Registed Nurses' Association of Ontario

Provincial Support and Funding for Supervised Injection Services

Provincial Support and Funding for Supervised Injection Services

We are writing to thank you for your genuine efforts to support harm reduction by ensuring that recently released inmates at high risk of overdosing will have access to life-saving naloxone.

We are also writing to urge you to work with the provincial and federal governments to secure all necessary steps to make supervised injection services (SIS), as part of a harm reduction approach, a reality in Ontario.

Since the Registered Nurses' Association of Ontario (RNAO) last wrote to the Ministry of Health and Long-Term Care (MOHLTC) in 2013 to support SIS, the need has only become more urgent and the evidence stronger.The original 2012 Toronto and Ottawa Supervised Consumption Assessment Study (TOSCA) recommended three SISs in Toronto and two in Ottawa as a cost-effective way to prevent premature deaths and improve health outcomes. Since then, SIS has been increasingly recognized as a cost-effective strategy, especially within the proposed model to integrate SIS into already existing health services.

Ontarians across the province continue to die without access to SIS. Toronto Public Health confirms a 77 per cent increase in reported deaths from drug overdose from 146 in 2004 to 258 in 2014, the highest annual number in Toronto to date. Toronto’s then-Medical Officer of Health Dr. David McKeown has presented compelling public health evidence to the Toronto Board of Health recommending the implementation of three SIS across the city, at South Riverdale Community Health Centre , Queen West--Central Toronto Community Health Centre, and the Works program (Toronto Public Health). These well-respected and experienced health organizations already provide harm reduction services for the highly marginalized people they serve in their communities. For these reasons, the Toronto Board of Health and Toronto City Council both support the implementation of these small scale SIS.

On June 21, 2016, the Ottawa Board of Health voted in favour of supporting proposals from community health centres seeking to set up SIS services as recommended by Ottawa's Medical Officer of Health. Work is now underway to complete the exemption application requirements under section 56.1(2) of the Controlled Drugs and Substances Act. London and Thunder Bay are in the process of doing studies to explore the need for and feasibility of SIS in their communities.

Eric, RNAO urges the province to provide strong and swift support for the exemption applications of all of these proposed SIS. In addition, we urge your Ministry, through the Local Health Integration Networks (LHIN), to fund proposed SIS in Ottawa and Toronto, and any subsequent SIS needed across the province, as part of existing health services.

Moreover, given the urgent need and your commitment to health equity and the province's emphasis on evidence-informed decision making, RNAO asks that you advocate for the repeal of federal Bill C-2, the Orwellian named Respect for Communities Act. This piece of legislation imposes unnecessary hurdles to make it as difficult as possible for new SIS to open, despite the compelling public health evidence and human rights concerns. Public education and engagement can be beneficial to helping the public understand the rationale for SIS. However, as evident from ongoing opposition to the opening of new homeless shelters, some forms of public consultation are damaging by further stigmatizing people who already suffer from discrimination.

An Ontarian suffering from a heart attack or a broken leg can access health services based on need. Those with addiction and mental health challenges should be able to do the same. These kinds of health services are basic human rights, especially among vulnerable populations, and should not be subject to politicized processes that often ignore evidence.

Ontario's registered nurses, nurse practitioners, and nursing students stand ready to move this critical issue forward. Please act now, lest more lives be lost.

Warm regards,

Doris Grinspun, RN, MSN, PhD, LLD(hon), O.ONT Chief Executive Officer, RNAO

Copy: Premier Kathleen Wynne
Patrick Brown, Leader of the Official Opposition
Andrea Horwath, Leader of the New Democratic Party of Ontario
Jeff Yurek, Health Critic, Progressive Conservative Party of Ontario
France Gélinas, Health Critic, New Democratic Party of Ontario
Janet DeMille, Medical Officer of Health, Thunder Bay District
Isra Levy, Medical Office of Health, Ottawa
Christropher Mackie, Medical Officer of Health, London
Barbara Yaffe, Acting Medical Officer of Health, Toronto

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