Researchers are recommending that a supervised injection site be set up in either Old East London or the downtown.
The results of the Ontario Integrated Supervised Injection Services Study were released Wednesday. Researchers questioned 199 people who have used injection drugs over the past six months. Of those interviewed, 65% said they inject drugs daily, 72% said they do so in public places, and 22% reported syringe sharing.
Overall, participants were largely in favour of supervised injection sites (SIS), with 86% stating they would use a SIS if one were available.
"Lets be clear, London has a very serious problem with injection drug use. Both in terms of the very severe health related harms that individuals are experiencing, but also from the public disorder that arises from the very high rate of public injecting that is occurring here," said Dr. Thomas Kerr, principal investigator of the study. "In a way, a supervised injection site offers sort of a win-win solution. Drug users get the health services they need and communities are safer as a result."
The study also found a SIS should be integrated within existing services that can provide enhanced wrap-around care including addiction treatment, mental health care, and housing supports.
Dr. Kerr said the recommendation to locate a SIS in Old East or the downtown is based on the preferences of the study participants -- 60% selected Old East as their neighbourhood of choice, while 37% picked the core.
"We are just saying that those are the places that people cited and I think that is because that is where people are using drugs. It is very important to locate these services in close proximity to where people buy and use drugs. In fact it is more important than having it close to where they live," said Dr. Kerr.
The recommendation was met with a mixed reaction from Peter Strack, president of the Old East Village Community Association. He foresees this as being a hot topic at the association's next meeting.
"In anything like this you are going to have a real diverse set of opinions. So you will have people who will be very against it and people who will be very for this type of service," said Strack. "I know for a fact on our own association board we have people at polar opposite ends of that spectrum."
Strack believes public consultations will be key before the city moves forward with any of the study's recommendations.
"I think what makes citizens most upset is when they don't have that opportunity to have that input into services that are being put into their neighbourhood," said Strack.
Community stakeholders from five sectors including police, health care, and business were included in the study.
"Again we found a very high level of support for supervised injecting services," said Dr. Kerr. "However, in some cases that was met with conditions around issues such as location and also having wrap-around services to ensure people are getting more than just their injection supervised."
A breakdown of injection drug use in Middlesex-London is included in the study. It shows a sharp increase in the spread of HIV and hepatitis C due to needle sharing, and a high rate of opioid-related deaths.
"We know that emergency room visits related to opioid drug use in London are one and a half times higher than the national average and that is significant," said Mayor Matt Brown. "We have to look at the numbers. We have to recognize that when we develop solutions we are not inviting more people to use drugs, we are trying to help the people that our in our community that are dealing with this on a day-to-day basis."
Brown said the results of this study open the door for a "frank and difficult conversation" among Londoners.
"The public consultation part of this conversation is so important and it's legislated. We need to have this conversation. We need to recognize that this isn't a neighbourhood issue. This is an issue that our entire community needs to face and needs to address," said Brown. "What that means is we can learn from best practices both nationally and internationally but we also have to develop a program that is a made in London solution."
Brown was unable to provide a timeline for any solution or steps moving forward other than to stress "this isn't a situation that is going to be decided overnight."
Supervised injection sites allow drug users to inject pre-obtained illicit drugs with sterile needles, under the supervision of healthcare staff in a safe setting.
Currently, there are 90 SIS in eight countries around the world, including two in Canada. Health Canada has approved plans to open three more sites in Montreal, while the Ontario government announced in January it would fund three sites in Toronto.
The study can be found by clicking here.