“A lot more people are going to die.”
This was the dire prediction oft-repeated back in March by a busload of lawyers who supported a legal challenge filed by an injection site in Toronto that claimed recent Ontario legislation forcing the closure of sites within 200 metres of schools and daycare facilities violates the Charter rights of drug users.
The two expert witnesses for that site, in the Kensington neighbourhood of Toronto, are employed by the
MAP Centre for Urban Health Solutions
, a hospital-run research centre. MAP had played a key role in the establishment of the city’s first injection sites in 2017. Dr. Ahmed Bayoumi and Dr. Dan Werb both submitted evidence that overdose deaths in Toronto would increase sharply if half of the city’s ten injection sites closed at the end of March because of the legislation.
Fred Fischer, a lawyer representing Toronto’s Board of Health, one of the intervenor groups in the case, also told Justice John Callaghan of the Ontario Superior Court that reducing harm reduction services in Toronto during the ongoing opioid crisis would have severe consequences —
more people will overdose and die
.
A lawyer for another intervenor, a harm reduction coalition, put an even finer point on it. He said that one of the Toronto injection sites not affected by the legislation was anticipating such an immediate and overwhelming increase in overdose deaths in April, after the closures, that the site was in the process of hiring grief counsellors for its staff.
More than two months have passed since then, and now that we’re in June, you might be wondering: How many more people ended up dying because of the closure of these sites?
According to
that’s compiled by Toronto Paramedic Services and Toronto Public Health, the answer, so far, is none. In fact, the number of overdoses in Toronto for the month of April, the first month after the sites had closed, dropped notably.
Toronto had 13 fatal overdose calls in April, one less than in March, when the now-closed injection sites were still open. Thirteen is less than half the number of fatal overdoses across the city in April of last year, and significantly below the monthly average for all of 2024 (19).
Thirteen fatal overdoses are far lower than the average monthly number during the period of Covid-19 emergency between April 2020 and May 2023 (25). The last time 13 was the norm for monthly fatal overdoses was prior to the pandemic.
The number of calls for non-fatal overdoses in April was 161. This may sound like a lot but it’s the lowest monthly total so far this year in Toronto. And 161 non-fatal overdoses are 55 per cent less than the 359 that occurred in April of 2024.
Remarkably, in the third week of April, there were zero fatal overdose calls, something that hasn’t happened in Toronto in months.
Of course, this data has barely been reported on, but I can assure that had overdoses gone up in April, even slightly, outlets such as the Toronto Star and other habitual defenders of injection sites would have run we-told-you-so pieces by now.
While this data was being released at the end of May, an injection site in the Sandy Hill neighbourhood of Ottawa was waiting to find out if Health Canada was going to be renewing its federal drug law exemption (required to operate). I wrote
about how Health Canada had only renewed the site’s exemption for one month at the end of April. Having received a letter from a prominent community group that was now withdrawing its support for the site, and with a newly elected federal government that has been decidedly opaque on the controversies surrounding injection sites, Health Canada bought itself a little more time.
Since that column, however, the campaign opposing the renewal of the Sandy Hill site’s exemption intensified. The new federal health minister, Marjorie Michel, was the recipient of many such letters, including one from a local daycare operator.
Then, on May 23, Minister Michel received a two-page letter from a heavy hitter, Ottawa’s chief of police, Eric Stubbs.
Stubbs, who has supported harm reduction, this time came to the aid of the community group, Action Sandy Hill, and Sandy Hill Daycare, whose letters had preceded his. The chief emphasized that his frontline officers in Sandy Hill “consistently report that their workload is heavily influenced and consumed by drug-related crimes, mental health crises and social disorder.”
The impact of the site on the surrounding community, wrote Stubbs, “cannot be overlooked.”
He added that his police force was “especially troubled by the unintended but serious consequences, such as the closure of nearby childcare facilities due to safety concerns, a situation that is without precedence in our city.”
Stubbs pleaded with the minister and Health Canada to “revisit the operational model of the site.” It appears that may be what’s happening.
On May 30, Health Canada informed the Sandy Hill site that it was renewing its exemption for six months. This is hardly a ringing endorsement. Another injection site in Ottawa,
facing equally vocal community opposition
, had its exemption renewed for five years last fall under the Trudeau government.
There are clear signs across the country that the disproportional focus on harm reduction from the Trudeau era is being reconsidered. So is the argument posited by some activists that the
only solution to drug encampments is more housing
.
In a recent Globe and Mail
about the open-air drug market on Victoria, B.C.’s Pandora Avenue, a local housing non-profit said that many of the street’s inhabitants turned down supportive units it had opened for them.
A sergeant with the local force called the population “unhousable.”
“This isn’t a housing issue,” said another Victoria officer. “It’s a drug issue. And it’s a mental health issue. People need off-ramps: treatment, long-term care. But we don’t offer them any of that.”
And just in case you don’t think police have the expertise to speak about such matters, Julian Daly, the CEO of a homeless shelter in Victoria called Our Place, advocates for involuntary care, which he says is long overdue: “There is a very small group of people on Pandora Avenue who will frankly need some sort of institutional care for the rest of their lives. They will not be able to go back into mainstream society and be safe and healthy.”
Next week, under Dr. Daniel Vigo, B.C.’s chief scientific advisor for psychiatry, toxic drugs and concurrent disorders, the province is opening
18 beds at a new mental health facility
in Metro Vancouver dedicated to long-term involuntary care. Vigo says these beds will go to patients who are “stuck in high-security hospital units indeterminately” because of a lack of other options.
Marjorie Michel, the health minister, had a
to the news, saying that forcing fentanyl addicts into treatment isn’t the answer because clear supporting evidence doesn’t exist yet. What the minister’s position doesn’t acknowledge, however, is that a growing number of street fentanyl users suffer from irreversible brain damage so severe they are unable to adequately care for themselves. They may never be able to.
Pointing to a lack of evidence about involuntary treatment for those without debilitating brain injuries while ignoring evidence about the hundreds, if not thousands, of those who will never recover from the neurological trauma opioids have caused, is short-sighted to say the least. Vigo is right to pursue more treatment options for those who want it while at the same time doing what’s compassionate for those who can’t care for themselves.
National Post
