The Ford government gets it wrong on drugs

Posted on September 4, 2024 in Health Debates

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TheStar.com – Opinion/Editorials
Aug. 22, 2024.   By Star Editorial Board

We know that supervised consumption sites save lives, relieve pressure on the health system and, depending on how they are funded and run, actually can reduce public use and overdoses.

At first blush, the provincial government’s decision to ban supervised consumption sites within 200 metres of schools and child care centres seems to make some sense. Many in this city have expressed concern with what they see as a connection between these sites and a growing sense of unease on Toronto streets. Keeping supervised consumption sites away from schools may be wise, if only to restore public confidence and a sense of security.

But this decision is not just about keeping kids at a distance from drug use. It will lead to the shuttering of 10 of the 23 supervised consumption sites in the province, including five in Toronto. Crucially, the government says it will not fund any new such sites. The move therefore amounts to a significant change in how the province is responding to the twin crises of drug addiction and toxic supply. And on this, the evidence is not on the government’s side.

It’s true that studying illicit behaviour is notoriously difficult. Gathering evidence on supervised consumption sites is especially so given that they are relatively new and few. And in trying to find a solution to a social problem as complex as addiction, controlling variables can be hard. To what extent is this about treatment options, mental health services, housing or any number of other social ills or gaps in the social safety net?

But what we do know with confidence is that supervised consumption sites save lives, relieve pressure on the health system and, depending on how they are funded and run, actually can reduce public use and overdoses.

In announcing the decision, Ontario Health Minister Sylvia Jones said there’s no reason to expect the closure of these sites will lead to an uptick in overdose deaths. But statistics show that in the last year alone, workers at supervised consumption sites were able to reverse hundreds of overdoses which might well have been fatal had they taken place instead in bathrooms or public parks. A study in the prestigious medical journal The Lancet from earlier this year showed a marked decrease in fatal overdoses in Toronto neighbourhoods with safe consumption sites.

Jones also said that “continuing  to enable people to use drugs is not a pathway to treatment.” Yet there’s ample evidence, however counterintuitive, that supervised consumption sites provide just such a pathway, in part because they help to destigmatize addiction.

Clearly the imperative to protect users must be balanced with the need to keep neighbourhoods safe and preserve a sense of security. On this front, the province has too often fallen short. Last year, Karolina Huebner-Makurat was killed by a stray bullet as she passed by a supervised consumption on the city’s east side. For months, community members had been complaining of lax security at the facility. Huebner-Makurat’s murder was a tragic reminder that it matters how these sites are run and whether they are held to account. It matters how they are organized and resourced, their hours of operation, and the availability of detox and treatment options.

In response, amid growing public concern and still-rising overdose deaths, the province rightly ordered a review of supervised consumption sites. It is, as always, worth questioning the status quo.

But on what basis has the government concluded that these sites are doing more to aggravate than to mitigate the drug crisis? On what basis has it concluded that public use is more likely to fall and public safety to rise as these sites close? What, other than the political mood or the premier’s oft-stated personal distaste, led it to this decision? The answers to these questions are not apparent either in the government’s announcement or in the available evidence.

No doubt this is a complex challenge that requires the balancing of competing interests. As overdose deaths continue to rise, along with the unease on Toronto streets, it’s clear that something needs to change. The province announced on Tuesday that it would invest nearly $400 million in new treatment programs. That’s a step in the right direction. As we have argued before, affordable housing and mental health services are also important parts of the solution. And it is no doubt worth asking whether supervised consumption sites are in the right places, with the right resources and operating in the right ways.

But closing nearly half of them? That will cost lives, further strain an already overburdened health system, and may well lead to more public use and disorder, deepening the very unease this move is meant to address.

https://www.thestar.com/opinion/editorials/the-ford-government-gets-it-wrong-on-drugs/article_11a06680-5ff3-11ef-9ba2-6b5ec4d330ed.html

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