Such facilities could improve the health of drug users and reduce harm among them, 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.
Dr. Lynne Leonard of the Faculty of Medicine at the University of Ottawa collaborated closely as a Co-Investigator on the research, having received funding from the Canadian Institutes of Health Research and the Canadian Foundation for AIDS Research (CANFAR) to undertake an earlier feasibility study for a supervised injection facility in Ottawa. Dr. Leonard is an assistant professor, Department of Epidemiology and Community Medicine and Director of the HIV and Hepatitis C Prevention Research Team in the Faculty of Medicine and is also a Career Scientist with the Ontario HIV Treatment Network.
After four years of independent research, the researchers recommend 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 and how to proceed with their recommendations. They were not asked to recommend specific locations and have not done so.
However, if Toronto and Ottawa act, the researchers recommend multiple sites, not a central location like Insite in Vancouver. Drug use is dispersed in Ontario’s two largest cities, unlike in Vancouver, where it is concentrated in the Downtown Eastside. In addition, people who use drugs indicated that they did not want a single facility, which could become a focus of opposition. Community members consulted by the researchers also preferred multiple locations spread out across each city, to minimize the possible impact on local neighbourhoods.
The researchers note 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 injection sites exist in Europe and Australia.
Their report is believed to be the broadest study of its kind. It was funded by the Ontario HIV Treatment Network and the Canadian Institutes of Health Research. The 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 recommend 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.
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