The opioid epidemic regularly kills more than 100 Ontarians a month, so it’s good that the provincial government has decided not to make the problem any worse. On Monday morning, Minister of Health and Long-Term Care Christine Elliott announced that, notwithstanding Premier Doug Ford’s personal views on supervised-injection sites (he is very much opposed to them), the government would continue to fund Ontario’s 18 existing facilities and allow three that had been approved earlier in the year to open.
But that’s it: there will be just 21 sites for the whole province, meaning many areas will be underserved. One new site will open in Thunder Bay, a city whose overdose rate is more than twice the provincial average. It will be the first and only such facility in the entire north. Another will open in St. Catharines, and one more in Toronto. The government is apparently betting that these will be enough to handle the worsening epidemic.
The Tories insist, though, that the facilities are only one part of what will be a larger effort. On Monday, Elliott stressed to reporters at Queen’s Park that the new cap on supervised-injection sites is part of a broader plan that will include addiction treatment, greater spending on health care, and more housing options.
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“We have come to the conclusion we need to do more if we are going to put a stop to the opioid crisis in Ontario,” she said. “It’s one thing to stabilize with overdose prevention — that’s very important — but it’s also really important to make sure people can connect with the services they need when they make the decision they want to enter treatment and rehab.”
The Tories contend that the previous Liberal government put too much emphasis on harm reduction and not enough on the next steps: treatment and recovery. Their new policy is intended to provide better access to those services.
But the government also says it’s serious about constraining the provincial budget deficit — so what happens if its cap on provincially funded harm reduction never sees the promised funding follow-up?
“The province is setting itself up for a disaster,” says Gillian Kolla of the Toronto Overdose Prevention Society. “We need massive infusions into affordable housing. They’ve already cut the basic-income pilot; they’ve announced they’re slowing the minimum-wage hike ... Those are things that make a difference on the ground to people every day.”
She added, “Unless you address all the aspects of these multiple crises that are going on, you’re not going to see any positive outcome.”
Ontarians will get a better sense of how the government intends to balance its spending priorities in a few weeks, when Finance Minister Vic Fedeli presents the fall economic statement. But until then, how committed the Tories are to funding this week’s pledges will remain an open question.
It’s true that Ontario hasn’t been hit as hard by the opioid crisis as some western provinces have — Alberta, for example, had 200 opioid deaths between October and December 2017, while Ontario had 280, despite the fact that its population is three times larger — but advocates were quick to point out on Monday that the 21 safe-injection sites the Tories have approved won’t be sufficient to deal with the problem.
“I’m confident this is the beginning,” said Doris Grinspun, CEO of the Registered Nurses Association of Ontario. “Nurses will continue to advocate, as we have all along, that every single community that requires these sites receives not just the okay [from the government], but the funding.”
The government’s new policy doesn’t just cap the number of sites — it also imposes rules about reporting and community outreach. Sites, for example, will have to make more of an effort to ensure that they don’t disturb the local community (one facility in Toronto has been blamed for an increase in discarded needles around the neighbourhood.) In January, when the new policy kicks in, existing sites will have to reapply for provincial funding, although Kolla and Grinspun both said they were confident that providers would be able to meet the new standard.
Kolla warned, however, that the cap could lead to more opioid deaths in the future. “We’re losing the flexibility to respond to an emergency,” she said. “If we see there’s an emergency happening in one area of the province, and we’ve already hit the 21-site cap, then how exactly are we supposed to respond to that quickly? This is not the way a public-health crisis should be run.”