At the end of the day, what really matters is that people are safe. That includes people who use drugs, as well as their neighbours who don’t want to see needles and syringes in public spaces,” said Jollimore. “If the government thinks there are better places for these services, let’s see a workable relocation plan. Until then, these closures must be put on hold or people will die and communities will become less safe.”

Facts:

  • People who access supervised consumption services are 69% less likely to share needles and syringes compared to those who do not use the services1,2,3,4
  • Use of supervised consumption services is associated with less public and outdoor injection, less needle reuse and safe disposal of used injecting equipment5,6
  • Providing sterile injecting equipment is associated with reductions in injecting risk behaviours and reduced HIV transmission rates7,8,9
  • Establishment of supervised consumption services is associated with reductions in opioid-related emergency department visits and ambulance calls1,2
  • Supervised consumption services increase referrals to and uptake of substance use treatment programs such as detoxification and opioid substitution therapy1,2
  • Supervised consumption services reduce public drug use and discarded injection equipment1,2
  • Research conducted in multiple cities has demonstrated that supervised consumption services are not associated with increases in crime in surrounding neighbourhoods10,3,11

For more information, contact media@catie.ca

CATIE is Canada’s source for HIV and hepatitis C information. We strengthen Canada’s response to HIV and hepatitis C by bridging research and practice. We connect healthcare and community-based service providers with the latest science, and promote good practices for prevention, testing, treatment and harm reduction programs. As Canada’s knowledge broker for HIV, hepatitis C, sexual health and harm reduction, you can count on us for up-to-date, accurate and unbiased information.

References

  1. Milloy MJ, Wood E. Emerging role of supervised injecting facilities in human immunodeficiency virus prevention. Addiction. 2009;104:620-621.
  2. Kerr T, Tyndall M, Li K, et al. Safer injection facility use and syringe sharing in injection drug users. Lancet. 2005;366:316-318.
  3. Wood E, Tyndall MW, Stoltz J, et al. Factors associated with syringe sharing among users of a medically supervised safer injecting facility. American Journal of Infectious Diseases. 2005;1(1):50-54.
  4. Bravo MJ, Royuela L, De la Fuente L, et al. Use of supervised injection facilities and injection risk behaviours among young drug injectors. Addiction. 2009 Apr;104(4):614-619.
  5. Kennedy MC, Karamouzian M, Kerr T. Public health and public order outcomes associated with supervised drug consumption facilities: a systematic review. Current HIV/AIDS Report. 2017 Oct;14(5):161-183.
  6. Potier C, Laprévote V, Dubois-Arber F, et al. Supervised injection services: What has been demonstrated? A systematic literature review. Drug and Alcohol Dependence. 2014;145:48-68.
  7. Strike C, Watson TM, Gohil H, et al. The Best Practice Recommendations for Canadian Harm Reduction Programs that Provide Service to People Who Use Drugs and are at Risk for HIV, HCV, and Other Harms: Part 2. Toronto, ON: Working Group on Best Practice for Harm Reduction Programs in Canada. 2015.
  8. Gibson DR, Flynn NM, Perales D. Effectiveness of syringe exchange programs in reducing HIV risk behavior and HIV seroconversion among injecting drug users. AIDS. 2001;15:1329-1341.
  9. Aspinall EJ, Nambiar D, Goldberg DJ, et al. Are needle and syringe programmes associated with a reduction in HIV transmission among people who inject drugs: A systematic review and meta-analysis. International Journal of Epidemiology. 2014;43(1):235–248.
  10. Freeman K, Jones C, Weatherburn D, Rutter S, Spooner C, Donnelly N. The impact of the Sydney Medically Supervised Injecting Centre (MSIC) on crime. Drug Alcohol Rev. 2005 Mar 1;24(2):173–84.
  11. Chalfin, A., del Pozo, B., & Mitre-Becerril, D. (2023). Overdose Prevention Centers, Crime, and Disorder in New York City. JAMA Network Open, E2342228.