New revelations about safe injection site backstory

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Good morning,

The Peterborough Currents team has learned new information about what was going on behind the scenes at Ontario’s health ministry in 2021 as Peterborough waited for a response to its application to operate a Consumption and Treatment Services Site (CTS) at 220 Simcoe Street.

Last March, we published our timeline describing Peterborough’s four-year fight for a safe consumption site. At the time, there were still some questions we had to leave unanswered. Chief among those questions: Was the long holdup in provincial funding a result of delays in the civil service’s review process, or was the delay a political one?

In the fall, we finally obtained documents that helped us to answer that question. We’ve just updated the timeline on our website with the new information, and I’ll explain the revelations a little later in this newsletter.

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New revelations about safe injection site back story

(With files from Brett Throop)

MPP Dave Smith announcing funding for Peterborough’s CTS in February 2022. (Photo: Ayesha Barmania)

This time last year, the drug poisoning crisis was worsening and concerned citizens were waiting impatiently for a response from the provincial government on whether it would fund a safe consumption site at 220 Simcoe Street.

Here’s something that wasn’t widely known at the time. According to a July 2021 email, Ontario’s civil service had already reviewed Peterborough’s funding application — and approved it.

That’s one key revelation Peterborough Currents has uncovered by filing freedom-of-information requests to Ontario’s Ministry of Health and Peterborough Public Health.

Last year, we requested documents regarding the CTS application process. We finally received those documents in the fall, and they include emails that show the application’s path through the civil service, and the sense of urgency that civil servants were trying to impress upon then-Minister of Health Christine Elliott.

One email, dated July 5, 2021, is from a health ministry staffer, and suggests that the deputy minister of health had already approved the application. “As you’ll note the DM [deputy minister] approved a few wks ago and so I’m really hoping to get some MO [minister’s office] traction on this one,” the email states, which suggests the deputy minister’s approval came sometime in June.

A few weeks later, Ontario’s Chief Medical Officer of Health Kieran Moore was also pushing for more speed. “Can we expedite?” he asked in a July 27 email about the application.

Months later, health ministry staffers were still trying to get Peterborough’s CTS application onto Minister Elliott’s radar. In emails sent in early November 2021, civil servants at the Ministry of Health were working to rank the priority of various approval packages that had reached the minister’s office but that Elliott had yet to deal with. They flagged Peterborough’s CTS application as a high priority.

But it would still take until February of 2022 for funding to be announced.

What does all this mean? In the provincial government, deputy ministers are the highest-ranking civil servants in their respective ministries. They are non-partisan, but they report to their minister, who is an elected member of the legislature affiliated with the governing party.

If the deputy minister had already approved Peterborough’s application by July of 2021, that suggests the application languished on the health minister’s desk, and that the delay in Peterborough’s CTS approval was a political one. The application stalled out in the minister’s office — where Progressive Conservative elected officials have the final say.

Dozens of people are suspected to have died of opioid-related causes in Peterborough’s public health region in the intervening months.

So why the delay on such a crucial public health and safety measure? One potential explanation is that Peterborough Kawartha MPP Dave Smith never appeared pleased with the proposal for 220 Simcoe Street.

Back when the application was still under review, Smith told Currents that it was “being evaluated by experts at the Ministry and I will defer to their expert medical opinion.”

However, just weeks before the provincial funding was announced on February 25, 2022 — and long after the site appears to have been approved by the civil service — he was still raising objections about it in an interview with Currents, questioning whether the site included enough treatment options.

In the trove of documents we obtained by FOI last fall, there is also an email Smith wrote to Peterborough’s Medical Officer of Health Dr. Thomas Piggott and sent in the middle of the night.

Smith’s email to Piggott explains how he had been pushing forward on plans for an alternative site for a CTS — the downtown branch of the CMHA — when community agencies rallied around the Simcoe Street site instead. (We reported on the CMHA proposal in the original version of our timeline in March, but we only recently obtained Smith’s email.)

In the email, Smith writes that if community agencies had gone along with his preferred location and model for a CTS, their application would have been approved, “likely within 2 weeks.” That quick turnaround time is in stark contrast to how long it took for 220 Simcoe to be approved.

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When we first started looking into this story, it was still unclear whether Peterborough would ever get a supervised consumption facility. Today, the site has been operating for over six months. So it feels a little late to be reporting these new details now, but sometimes journalism moves slowly, and we still think it’s important to enter these new facts into the public record.

At the same time, it’s also important to keep looking forward. So, where do things stand now?

According to a report released by Fourcast, which operates the CTS, there were 1,584 visits to the site and 149 registered users of it recorded in the first three months of operation. In the first month or two, there were nine overdoses at the site and no deaths, the report states.

However, there are still deficiencies. Over the past couple of years, there has been a cultural shift in the way people use drugs in Peterborough. This shift has seen people injecting less, and smoking more. Inhaling drugs is now the leading cause of opioid-poisoning deaths in our region, not injecting.

Provincial regulations do not currently allow for inhalation at CTS sites, and so people who choose to inhale their drugs are not able to receive supervised consumption services at the site. In November, the board of health voted to write to Ontario’s Health Minister Sylvia Jones to request funding to adapt the CTS model to allow inhalation.

I hope to God we don’t have to write an in-depth timeline about that request a few years from now. But we will if we have to!