Item - 2019.HL4.9

The Board of Health recommends that:

1.  City Council request the Province of Ontario to reinstate funding for supervised consumption services at Street Health and St. Stephen's Community House and to maintain funding for Toronto Public Health's The Works.

The Board of Health:

1.  Requested the Medical Officer of Health to engage with the Federal Government on support for supervised consumption services in Toronto.

The Medical Officer of Health gave a presentation on Opioid Poisoning Crisis Update.

The overdose crisis is the defining health issue of our time. In both our city and our province, the number of people dying from opioid overdoses continues to rise. Recent data from the Coroner shows that in 2017, 308 people in Toronto died from opioid overdoses. This represents a 66 percent increase from 2016, and a 125 percent increase from 2015. Preliminary data from the Coroner for the first nine months of 2018 there were 193 deaths from opioids. This number is expected to rise as cause of death is determined in more cases. Just last month, the city saw 22 people die from suspected opioid overdose, with over 450 additional paramedic calls for suspected non-fatal opioid overdoses, the most since Toronto Public Health began reporting this data in August 2017. The situation remains urgent, and we need to do everything possible to save lives.

Late last year, the provincial government introduced new regulations for supervised consumption services in Ontario, and announced a cap on the number of sites in the province of 21. Although there were concerns with the restrictive nature of the new Consumption and Treatment Service guidelines, the acknowledgement of the role of harm reduction services within the new framework was critical. At that time, the Board of Health formally requested that the Province maintain funding for all existing supervised injection and overdose prevention sites in the Toronto.

On the afternoon of March 29, without prior notice, the Provincial Government announced only 15 of the 21 supervised injection and overdose prevention sites in Ontario had been approved for funding under the new regulations. The six sites not approved include three in Toronto, and three in London and Ottawa. Two overdose prevention sites in our city - Street Health at Dundas and Sherbourne and St. Stephen's Community House – were informed their funding would end abruptly two days later, along with their legal ability to operate. The third Toronto site not formally approved – Toronto Public Health's The Works – was informed they were still under review.

Although emergency exemptions from the Federal Government were secured to ensure the continued legal operation of Street Health and St. Stephen's, both are currently operating using fundraising dollars alone. Without sustainable funding, it is possible these life-saving services could close.

The evidence is clear - supervised consumption sites save lives. At Toronto Public Health's The Works alone, there have been over 40,000 client visits and 750 overdoses reversed since they opened in August 2017 – and, demand only continues to increase. With less access to supervised consumption services, we will see more fatal overdoses in our city.

City Council has clearly articulated its support for evidence-based responses to the opioid overdose crisis, including harm reduction and supervised consumption services. In the midst of the most deadly public health crisis of our generation, we should be expanding life-saving services by opening new sites, not closing the ones we already have.