Public Health

Doctor's Notes

Doctor's Notes

Official Blog of Toronto's Medical Officer of Health

Posted on December 1, 2016


Supervised Injection Services: Toronto Public Health Seeks Federal Approval  


On December 1, 2016, in recognition of World AIDS Day, Toronto Public Health submitted its exemption application to Health Canada to operate a supervised injection service (SIS) at our harm reduction program, The Works. Central Toronto-Queen West Community Health Centre and South Riverdale Community Health Centre also submitted applications to operate these health services. Legal operation of an SIS requires an exemption from the Controlled Drugs & Substances Act, which is granted by the federal health minister.


Supervised injection services are health services that provide a safe and hygienic environment for people to inject pre-obtained drugs under the supervision of qualified staff. We know from research that these health services reduce drug overdoses, and limit the spread of blood-borne infections such as HIV and hepatitis C. Supervised injection services are also proven to reduce public drug use and the number of publicly discarded needles.


In July 2016, the Toronto Board of Health and City Council approved the three proposed SISs for Toronto. In August 2016, all three health care organizations submitted funding proposals to the Ontario Ministry of Health and Long-Term Care.


The model we plan to implement in Toronto is small-scale SISs that are integrated into the health services that people who use drugs are already accessing. Individuals are already coming into our harm reduction services for sterile injection supplies, education on overdose prevention and intervention, health counselling services, as well as referrals to drug treatment, housing, and other services. The SIS will provide another critical part of that continuum of health services.


We need to implement this SIS model now. There has been a 77% increase in the number of reported overdose deaths in Toronto between 2004 and 2014 (the last year for which data are available). The majority of these deaths are accidental and due to opioids such as heroin and fentanyl. The issue of drug overdose is critical in our city, and Toronto Public Health is committed to doing all we can to save lives, and improve the health outcomes of people who use drugs.


As Acting Medical Officer of Health, it is my goal to have this service open in Toronto as soon as possible. Toronto Public Health, Central Toronto-Queen West Community Health Centre and South Riverdale Community Health Centre have worked together on the SIS exemption applications and program development to meet the extensive requirements for a federal exemption. It has been a very successful collaboration between public health and community health in Toronto, with endorsement by City Council. We now need federal approval and provincial funding.


I encourage you to visit The Works at Toronto Public Health to learn more about our harm reduction programs and services.



Dr. Barbara Yaffe
Acting Medical Officer of Health