As a fentanyl crisis sweeps the country, medical officials in Ottawa are moving quickly and quietly to open a supervised injection site for opioid users.

The opioid substitution program, which will be the only the second of its kind in Canada, is expected to formally begin in September at the Shepherds of Good Hope in the ByWard Market area.

While attention in this city has been focused on a recently approved supervised-injection site for illegal drug users, officials with Inner City Health have been planning the managed opioid program, which will open first.

It will be somewhat similar to the supervised injection site to be run out of the Sandy Hill Community Health Centre, where injection drug users inject their own illegal drugs under supervision in a sterile location. Under the managed opioid program, however, participants will be prescribed hydromorphone, provided by Inner City Health, which they will either inject or take orally several times a day under supervision.

Because the drugs involved are legal when prescribed, the program does not require a special exemption, as supervised-injection sites for illegal drugs do. But Inner City Health has contacted both the College of Physicians and Surgeons of Ontario and the Ontario College of Nurses about the plan and for support.

Inner City Health, which provides health care to Ottawa’s homeless, has been thinking about introducing the program for some time, said executive director Wendy Muckle, but the fentanyl crisis has made the need urgent.

“We can’t sit around and talk about this any longer. This is like you are in a war zone, you’ve got to do what you’ve got to do,” she said.

Health Canada has granted an exemption that paves the way for Ottawa's first supervised injection site to open in the city's Sandy Hill neighbourhood — potentially as soon as this fall.

On Wednesday, the federal department gave the Sandy Hill Community Health Centre the green light to build the site at its Nelson Street headquarters.

The community centre has proposed a facility that would provide supervised injections to between 80 and 150 people a day, many of whom already use the centre for other reasons.

"The work of the last five-plus years has come to fruition," said Rob Boyd, the director of the centre's Oasis program, on Wednesday after Health Canada made their decision public.

"It's a bit surreal right now, when I think about the struggle and the efforts over the years, that we're finally here at this point," Boyd said. "I think it's significant for Ottawa. I think it's a recognition that the opioid crisis and the overdose crisis are here in Ottawa."

In January, the centre's board of directors voted to submit their application to Health Canada, shortly after Ontario Health Minister Eric Hoskins expressed his support for the supervised injection site plans in a letter to Jane Philpott, his federal counterpart.

The application was necessary since Health Canada has to grant an exemption under the federal Controlled Drugs and Services Act before such a site could open.

Boyd said the exemption is "conditional upon a final inspection," meaning the centre has to build the supervised injection room before getting absolute approval.

"Then they come in to inspect it. So now our focus is going to be on getting those renovations completed," he said.

Boyd said he expected the site would open in October.

The first supervised injection site in the nation’s capital could be open within months now that the Sandy Hill Community Health Centre has a conditional approval from Health Canada.

The federal government signed off on the health centre’s application Wednesday after receiving the request for an injection site last January.

Once a follow-up inspection is done and provincial money comes through, clients will enter one of five injection stations on the first floor of the health centre’s facility on Nelson Street and shoot his or her drugs under the supervision of health experts.

Rob Boyd, director of the harm-reduction program at the centre, said staff can now focus on renovations for the injection room and work with the province on funding.

He wants to have the injection site up and running as soon as possible, but he expects it won’t be until October that the service is ready.

“For many of our clients, this is a difference between life and death,” Boyd said. “This is going to make a huge positive impact.”

David Gibson, executive director of the centre, said it has been five years in the making for the facility.

“It’s a great accomplishment and it speaks mountains of the partnerships with public health, (medical officer of health) Dr. Isra Levy, and all the partners that we have that have stepped up, and more importantly the people that we serve and who have been asking for this way before the five years started,” he said.

Health Canada’s final decision on whether or not a supervised injection site can open at the Sandy Hill Community Health Centre could be coming any day.

According to the Health Canada website, the proposal has completed all five of the required application steps and has now reached the decision stage.

Rob Boyd, Oasis program director at the centre told Metro News he was notified by the department Wednesday they had completed the application to the satisfaction of Health Canada and their case would now be forwarded for a final decision.

There are at least two firefighters on every truck in every urban Ottawa fire station trained in administering naloxone, a powerful antidote for opioid overdoses, and training will continue until all firefighters in all 45 stations can administer the drug.

“Two years ago the most recent statistics showed we had approximately 45 people died by overdose in the city of Ottawa,” Mayor Jim Watson said Tuesday during a joint announcement with Ottawa Fire Chief Gerry Pingitore at Station 36.

Last month Pingitore said that naloxone kits and training would be rolled out across the department by the end of June.

A piece of legislation that makes it easier to open supervised injection sites has become law, replacing Harper-era regulations that effectively stalled the harm-reduction service as overdose deaths climbed.

Under Bill C-37, which received royal assent on Thursday, agencies wanting to open a supervised-injection site must meet five streamlined conditions, down from 26 under the previous Respect for Communities Act.

The Liberal government tabled the bill in December. It received final approval on Wednesday, with minor amendments.

Federal Health Minister Jane Philpott called the passing of the bill “very good news.”

“As you well know, we’re facing an overdose epidemic in this country of unprecedented proportions,” she told reporters in Ottawa on Thursday.

“[The legislation] will have a significant impact in terms of our ability to offer harm-reduction services, including, of course, facilitating the ability for communities that want and need supervised consumption sites to be able to establish those facilities.”

As Ottawa’s opioid crisis grows, the proposed Supervised Injection Site (SIS) in Sandy Hill has cleared another hurdle.

The Ontario government confirmed in the budget released April 27 that it will fund the site, as long as it gets approval from the federal government.

Rob Boyd, Oasis program director at the Sandy Hill Community Health Centre, where the SIS will be housed, said they are still in negotiations with the province and have not yet nailed down the exact capital and operating costs.

“We are very concerned about this recent spike in overdoses. We don’t think it’s an anomaly. We think it’s very likely the way things are going forward now,” he said.

But, Boyd said, it is looking less likely the site will be able to open this summer because the community health centre will have to do some renovations and hire and train specialized staff before they can open it.

“Everybody is working together as quickly as possible on this and I think everybody is motivated to get this thing up and running as quickly as possible,” he said.

With the promise of funding in the Ontario budget tabled Thursday, Ottawa’s first supervised drug-injection site will almost certainly open later this year.

Though no dollar amounts were announced, the document firms up a promise by Health Minister Eric Hoskins in January in supporting an application from the Sandy Hill Community Health Centre.

The centre has asked for $1.4 million annually to run the site, which organizers hope will be open 12 hours a day, seven days a week in their location on Nelson Street, near the corner of Rideau.

Rob Boyd, director of the Oasis program at Sandy Hill — and a key figure in the injection-site application — said he was pleased to see Ottawa’s plan mentioned in the document. “This is going to happen.”

He was initially hoping the site would open this summer but he said the centre needs at least four to six weeks after capital funding has been secured. The site would accommodated by reconfiguring existing space in the centre.

“We can’t get this open fast enough,” said Boyd. He said he’s very concerned about the spike in overdoses that struck the city in a 72-hour period last week, suggesting an influx of a powerful version of fentanyl had flooded normal supply lines.

 With no time to waste, Somerset West Community Health Centre is moving forward with its plan to offer a supervised injection site.

“Our current attempts at solving the drug crisis are not enough,” Stan Kupferschmidt, harm reduction outreach worker at the centre, said in a recent interview.

 “We felt we had to go ahead with this. We’ve lost far too many community members in just the last year.”

The health centre is moving forward with its plan to offer the service by applying for funding from the province and applying to the federal government for an exemption under the Controlled Drugs and Substances Act to operate the site.

Consultations were held earlier this month and the feedback from recent meetings forms part of the document required so the health centre can be considered for the federal government exemption.