Nurses say the evidence is robust: Supervised injection and overdose prevention services save lives

Aug. 7, 2018

Ontario nurses say they are gravely concerned the government needs to assess the “merit” of sites offering supervised injection and overdose prevention services.

In an open letter addressed to Health Minister Christine Elliott, members of the Registered Nurses’ Association of Ontario (RNAO) say there is robust peer-reviewed evidence that these services are saving lives and making a difference as the province grapples with a growing opioid crisis.

According to figures from the government of Ontario, in 2017 there were at least 1,261 deaths across the province attributed to opioid poisoning. That’s an increase of 45 per cent over the previous year when 867 deaths were recorded.

“People’s lives are at stake and families are being torn apart by this crisis. Yet, we know supervised injections services (SIS) and overdose prevention services (OPS) are making a difference, and we need more of these services instead of delays in funding and operating them,” says RNAO president Angela Cooper Brathwaite.

Supervised injection services are offered in health-care settings and allow people to inject drugs under the supervision of trained registered nurses and other health workers who provide sterile supplies, overdose prevention and management, as well as other health and social support services. Given the scale of the crisis, Health Canada announced in December 2017 that it would grant exemptions to the province of Ontario allowing temporary overdose prevention sites to operate. London was the first city to have a sanctioned OPS in the province and it has been operating since February.

RNAO says the government’s review is especially problematic because funding for the London site is due to run out on Aug. 15. Since opening its doors in February, nurses and outreach workers have supervised more than 4,700 injections and there have been no deaths due to overdose.

To strengthen the work of clinics offering SIS, and in response to a request by former Medical Officer of Health, Dr. David McKeown at Toronto Public Health, RNAO released a best practice guideline (BPG) that offers 11 recommendations for implementing these services. The recommendations cover a range of topics, including integrating peer workers and health and social services into SIS programming, as well as aligning future SIS locations and operations according to local population needs. The guideline is already being used in Ontario’s SIS and all over the world.

“Nurses are on the frontlines of the overdose crisis and we will work tirelessly to protect the health of people who inject drugs because their lives are important. If the health minister wants to reverse the rapid rise in the number of opioid-related deaths, she can do that by immediately extending approval and funding for all existing temporary overdose prevention sites across the province and by embracing more supervised injection services in communities that need them,” says RNAO CEO Doris Grinspun.

Read RNAO’s letter to Minister Elliott.

The Registered Nurses’ Association of Ontario (RNAO) is the professional association representing registered nurses, nurse practitioners, and nursing students in Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health-care system, and influenced decisions that affect nurses and the public they serve. For more information about RNAO, visit or follow us on Facebook and Twitter.


Contact info

Marion Zych
Director of Communications
Registered Nurses' Association of Ontario (RNAO)