Thank you very much. Good morning. I do appreciate the opportunity to appear before the committee today.
As you have heard, my name is Dr. Eileen de Villa, and I'm the medical officer of health for the City of Toronto.
As I believe this committee is aware, I contributed to a joint brief, along with colleagues from Montreal and Vancouver, that was presented to this committee earlier this year. That brief spoke to the nature of the toxic drug crisis in Canada's largest urban centres, so I'm very pleased to be here today to join you and expand on that information that was already provided and certainly to answer any questions you may have.
Before I go further into my remarks, I do want to note that as I talk about data that are related to the crisis, to the epidemic that we see today, I'd like to note that I do so with respect and with a deep appreciation for what these data mean. As you have just heard from my fellow witness, we're talking about people. We're talking about people who are our loved ones, our friends, our families and our colleagues.
One of the reasons I'm here today is to share with you some stories from our clinic, where I have an incredible team of colleagues who support hundreds of clients every single day.
I simply cannot overstate the heroic efforts of our frontline service delivery partners, some who work directly with me and some who work throughout the system in Toronto. They have seen the epidemic escalate over the past decade, as my fellow witness, Professor Fallu, mentioned. My colleagues have experienced immeasurable grief, as have many communities throughout Canada. My colleagues have saved thousands of lives, and they continue to show up every day to work despite the enormity of the loss that they have experienced and the unrelenting nature of the epidemic we are witnessing.
I do want to tell you about our clinic in the heart of downtown Toronto operated by us at Toronto Public Health. We offer a full range of services and referrals, and we actually see a very high volume of clients every year. In fact, last year, 2023, we supported 18,575 client visits, and over 21,000 client visits to our supervised consumption service at Toronto Public Health in 2022.
As you know, supervised consumption service sites are clinical spaces for people to bring their own drugs to use in the presence of trained health professionals. I know this committee has heard that Canadian and international evidence and our own experience in Toronto show that these sites do save lives and, yes, we do connect people to social services, and we are a pathway for many to treatment.
There are currently 10 of these sites located across Toronto operated by a range of health providers and funded by a variety of sources. The demand—and need—for these services is high.
Across the 10 supervised consumption sites in Toronto, there were just over 96,000 visits in 2022 and just under 95,000 visits in 2023. Amongst these visits, staff at these services responded to almost 2,000 visits in 2022 where overdoses occurred and almost 2,300 in 2023. We saw those many visits with overdoses, and we responded to them.
In addition to providing medical interventions for overdoses, the sites also offer thousands of referrals to health and social services annually, roughly 6,500 in 2022 and almost 10,000 in 2023. In addition to providing direct medical care, we know that the sites serve as an important entry point to a fragmented, although well-intentioned, health care system. We do help link individuals to further sources of care and, of course, to connection, which is an important component of that care.
When people talk about harm reduction, this is what it looks like in our clinical spaces. These harm reduction efforts are meant to work hand in hand with connecting clients to a range of treatment options.
At Toronto Public Health, we operate the only injectable opioid agonist therapy clinic in the city. We currently have funding to provide this treatment option to roughly 35 clients at any given time, although I can tell you that this funding is time limited.
This program offers injectable hydromorphone to medically and socially complex clients who may benefit from this treatment approach, which is delivered on site in our clinic and in an observed fashion. This particular program also includes wraparound services and supports for clients, observed doses and monitoring, a coordinated referral network, case management, and overdose and prevention education.
Eligibility for this program follows national clinical guidelines and focuses on those who are at greatest risk of overdose. I should note that the average length of treatment in this program is a little over 50 days—53 days roughly—although every client will have a different experience. That's the case when we see other health issues and health matters. There may be an average, but there is a slightly different experience, depending on which person we're talking about.
When it comes to this kind of treatment, we have observed and noted that some people will start and stop treatment multiple times. That's why it's incredibly critical that we have a range of options available to meet individuals where they are in their journey.
When we look at our data, we see that since opening the doors, the program has served a wide range of clients, ranging in age from 24 to 62, with 73% of the clients identifying as male.