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Screenshot of man smoking crack on TTC streetcar.© Provided by Toronto Sun

British Columbia has admitted that decriminalizing all drugs was a mistake.

So why are the top doctors for the Province of Ontario and the City of Toronto still pushing for decriminalization to be adopted here?

“Keeping people safe is our highest priority,” B.C. Premier David Eby said to reporters at a news conference Friday.


“While we are caring and compassionate for those struggling with addiction, we do not accept street disorder that makes communities feel unsafe.”

On Jan. 31, 2023, Health Canada granted B.C. an exemption to the Controlled Drugs and Substances Act. This meant that using drugs like crack, cocaine, methamphetamine and MDMA, or opioids like fentanyl, were free and legal to use in the open.

The argument for making the change was to do away with stigma for addicts. But the reality was utter chaos in the streets, and the hospitals of the province.

Open drug use in parks, on public transit and elsewhere became problematic. Police were unable to do anything about public complaints, something Eby now acknowledges was a mistake.


“Clearly, with the benefit of hindsight, police needed those authorities,” Eby said.

The recriminalization won’t be complete and having small personal amounts of the otherwise banned drugs won’t be illegal in your home, in homeless shelters or in so-called safe consumption sites.

The problem with the policies adopted by B.C. in recent years goes well beyond open public drug use. Toronto hasn’t adopted decriminalization yet and we have open drug use in parks, on the TTC , on street corners and elsewhere.

The real problem with B.C.’s ever-liberalized drug laws is that they don’t work at what they are supposed to do, lowering the overdose death rate.

In 2023, decriminalization was in legal effect for 11 months and the province still had a record-breaking 2,546 drug overdose deaths . With the exception of 2019, overdose deaths have been on the rise every year in the last decade.


B.C.’s population is one-third of Ontario’s, but they have more overdose deaths. In 2014, B.C. had just 370 overdose deaths, in the first two months of this year they had already recorded 377 deaths

These are clear signs that we shouldn’t be following B.C.’s lead.

Yet, the City of Toronto has an official request before Health Canada asking for the same kind of exemption B.C. was granted. Under what the city calls the Toronto Model , drugs would be legal to use everywhere except child care centres, K-12 schools and airports.

That means smoking crack on the bus, streetcar or subway would be legal. Shooting heroin or fentanyl in a kid’s playground would be legal.

It’s utter madness masquerading as compassion and forward thinking. It’s supported by Toronto Mayor Olivia Chow, Toronto Police Chief Myron Demkiw and the city’s Chief Medical Officer Eileen de Villa.

Last month, Dr. Kieran Moore, Ontario’s Chief Medical Officer, released his annual report calling for the decriminalization of hard drugs, while also making alcohol harder to get.


Thankfully, the Ford government shut down Moore’s ideologically based and scientifically flimsy report and recommendations.

In his report, Moore called for Ontario to evaluate and learn from jurisdictions that had already gone down the decriminalization route, including Oregon and B.C. But both of those jurisdictions have now reversed course after horrific experiences.

It’s time for the chief medical officers for Toronto and Ontario to withdraw their recommendations and follow suit.

We need real solutions for the problems of addictions and overdoses – and decriminalization is now the answer.


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but everything changed when safer supply programs began operating in the city in early 2020. 

These programs hand out large numbers of 8mg hydromorphone pills (roughly 10 to 30 per day) to severely addicted drug users under the assumption that this will dissuade them from consuming potentially tainted illicit substances. 

However, as hydromorphone is generally not powerful enough to get fentanyl users high, recipients  frequently sell (“divert”) their safer supply on the black market to purchase fentanyl. This floods surrounding communities with diverted hydromorphone, which causes the drug’s street price to collapse and  fuels new addictions .

Concerns about safer supply were recently outlined in an open letter to Ya’ara Saks, the federal minister of mental health and addictions, from 17 Canadian addiction experts. Diverted hydromorphone has been “flooding our streets,” leading to rising addiction, the letter stated. “We are regularly seeing and hearing in our practices that diverted hydromorphone is causing harm to both adults and children.” 

The addiction specialists are calling upon the government to either supervise the consumption of safer supply hydromorphone or cancel the programs altogether. 

Mark’s experiences were consistent with these physicians’ observations, and with reports from  over 25 other addiction experts I have interviewed in the past year.


and this is how we got to the present situation ….. theory meets reality:


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KLEIN: ‘Safe injection’ sites have spectacular record of failure


The 2024 Manitoba NDP Budget announced that it was setting aside $2.5 million for a “supervised consumption site” otherwise known as a safe injection site to be opened in 2025. A location for the site has yet to be established.

Safe injection sites are not new in Canada with several established since Vancouver opened Insite in 2003. These facilities are sites where drug users can legally consume heroin, fentanyl and methamphetamine in a supervised manner to prevent overdose deaths.


Activists collectively refer to the principle as “harm reduction” and invariably cite the practice as a part of a greater drug decriminalization scheme.

But have safe injection sites actually delivered on their promises to reduce harm? It seems counterintuitive to claim that there is any safe way to inject drugs like heroin or fentanyl and that sites that enable the practice are more akin to “harm facilitation”.

Supervised consumption may prevent overdose deaths and reduce the spread of infectious disease but it has also proven to significantly increase crime, bio-hazardous trash and social disorder.

Communities around safe injection sites are often associated with homeless addicts sleeping on nearby streets, discarded needles and a high social cost for area residents and small businesses.

The activist narrative of zero collateral costs is simply not the case in reality. The experience at nearly every Canadian site has demonstrated that collateral costs are real and significant.


But even if we dismissed the zero collateral cost myth just for a moment and focused entirely on the user, it’s still difficult to nail down the net benefit of perpetually enabling an addiction both for the user and the community.

It has been proven that safe injection sites have an extremely poor record of moving drug users into treatment and recovery programs. Transition into treatment generally occurs less than 5% of the time.

Sites are not so much a gateway to recovery as a continually expanding drug market that enables addiction and attracts more users. The notion of “inviting” drug usage with only marginal conversion to treatment is more an exercise in perpetuating harm than reducing it.

Government money that simply facilitates addiction would be far better invested into treatment and recovery programs. Facilitating, enabling and perpetuating drug usage is not a solution.


Not surprisingly, harm reduction activists choose to dismiss the very real financial and social costs of safe injection sites.

Their existence also raises significant legal and ethical implications. Government-sanctioned drug consumption is itself a political gateway to the next prized objective of progressive activists — the decriminalization of illicit drugs.

That social experiment has been nothing short of catastrophic. In 2021, the state of Oregon decriminalized illicit drugs and saw an explosion in public drug use and fentanyl and opioid overdoses.

Under the new law possession of small amounts of illicit drugs were subject to a ticket and a fine of less than $100 which could be dismissed by calling a 24-hour addiction screening hotline within 45 days. That hotline was only utilized 1% of the time by those who received a citation. Drug overdoses have skyrocketed. Oregon lawmakers are now reversing their decision and recriminalizing drug usage.


The knee-jerk narrative from harm reduction activists is that criminal enforcement followed by incarceration and mandatory treatment lacks compassion and effectiveness. And while a harm reduction approach does save user lives it certainly has no credible claim to effective treatment or recovery.

Incarceration is just as effective at saving lives but offers a far greater chance of recovery through treatment — without the collateral costs and social disorder.

The Manitoba NDP have only to look to east Vancouver to get a glimpse of what we are in store for if they establish a safe injection site in Winnipeg.

The proof is there for all to see — unless, of course, it’s by choice not to.


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Dr. Sharon Koivu: 'Safe supply' has only worsened the addiction crisis in London, Ont.

I have been a practicing physician in Ontario for 39 years, the last 16 of which have been in London. I have served in many capacities, including having a family practice and working as an acting medical officer of health. Since 2012, I have worked in addiction medicine. I feel compelled to speak out about the harm “safe supply” is causing in my community.


London is home to Canada’s first “safe supply” program that started at London InterCommunity Health Centre in 2016. It was, in part, a response to a public health emergency of tricuspid valve endocarditis, HIV and hepatitis C related to the injection of hydromorphone capsules. The goal was to provide high-risk sex workers using these hydromorphone capsules with an alternative: short-acting hydromorphone tablets, also known as Dilaudid.

I lived close to the health centre, and I initially supported the program. We did not have a problem with illicit fentanyl at the time.

The program later expanded to include people potentially at risk of overdose from illicit drug use. Clients are often prescribed 30 to 40 Dilaudid pills per day, many of which are being diverted. This is fuelling the use of illicit fentanyl,  which began appearing on the streets of London in 2018, leading to an increase in overdoses . I am repeatedly hearing disturbing stories that people with prescriptions are vulnerable to violence. Diversion appears to have shifted from being sold to individuals to being sold to organized crime as more is appearing in large amounts in police seizures.


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It is also causing significant harm to the patients I serve. From 2012 to 2017, I rarely saw patients with spine infections. In the summer of 2017, I saw five patients in one month. The numbers continued to climb. The common thread among most of them was that they were injecting Dilaudid tablets. Most told me that they were buying diverted Dilaudid from clients of the “safe supply” program, while others were in the program directly.

I had patients who were housed, using clean equipment and only injecting Dilaudid, developing horrific infections. Spine infections cause perhaps the worst suffering I have ever seen. Not only are they unbearably painful, but they can also cause paraplegia or quadriplegia. Since 2017, I have been part of the care team in about 100 hospitalizations of people with injection drug-related spine infections.

In June of 2018, I had my first patient tell me that he had left his apartment to live in a tent near the pharmacy and “safe supply” clinic from which much diversion takes place. This was because “safe supply” pills were cheaper and more abundant near the source. After he moved to this encampment, he, too, developed a spine infection from injecting Dilaudid.


Over the past year, we have seen about one patient per month with a spine infection. Half of these were receiving a “safe supply” prescription and half reported buying diverted Dilaudid. About 30 people per month are admitted with another severe infection. Of patients admitted with opioid use disorder, 25 per cent were receiving a “safe supply” prescription and 25 per cent reported using diverted Dilaudid. Only four per cent of our consults were for an unintentional overdose.

The failure of “safe supply” was predictable. Purdue Pharma’s OxyContin helped start the addiction crisis, and Dilaudid, which is also manufactured by Purdue, is an even stronger and more addictive opioid. I and many of my addiction physician colleagues have been warning about the pending harms from the start.

Public Health Ontario data shows that the harms we’ve been warning about are very real. Prior to the start of the “safe supply” program, the Middlesex-London area was principally less than or equal to the provincial average rates for measured harms from opioid toxicity (i.e., emergency room visits, hospitalizations and deaths). Since the “safe supply” program started and expanded, the harms experienced in Middlesex-London have escalated substantially, beyond the rates experienced in the rest of the province.


The rate of death from opioid toxicity is of utmost concern. In 2014, Ontario had a rate of death from opioid toxicity at 4.9 per 100,000 people. Middlesex-London had a rate of death from opioid toxicity that was much less, at 2.8 per 100,000 people — that’s 43 per cent lower than Ontario’s average. In both 2015 and 2016, London and the province of Ontario experienced equal rates of death from opioid toxicity.

Since the onset of “safe supply,” the rate of death from opioids has escalated at a much greater rate in Middlesex-London and has consistently remained higher than the Ontario rates. By 2022, opioid-related mortality in London had risen more than four times higher than the rate in 2015, 40 per cent higher than the rate for the province of Ontario.

This has particularly affected youth and young adults, ages 15 to 44. Lives lost in these age groups were generally less than the provincial average, but since “safe supply,” they are much greater.


It has also been costly to the emergency department. In 2014, emergency department visits were lower than average. In 2015, they were five per cent higher in Middlesex-London than the rest of Ontario. From 2020 to 2022, emergency department visits were, on average, 80 per cent higher.

Interestingly, London Health Sciences Centre has a $76 million deficit even after receiving a $95 million bailout from Queen’s Park. While hospital budgets are complex and multifactorial, this deficit parallels the expansion of London’s “safe supply” program. Instead of saving health-care dollars, “safe supply“ is costly.

Importantly, as I referenced previously, when “safe supply” started in 2016, we did not have a problem with illicit fentanyl in London. We do now. Many patients have told me they sell or trade much of their prescribed “safe supply” to buy fentanyl. Others, not in the program, have told me that their dealers have sold them fentanyl after claiming to be out of Dilaudid, starting them down that path.


Our hospital experience shows that “safe supply” is also preventing patients from choosing opioid agonist therapy and the opportunity for recovery.

Additionally, the percentage of people found to be positive for fentanyl at death has been very similar in Middlesex-London and the province of Ontario. However, in Middlesex-London, the percentage of people positive for hydromorphone has been 200 per cent higher than the provincial average.

The Public Health Ontario data is conclusive. “Safe supply” programs, evident from the London experience, are not effective at addressing illicit fentanyl or the tragic addiction crisis. “Safe supply” is not safe, and in fact, it substantially contributes to societal harm.

We need a comprehensive, collaborative recovery-focused approach to the addiction crisis, including the expansion of evidence-based treatments that do not contribute to harm. To prevent further harm, a moratorium on funding and expansion of “safe supply” programs must be put in place. Finally, those currently in “safe supply” programs need the support of an effective exit strategy.

National Post

Dr. Sharon Koivu has been a physician in Ontario for 39 years and worked as an addiction medicine consultant for 12. In addition to front-line health care, her career has spanned teaching, research, leadership and advocacy.

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On 5/12/2024 at 11:31 AM, Malcolm said:



The 2024 Manitoba NDP Budget announced that it was setting aside $2.5 million for a “supervised consumption site” otherwise known as a safe injection site to be opened in 2025. A location for the site has yet to be established.



New proposal;  any safe-injection site can only be located across the street from the politician's home who brought the legislation.

Prediction - no new sites will be proposed.

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39 minutes ago, Seeker said:

New proposal;  any safe-injection site can only be located across the street from the politician's home who brought the legislation.

Prediction - no new sites will be proposed.


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3 minutes ago, Malcolm said:


It's clearly true that people who are addicted need something.  I don't think more and easier access to their drugs is the thing. 

It's like saying that the way to treat pyromaniacs is to give them easier access to matches and jerry cans of gasoline!

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