The Ford government is planning to develop new safety protocols for drug consumption and treatment sites prompted by a shooting outside of a site in Toronto in July, the associate minister of mental health and addictions said Thursday.
In the meantime, some applications for new sites have been waiting for provincial approval for more than two years — and they will have to continue to wait, according to Michael Tibollo.
"We lost one life and we want to make sure that we don't lose another," he told reporters.
The province launched a "critical incident review" of South Riverdale Community Health Centre in east-end Toronto after a passerby, 44-year-old Karolina Huebner-Makurat, was killed by a stray bullet from a fight that broke out in the area around the site in July.
At Queen's Park on Thursday, Minister Tibollo said the province's review will determine what protocols should be in place for all of the province's 17 consumption and treatment sites and the province does not want to open additional sites until the new protocols are in place.
"The protocol has to be put in place because we recognize the problem with what happened at Leslieville, and we don't want to be precipitous and open something that could potentially lead to that issue being repeated elsewhere," he said.
There are at least five sites with pending applications before the province. Applications for sites in Sudbury, Windsor and Barrie have been waiting for approval for about two years.
Windsor and Sudbury have opened temporary sites with municipal funding in the meantime, but Barrie has not, and Sudbury's municipal funding is set to expire at the end of the year.
When NDP MPP Jamie West asked about the pending closure of Sudbury's site in Question Period, Tibollo cited the Toronto shooting.
"Unfortunately, with the situation that we had at Leslieville, it’s forced us to look at the consumption and treatment sites to determine the impact it is having on public safety as to where they’re located," Tibollo answered and received a standing ovation from the PC caucus.
Watching a video of that ovation was painful for the team at the site in Sudbury that is at risk of closing, said Heidi Eisenhauer, executive director of the Réseau ACCESS Network.
"We recognize we've lost hundreds and hundreds of lives here in Sudbury, and this is a crisis," Eisenhauer said. "And again they stand together in a standing ovation to stop an evidence-based solution to this overdose crisis. It's shameful."
Eisenhauer said she believes the Ford government is using the shooting as a "scapegoat" and that evidence shows the supervised consumption sites decrease crime, which is why they've earned the support of police in many jurisdictions, including Sudbury.
Speaking to the media afterwards, Tibollo defended the government against criticism that the death of one person should not cost the lives of others who could be saved if the pending sites were open and funded.
"And how many deaths are we going to potentially expose people to if we don't go through this carefully? You know, public safety is a priority for us. And we have to make sure that whatever we do is calculated to be done in such a way as to make sure that no one is going to be harmed as a result of the sites being open and being operational."
Tibollo said the province intends to keep the sites as low-barrier access points for drug users to get the care they need but that a lot of ideas are being considered and changes to the health human resources at the sites, security and the hours of operation are all on the table.
For instance, he said he was curious about the hours of operation for the sites, noting that people are still overdosing and dying alone at night when the consumption and treatment services sites are closed. He floated the idea of something like Alberta's Digital Overdose Response System (DORS), an app that can summon a paramedic if a drug user becomes unconscious.
He also suggested free test kits for benzodiazepine, xylazine and fentanyl could be helpful.
Tibollo said safe supply — the legal provision of drugs that haven't been adulterated — is an interesting topic but he voiced arguments against it, including that it hasn't been proven to be effective and that it increases the overall supply of drugs.
Tibollo said he couldn't rule out that on-site supervised drug consumption would no longer be part of the sites because he hasn't received recommendations back from the critical incident review, but said he sees value in that model because it's shown to build trust with drug users that helps get them into care.
"We know that there is some benefit to them because we've seen the outcomes," he said.
The recommendations by the experts doing the review will be debated and decided on by the government, he said.
"The issue that I'm most concerned about is how much work are we doing to help those individuals get into treatment because ... no person who's addicted wanted to be addicted or wants to be addicted," he said. "And we know that typically there's an underlying concurrent disorder that needs to be addressed. And so if we can help people get to a place where they're getting the right supports, build that trust, I honestly believe that we'll see a reduction overall in the emergency room usage and we'll also see a reduction in police interventions."
He also touted 400 additional beds and 7,000 treatment spaces added by his government and said there's more work to be done to add sufficient treatment capacity to the system.