Toronto neighbourhoods that are home to a supervised consumption services (SCS) are seeing significantly fewer fatal drug overdoses than they were before the service opened, a new study has found.
In February, The Lancet published a nine-page study that found fatal overdoses declined by 67 per cent within 500 metres of locations offering this kind of harm reduction program.
That figure rose slightly to 60 per cent within a five-kilometre radius of the nine SCS sites analyzed in the study, lead author Indhu Rammohan, a research assistant at the Centre on Drug Policy Evaluation, told CP24 on Tuesday evening.
The study examined 787 fatal overdoses between May 1, 2017 and Dec. 31, 2019, in the vicinity of programs at 139 Jarvis St., 134 Sherbourne St., 168 Bathurst St., 1229 Queen St. W., 465 Dundas St. E., 955 Queen St. E., 338 Dundas St. E., 260 Augusta Ave., and 277 Victoria St.
“We found that there was an association between the implementation of these sites and a reduction in overdose deaths in areas surrounding the sites,” Rammohan said, adding that while it is widely known that supervised consumption services are effective in preventing deaths on site, there are gaps when it comes to knowing the impacts they have on fatal overdoses in the neighbourhoods they’re located in.
“You know, no one has ever died from an overdose at one of these sites, but we were interested in looking at if there were additional impacts in the communities in which they were located.”
Supervised consumption services, or Consumption and Treatment Services (CTS) as they’re called when funded by the provincial government, require Health Canada’s approval and only open in communities where they are most needed, especially where drug consumption and overdoses are elevated.
“So it is in these neighbourhoods that we would be expecting to see increases, particularly in the current fentanyl era, the overdose crisis. And so to see a reduction in those neighborhoods, specifically, surrounding this site was pretty significant,” she said.
Rammohan noted, however, that the study’s authors aren’t necessarily inferring that the existence of supervised consumption programs in these neighbourhoods is the reason why overdose mortalities are lower.
“But we can say that something did change in those surrounding neighbourhoods, after the sites were implemented, in a time when we would expect there to be an increase (in fatal drug overdoses) in those areas,” she said, adding it is notable that these programs are often located within, or near, what might be considered a local harm reduction hub.
“They're in Toronto, typically co-located or integrated with community health centres, so they offer linkages to health and social services. They facilitate naloxone distribution into the community. They provide a sense of community and safety,” Rammohan said.
“There are a lot of additional services associated with these sites that can have sort of far-reaching effects in the community, and that was sort of the idea that we were following with taking on the study thinking, there are so many ways that these sites can impact positively impact communities in terms of overdose prevention. So let's see if we can see any association with those effects in the community.”
The report’s lead author went on to say that supervised consumption is an essential service, as it’s “one of the best ways that we can directly prevent overdose deaths.”
“So in that way, they're one of the best things that we can have in the midst of the overdose crisis, but I think that also means that these services need to be sustainable, and for them to be sustainable in the communities that we've put them in we need to have the people living in those communities to be on board with these sites,” she said.
Reality on the ground matches study's findings
Dayn Kent, the manager of Regent Park Community Health Centre’s CTS, said the report’s findings reflect what he’s now seeing on the ground.
“It makes sense to see this decrease in overdose deaths in and around those boundaries […] People will use these sites if they’re accessible to them, and if they’re too far away, they may choose to use alone or someplace else,” he told CP24.com, adding, on average, people who use drugs will walk a maximum of 15 minutes to consume their substances safely.
Kent went on to say that supervised consumption services contribute to making neighbourhoods feel “safer” as people who use them are using drugs under the care of trained professionals, while also connecting with the local resources and supports they need.
“The supervised consumption model is about stopping people from dying, but we actually become someone who is trusted by that community and they ask us for help and referrals,” he said.
“The actual value of the CTS program is preventative healthcare versus reactive healthcare. People come to us and talk frankly about their substance use, where they’re at, and the solutions that work for them.”
Without programs like this, more people will surely die of a drug overdose in the community, he said.
“Every overdose (at) any (supervised consumption) site reverses (what) would likely be a death if it was outside,” Kent said, adding in some cases, there aren’t ambulances immediately available to respond to a person who is experiencing an overdosing, not to mention lengthy emergency room wait times.
At this time, there are 10 supervised consumption programs in Toronto, all of which are south of Bloor Street. The most recent one opened at Casey House in April 2022.
Last October, Ontario’s associate minister of mental health and addictions Michael Tibollo announced that approvals of new supervised consumption sites have been put on hold pending a review of 17 locations across the province.
Kent said that the situation Toronto and communities across the country are facing isn’t actually due to more people consuming drugs, but is the result of a more toxic and unpredictable drug supply.
He added that putting in place policies, like low-barrier safe supply programs, that effectively address Canada’s drug crisis would mean that people won’t find themselves and their communities in unsafe situations.
“100 per cent, no one wants daylight shootings, but Canada’s drug framework is adding that risk,” Kent said.
Class action lawsuit against a CTS in Toronto’s east end
This new report comes as a proposed class-action lawsuit is being launched against the South Riverdale Community Health Centre (SRCHC), which operates a supervised consumption program called keepSIX.
The lawsuit’s claimants, Riverdale resident Jacqueline Court and local business JSCS, say that SRCHC, the provincial government, and the City of Toronto are to blame for the neighbourhood’s "rapid" deterioration since the service opened six years ago.
The plaintiffs in the suit, which was filed with the Ontario Superior Court of Justice earlier this year, say that the area has worsened to such a degree they have grown fearful for everyone’s safety and charge that the city and the province have both failed to operate the site according to regulations.
They are seeking an unspecified amount in damages for loss of income, out-of-pocket expenses to repair property damage arising from criminal acts, and diminished value of real property.
South Riverdale Community Health Centre has been under intense scrutiny since last summer when a stray bullet killed a 44-year-old mother of two from the area just steps away. The province as since launched a "critical incident review" of SRCHC’s SCS.
Three people are facing murder charges in connection with that fatal shooting, which is believed to have stemmed from a gunfight outside the centre.
A fourth person, an employee of the centre, has also been charged with obstruction of justice and accessory after the fact to an indictable offence.
With files from CTV News Toronto’s Abby O’Brien.