Community Safety Consideration for Supervised Injection Sites.

By Larissa Alszegi


Earlier this year, Ontario’s Minister of Health and Long-term Care agreed to fund three pilot supervised injection sites (SISs) in Toronto after years of debate and review following the implementation of the Insite supervised injection site in 2003 located in the Vancouver’s downtown Eastside neighbourhood. Supervised Injection Sites (SISs) have been controversial, especially as a potential response to record-breaking opioid-related deaths across Canada but what do SISs actually do? What effects will it have for Toronto and other communities in terms of its users, facilities, neighbourhoods and law enforcement services? The answers to the above questions ultimately rely upon the lens through which one makes the analysis and whether there is more value in harm-reduction strategies as opposed to the crime control model.

Harm-reduction strategies have their roots in the Netherlands, where the first needle exchange programs emerged in the 70s in response to an emerging heroin addiction and HIV surge among young people in that European nation. The underlying principles of this approach are tolerance (to drug policies that criminalize users) and acceptance (that people will engage in substance abuse regardless of sanctions or deterrents). The goal of Harm Reduction Strategies is to limit the spread of blood borne diseases (Hepatitis, HIV, etc.), decrease public nuisance, regulate the underground drug market and increase access to services assisting with homelessness, addiction and prostitution. As the years passed, intended and unintended consequences were examined and supervised drug consumption sites evolved into more formalized services which eventually spread to other countries such as Germany, Switzerland, Australia and eventually, Canada.

Harm-reduction advocates have deemed Vancouver’s Insite program as a success and report that the program is worthy of sustaining and expanding across the country. However, the surrounding neighbourhood of Downtown Eastside continues to suffer from a great deal of substance abuse and mental health issues warranting insight on what other measures can be taken to assist this vulnerable population. While Insite’s success can be measured by its record of zero overdoses within its facilities, the neighbourhood of Downtown Eastside is still plagued by disproportionate rates of crime, public disorder, prostitution, poverty and homelessness. Whether these issues existed previously or were made worse by the presence of Insite is worthy of discussion, but it’s not difficult to imagine how a drug using facility can impact its neighboring community.

Where there are illegal drugs more illegal activity tends to follow. This is of great concern to citizens and law enforcement officials in neighbourhoods where SISs are being proposed. The proposed sites in Toronto will be in relative proximity to each other, which aside from not addressing the issue in other areas of the city, puts the whole triangular area in between at risk of becoming a hotspot for drug-dealers. Law enforcement services are quite concerned about how this will affect their role and interactions with citizens. Approved and regulated SISs are legal; therefore, the individuals within its confines are safe from legal enforcement and prosecution, but what about the ones outside the door or around the corner? There are no definite limits to where and when the law will be upheld as opposed to applying principles of discretion and tolerance. The Ministry of Health along with the Ministry of Community Safety and Correctional Services need to support police services by guiding them in how to adjust their roles in response to SISs, through training and specialized staffing in order to effectively meet the demands of this initiative, while still effectively protecting the community.

Chief Bryan Larkin, President of the Ontario Association of Chiefs of Police, believes that police services must be multifaceted in how they responds to a city’s changing demographics and emerging issues. According to Chief Larkin, re-engineering police priorities and strengthening its ties with health and social service agencies to promote diversion strategies would assist in decreasing police intimidation and provide a more balanced approach during intersections with drug users.

Although preventing deaths is a priority that police strongly believe in, equally as important are efforts to assist people overcome their drug addictions and help  rebuild community connections and improving outreach for mental health services for such individuals.

There is no doubt that supervised injection sites can assist in saving lives while decreasing stigma and criminalization of substance users but there are also many other concerns that follow. Police must play a supportive role in the community but there should be no leniency in regard to drug dealers who further victimize already vulnerable individuals in our communities. There is much that Canada can learn from the effects of drug decriminalization and harm-reduction strategies in Europe and we must look to our own solutions in terms of realistic program transferability. Regardless, we need honest and open dialogue between police, advocacy groups and governments on the issue of SISs. Issues surrounding crime and addiction are inherently linked and are dependent on the collaboration of all sectors. The degree to which all stakeholders are able to collaborate on future initiatives is a better predictor to the success and outcome of any program regardless of how it has been implemented in the past.


Larissa Alszegi will complete her Bachelor of Social Science – Criminal Justice degree at Humber College in 2018.  She served as a Placement Student with the OACP in 2017. Follow Ms. Alszegi on Twitter at @Lalaszegi.