Such facilities could improve the health and reduce harm among people who use drugs, and could also reduce public drug use, according to research led by Dr. Ahmed Bayoumi of St. Michael’s Hospital and Dr. Carol Strike of the University of Toronto.
After four years of independent research, they recommended the creation of three supervised injection facilities in Toronto and two in Ottawa.
“Using multiple sources of data, we projected that supervised injection facilities would prevent HIV and hepatitis C infections and result in meaningful health benefits for people who use drugs in Toronto and Ottawa,” Dr. Strike said.
“Our analyses also suggest that three supervised injection sites in Toronto and two in Ottawa are likely to represent good investments of health care dollars,” said Dr. Bayoumi.
The researchers stressed that it is up to the communities in both Ottawa and Toronto to decide if, when or how to proceed with their recommendations. They were not asked to recommend specific locations and have not done so.
However, if Toronto and Ottawa proceed, the researchers recommend multiple sites, not a single, central location like Insite in Vancouver. Drug use is dispersed in Ontario’s two largest cities, unlike Vancouver where it is concentrated in the Downtown Eastside. In addition, people who use drugs indicated they did not want a single facility that could become a focus of opposition. Community members consulted by the researchers also preferred multiple locations spread out across each city to minimize possible impacts on local neighbourhoods.
The researchers noted there has been a reduction in needle-sharing, drug overdoses and public drug injections since Insite opened in Vancouver in 2003. More than 90 supervised injections sites exist in Europe and Australia.
Dr. Bayoumi is a general internist and HIV physician at St. Michael’s, a health services researcher at the hospital’s Centre for Research on Inner City Health and an Associate Professor in the University of Toronto’s Faculty of Medicine. Dr. Strike is an associate professor in the Dalla Lana School of Public Health at the University of Toronto. She is an expert in the study of health and social services for marginalized populations, in particular people who use drugs.
Their report is believed to be the broadest study of its kind and was funded by the Ontario HIV Treatment Network and the Canadian Institutes of Health Research. Their research addresses the Toronto Drug Strategy, passed by Toronto City Council in 2005, which called for a needs assessment and feasibility study for supervised consumption sites. Dr. Bayoumi and Dr. Strike recommended only supervised injection sites, saying there is not enough evidence showing the value of supervised consumption sites where users would also be able to smoke drugs.
A full copy of the report of the Toronto and Ottawa Supervised Consumption Assessment is available at www.toscastudy.ca.
About St. Michael’s Hospital
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 23 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Center, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
About the University of Toronto Faculty of Medicine
The University of Toronto Faculty of Medicine is at the heart of one of the great biomedical research, education and clinical care networks in the world. With nine fully-affiliated hospitals and research institutes and 19 community-affiliated hospitals and clinical care sites, U of T Medicine is a research powerhouse that offers unparalleled opportunities for its 6,800 faculty and 7,000-plus students at all levels. Nearly half of Ontario’s medical doctors and fully 25 per cent of all health and biomedical PhDs in Canada were trained by U of T Medicine, which consistently ranks among the top medical schools worldwide.
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