Overdose Deaths in Toronto: Supervised Drug Consumption Services Bring Hope & Questions

Supervised drug consumption appear to reduce deaths, but questions remain.

“Between 2015 and 2021, annual deaths from opioid overdose in Toronto increased by more than 300%, from 137 to 574.”

While the world attempts to navigate a confluence of global crises — an opioid overdose epidemic, surging mental health issues, housing instability — studies of safe injection sites have shown some promise in reducing overdose deaths.

What exactly are they? At Supervised Consumption Services (SCS) facilities, individuals can consume their own drugs under medical supervision. The aim is to prevent overdoses and drug-related deaths while reducing needle transmission of diseases like HIV.

Led by Indhu Rammohan at the University of Toronto, a 2024 study published in the Lancet found a significant decrease in drug overdose mortality in Toronto neighbourhoods with access to SCS.

Core Findings: Drug Consumption Services Prevent Deaths

• Significant Decreases in Mortality: In neighbourhoods with SCS, overdose mortality rates dropped from 8.10 per 100,000 people in 2017 to 2.70 in 2019.

• The Closer, the Better: Drug mortality rates dropped in relation to the proximity of the SCS facilities.

“SCS have been shown to reduce harms associated with drug injecting, including overdose mortality, syringe sharing, and public injecting...”

Global Perspectives: Tracing A Public Health Emergency

Over the last decade, many countries (largely in North America and parts of Europe) have experienced a growing drug overdose epidemic, largely fueled by opioids like fentanyl. In 2017, the U.S. Center for Disease Control and Prevention declared it a public health emergency, citing a rapid rise in overdose deaths in recent years.

Adoption & Effectiveness of SCS

Countries like Canada, Australia, and some European nations, have already implemented SCS services as a harm reduction strategy.

• SCS has been shown to help reduce overdose deaths in other studies worldwide, which also indicate that SCS can help connect drug users with addiction treatment services, healthcare, and social services.

• A report by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) suggests that SCS can lead to reduced public drug use and reduced littering of drug paraphernalia.

“These facilities operate in 12 countries and more than 100 peer-reviewed studies have shown they reduce transmission of infectious disease, death from overdose, and increase participation in treatment without increasing crime or drug use in a community.”

— Human Rights Watch

Future in Focus: Addressing Community Concerns While Supporting Sufferers

Despite these findings, SCS sites continue to face public and political pushback. Although some consider them vital to keeping people alive, others oppose them due to concerns that they promote drug use.

Thankfully, research continues to provide critical data points.

The success of SCS programs in cities like Vancouver, Canada — which operates Insite, the first legal supervised injection site in North America — has helped drive evidence-based discussions.

Of course, more research will be crucial to fully understanding any potential impact on neighbourhoods, economics, and long-term community health.

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