Item - 2016.HL10.1

The Board of Health:

1.  Directed the Medical Officer of Health to participate in a coordinated community consultation with Queen West - Central Toronto Community Health Centre and South Riverdale Community Health Centre on the integration of supervised injection services into existing clinical health services; and

2.  Directed the Medical Officer of Health to report to the Board of Health at its July 2016 meeting on the outcome of community consultation and strategies that address any concerns related to the implementation of supervised injection services.

Injection drug use is associated with important health risks, including overdose and the transmission of blood borne diseases such as HIV and hepatitis. Supervised injection services have been implemented around the world to help reduce these and other health harms.

A supervised injection service (SIS) is a health service that provides a safe and hygienic environment where people can inject pre-obtained drugs under the supervision of trained staff. In Canada, nurses provide this supervision. In addition to reducing overdoses and the spread of infectious diseases they also increase access to other health and social services, and reduce public drug use and discarded needles. In 2012, the Toronto and Ottawa Supervised Consumption Assessment Study concluded that Toronto would benefit from multiple SISs that are integrated into existing health services already serving people who inject drugs. In 2013, the Board of Health approved a recommendation from the Medical Officer of Health supporting implementation of this integrated SIS model in Toronto.

Three health services in Toronto are planning to add small scale SIS to their existing clinical services to improve health outcomes for clients. These agencies are Toronto Public Health through The Works program, Queen West - Central Toronto Community Health Centre, and South Riverdale Community Health Centre. These organizations are well established in their communities and have been delivering harm reduction services to people who inject drugs for many years. They currently serve clients with high rates of injection drug use and associated high-risk behaviours (e.g., frequent injectors, incidence of overdose, public injection).

The addition of supervised injection to existing services in all three organizations is expected to improve health outcomes and reduce the community impact of injection drug use.

This report outlines the process for SIS implementation and seeks BOH support to begin stakeholder consultations, to meet federal requirements. Results of the consultations and next steps for this initiative will be reported to the BOH in July 2016.