Deputation to the Toronto Board of Health in Support of Supervised Injection Services
Good afternoon. My name is Dr. Doris Grinspun and I am Chief Executive Officer of the Registered Nurses’ Association of Ontario, or as it is best known: RNAO.
We thank you for the opportunity to be here today, representing Ontario’s registered nurses, nurse practitioners, and nursing students to speak in staunch support of supervised injection services (SIS). This issue is tremendously important to us as health professionals, community members, family members, and friends of loved ones whose lives have been lost or are at risk because of substance use and addiction. Implementing SIS is a pragmatic and evidence-based policy that will improve health outcomes, prevent needless deaths, and contribute to safer communities.
RNAO has a track record of advocating for evidence-based healthy public policies, and values of inclusivity, equity, and social justice. We advance knowledge-driven nursing practice through our comprehensive Mental Health and Addictions Initiative and new best practice guideline on engaging clients who use substances.
We are committed to the principles of harm reduction and, as many of you know, nurses are actively leading harm reduction programs throughout our cherished city and province. In fact, RNAO leads on this policy imperative at every level of government, and in 2011, we convened a coalition with the Association of Nurses of British Columbia, and the Canadian Nurses Association which secured intervener status to fight then prime minister Stephen Harper in his failed attempt to shut down InSite in Vancouver. We said at the time, and we say to you today, that harm reduction, including SIS, is an essential tool in a comprehensive health strategy for substance use and addiction.
By treating people with respect and establishing trusting relationships, SIS expert registered nurses, nurse practitioners and other health workers create safe spaces that save lives and improve health. The evidence presented by Toronto Public Health is clear: SIS helps vulnerable people access health and social services including overdose prevention and management, first aid, HIV testing, acute and chronic wound care, immunizations, reproductive health care, health education, counseling, and referrals to other services such as detox.
RNAO commends the Board of Health, Toronto City Council and Toronto Public Health for your ongoing leadership over the last decade with the comprehensive Toronto Drug Strategy. Increasing access to SIS will further the Toronto Drug Strategy Vision to "improve the quality of life for individuals, families, neighbourhoods and communities in Toronto by creating a society increasingly free of the harms associated with substance use." As Toronto Public Health has outlined in their report to you, there was a 41 per cent increase in the number of people dying from overdose in Toronto: from 146 in 2004 to 206 in 2013. If a plane went missing or crashed each and every year causing this many deaths, we would take notice and take collective action. Tragically, many of those who die from overdoses are as invisible, forgotten, and marginalized in death as they have been in life – from poverty, discrimination, historical and current trauma. These deaths are preventable and by working together we can, and we must, make a difference.
As an important start to this life-saving initiative, we need our municipal politicians to work together to support the urgent opening of SIS. The three locations already providing harm reduction services at Queen West Central Toronto Community Health Centre, South Riverdale Community Health Centre, and The Works are well-chosen and will provide templates for further expansion as the need demands. We support community education and engagement to address misconceptions and fears within a human rights framework that acknowledges access to SIS as a critical health service.
When RNAO made a deputation on this issue to the Board of Health in 2013, we said that your leadership is critical for the people of Toronto and also for vulnerable persons across Ontario and Canada. This is true now more than ever, with nearly one of every eight deaths among young Ontarians aged 25 to 34 years related to narcotics. We, as a society, can no longer turn a blind eye – for the sake of the many who may still die if we don't act – and in memory of those who are no longer with us.
Thank you once again for the opportunity to be here today and we urge you to support SIS.