Doug Ford needs to follow the evidence on supervised consumption
Posted on November 28, 2024 in Inclusion Delivery System
Source: TheStar.com — Authors: John Tory
TheStar.com – Opinion/Contributors
Nov. 27, 2024. By John Tory, Contributor
I have devoted much of my life to public service, and to a city I love deeply. Holding the office of mayor in Toronto was my greatest honour and greatest challenge. I know there are no simple solutions in governance, including to public health crises like the COVID-19 pandemic or the crisis ravaging the province of Ontario today: opioid addiction.
But I also know that the shortest path to progress is paved with evidence — and a strong comprehensive plan.
It is on this point that the provincial government’s current strategy, and its newly introduced legislation to tackle the opioid crisis, would benefit from further refinement and additional investment.
Premier Doug Ford should be commended for trying to improve the lives of Ontarians battling addiction. His recent announcement to invest $378 million into 19 new “Homelessness and Addiction Recovery Treatment” (HART) centres is a good start. These HART Hubs aim to provide valuable abstinence-focused services to those who seek them, accompanied by several hundred supportive housing units.
But while the HART hub plan offers us a path to a solution, it is an incomplete path.
Evidence shows that an abstinence-only approach to addiction doesn’t work for everyone, and without a wide range of services, these hubs will likely fall dangerously short of meeting the needs of our loved ones dealing with addiction.
Consider the fact that every year, the supervised consumption sites being slated for closure in Ontario receive nearly 20,000 unique visitors. Now consider that the provincial government’s proposed HART initiative will build just 19 hubs province wide, with less than 400 new units of supportive housing overall. There are 444 municipalities in Ontario and just 19 proposed hubs in a province facing a deadly toxic drug crisis. That’s simply not enough support to go around, especially in a major city like Toronto.
It’s admirable that premier Ford has recognized the need for wraparound services, but for these services to work on a large scale, the province must also invest in them on a large scale. That means more hubs, more supportive housing, and substantially more treatment options.
Ontarians facing addiction challenges are often chronically homeless or at risk of becoming homeless. Yet it is often only when people have a roof over their heads that they are able to seek treatment and stick with it.
In other words, we must meet people where they are, not where we wish them to be.
This same principle holds true when it comes to needle exchange programs and other harm reduction efforts, which the province’s new plan seeks to curtail if not eliminate. To address Ontario’s opioid crisis, we must offer diverse treatment options, including in correctional facilities, as has been successfully achieved in Alberta.
Indeed, some harm reduction models exist in other parts of Canada where an abstinence focused treatment model is also in place. This is because harm reduction doesn’t simply prevent overdoses and infectious diseases; it eases pressure on Emergency Response Services and our crowded ER’s.
It’s clear Premier Ford is going to bat for residents who are concerned about the impact of harm reduction on their own neighbourhoods. I will be the first to say that all residents deserve to live in peace and security.
However, community safety is not a zero-sum game. It is possible to keep our neighbourhoods safe and clean while implementing comprehensive treatment services that save lives — even if it means moving those services to more appropriate locations and improving the way we deliver them. Our efforts must be focused on combatting addiction, not each other.
There is no one-size-fits all approach to the opioid crisis. This is why I am urging the provincial government to invite all community stakeholders in the addiction treatment space to sit at the table when it designs the HART Hub program. Premier Ford has an opportunity to make a big difference in the lives of Ontarians. But to do it he has to think big and invest big to meet the needs of vulnerable people.
There is no simple solution to the toxic drug crisis. But I know this: there will be no lasting solution in the absence of a collaborative, evidence-based approach.
John Tory was mayor of Toronto from 2014 to 2023.
https://www.thestar.com/opinion/contributors/john-tory-doug-ford-needs-to-follow-the-evidence-on-supervised-consumption/article_b691685e-ac21-11ef-abb6-fbaad9b1ad9b.html?source=newsletter&utm_content=a06&utm_source=ts_nl&utm_medium=email&utm_email=0C810E7AE4E7C3CEB3816076F6F9881B&utm_campaign=top_5940
Tags: budget, crime prevention, Health, ideology, jurisdiction, pharmaceutical
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One Response to “Doug Ford needs to follow the evidence on supervised consumption”
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As much as I appreciate gubernatorial candour, “further refinement and additional investment” is so far off the map that there isn’t a good place to start a reply. So instead, let’s start from 2018 when Ontario Health released Doug Ford’s ostensible Substance Use Prevention and Harm Reduction Guideline, which includes popular headings like “Infectious and Communicable Diseases Prevention and Control,” “Create Supportive Environment” (which includes collaborating with local partners), “Reducing Stigma,” “Assessment of Risk and Protective Factors” (which recognizes different risk factors and personal characteristics that increase the potential harms related to substance use, it includes stigma as one of those factors), “Harm Reduction”, and “Distribution of Harm Reduction Supplies” (which recognizes that the “distribution of needles/syringes and other drug supplies has proven to be an effective method of reducing blood-borne infections..)
Doug Ford does not need to “follow the Evidence”; Doug Ford needs to not ignore the evidence. With that being said, the “current strategy… would benefit from further refinement” is an interesting way of saying “current strategy… would benefit from not condemning people to sickness and death.”
Doug Ford knows that abstinence doesn’t work for everyone, and what’s worse is that Doug Ford knows that people are going to die; what Doug Ford has done is decide who does and does not deserve to suffer.
Let us, for a moment, focus on community safety; this is an essential factor in any decision. However, consider why supervised consumption sites (SCS) are where they are. The choice is not arbitrary. We know that travel for people who use drugs (PWUD) is not always easy. SCS are where they are because that’s where PWUD are, and removing an SCS does not remove PWUD. Do not worry; the coalition of Ontario Big City Mayors (OBCM) will request, with such timely bravado, that we do something about PWUD in public! Without SCS, then what option is left? Forced treatment, of course! It’s too bad that the Charter of Rights and Freedoms and the Ontario Health Care Consent Act (HCCA) exist. Let’s also not forget that the notwithstanding clause is a political time bomb! So, instead, the OBCM has requested amendments to the Mental Health Act, which would also require amendments to the HCCA; what… could… possibly… go… wrong…? Involuntary treatment in abstinence-based-only programs? I’m sure I don’t have to remind anyone that the most likely time for someone to overdose is after they’ve been sober and go back to using a substance. It might not be criminally negligible to knowingly leave someone in a position where their next decision might be their last if there were places that this person could go where the chances of death were near zero. However, hope for the best, be damned the rest…
I can admire the political tone a politician uses to paint public responses, but it is wildly unjustified when people in our communities face life-and-death situations.
There may be no simple solutions, but there are heartless decisions in the light of known facts.