Brooklyn McNeil spent much of the last year advocating for a service that could have saved her own life.

Instead, there will be an empty chair Monday as Toronto’s board of health debates whether to proceed with three safe-injection sites in the city after a record 258 overdose deaths in 2014 — a 77-per-cent increase over a decade ago.

McNeil, an Ontario scholar, singer, artist and harm-reduction advocate, died of an overdose in an east-Toronto alley last month. She would have turned 23 on Tuesday.

“She was so amazing at helping so many people,” said her grieving mother, Thia Massaro, on the phone from Thunder Bay where McNeil grew up.

“But in the end, she couldn’t help herself.”

McNeil began injecting opiates when she was 18 and had survived six previous overdoses. She was the last deputant to speak in March when the board of health voted to conduct community consultations around the proposed supervised-injection sites.

The service provides a safe, hygienic place for addicts to bring their drugs and inject under the supervision of a nurse who can help if anything goes wrong. She had planned to speak at the board of health again Monday on the life-saving initiative.

“Brooklyn’s death is speaking louder than anything she could have said at the meeting,” Massaro said. “It happened to her — exactly what she was crying out for, a safe place to inject.

“Instead, she was (found) sitting in an alley, by a dumpster, by herself. That is the most heart-wrenching thing.”

With an online poll showing community support as high as 96 per cent and recent letters of support from both Toronto Mayor John Tory and police Chief Mark Saunders, the board is expected to give the green light Monday. City council will be asked to give final approval later this month.

A week ago, as news of McNeil’s June 22 death spread throughout the youth shelter system where she lived and worked as a peer mentor, heartbroken friends and shelter staff gathered at the South Riverdale Community Health Centre’s Drug Users’ Memorial to mourn.

More than 60 community members congregated next to the eight-foot copper flame sculpture to light candles, hold hands and pay tribute to McNeil and others lost to overdoses and related health complications.

The permanent memorial, believed to be the first of its kind in North America, was designed by current and former drug users over two years under the guidance of local street artist Rocky Dobey and unveiled in 2013. The names of 130 who have died in the city’s east end are etched into the sculpture, including 10 added last month. Services are held every three or four months.

“We are here to share our stories and our sorrow,” said Jason Altenberg, director of programs and services for the centre, one of the three proposed supervised-injection sites.

“The war on drugs has turned into a war on people and that has got to end,” he told the gathering.

Services like the one last Monday take away the shame and stigma attached to drug use by allowing friends and family members to honour their loved ones together in a public way, he said in an interview.

“The community wanted something specific to humanize these deaths,” Altenberg said about the memorial. “These deaths are not just about homelessness and HIV, but about overdoses and the long-term criminalization of a serious health issue.”

McNeil’s friends were among the last to speak during the moving, open-air service that included songs and drumming by indigenous musician Kayla Sutherland and vases of freshly cut flowers donated by a neighbouring florist.

“You were a colleague, a friend and a mentor,” said McNeil’s friend Akia Mungo, 24 as he choked back tears. “You were the face of harm reduction and your light and words shall be missed. The impact you made in my life, helping me keep sober and encouraging me to be a radical activist even in the face of adversity will never cease to exist.”

Meagan Masse, 34, couldn’t believe her friend is gone.

“She has given more to people in her short life and done more for harm reduction than many professionals,” Masse said. “Anything negative you were feeling, she had a way of turning it around.”

McNeil, who had been staying at the YWCA’s Woodlawn residence since January, was “on top of the world” because she was about to move into her own apartment in a social housing building, Masse said.

Her family was planning to visit Wednesday for a trip to Canada’s Wonderland and an evening at the theatre to see the Mirvish production of Matilda.

“These deaths are absolutely preventable. Sure, there is the buddy system. But you need somewhere safe to go,” Masse said.

An animation student at Humber College before her addiction forced her to drop out several years ago, McNeil was already making a mark in harm-reduction work, shelter staff said.

“Brooklyn was an advanced peer worker, which meant that she was a leader in the homeless youth community as a role model and harm-reduction advocate,” said Audrey Batterham, co-ordinator of the peer program for Eva’s Satellite, a shelter for youth struggling with addictions, where McNeil lived last year.

Peer work is about people with “lived experience” supporting their peers in ways that many social workers can’t, Batterham said.

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As McNeil told the board of health in her March deputation, “many of my resources have come from addicts and harm-reduction workers over, say, counsellors and therapists at rehab.”

McNeil was paying it forward by offering workshops in youth shelters and sharing her story and advice as a public speaker, Batterham said.

“My sister was crazy smart. She helped me write all my essays,” said Madison, 20. “She was an old soul who, at age 5, asked my mom ‘what is my purpose?’ ”

“I think she found her purpose,” said Massaro, drawing strength from stories of how her daughter changed the lives of so many other troubled youths who have been flooding Facebook with condolences. “We will be watching on Monday to see what happens.”

Facts about safe-injection sites

Supervised injection sites are safe, hygienic places where people can bring their drugs to inject while a nurse watches for signs of overdose or other complications.

To operate legally, municipalities must seek exemptions for the sites under the federal Controlled Drugs and Substances Act.

Also required are letters of support from numerous players, including the local police chief and colleges of physicians and nurses as well as results of consultations with community groups and proposed measures to address any concerns.

Toronto Public Health is proposing three sites in community health clinics already serving people who inject drugs including The Works, at Yonge and Dundas Sts., Queen West-Central Toronto Community Health Clinic at Queen St. W. and Bathurst St., and South Riverdale Community Health Clinic at Queen St. E. and Carlaw Ave.

Benefits of supervised injection sites include fewer overdoses and less risk of infectious diseases such as HIV, decreased public injection and increased use of other health and social services.

Community concerns include potential increase in crime and neighbourhood stigma. Strategies to address concerns include community advisory committees, adequate waiting room space, police protocols, active monitoring and evaluation.

If approved, Toronto would seek provincial funds of about $350,000 to build cubicles and a waiting room in each location and $1.8 million in annual operating costs.

If approved by council, the health centres plan to submit their exemption letters to Health Canada this fall.

Across Canada, Vancouver has two sites, Montreal is awaiting federal approval for multiple sites and Ottawa is considering one. Needs assessments are underway in London and Thunder Bay.

Injection drug use in Toronto, By the numbers

77%: Increase in drug overdose deaths in Toronto between 2004 and 2014.

258: Drug overdose deaths in 2014.

61%: Injection drug users who tested positive for hepatitis C in 2012 study.

5%: Those who tested positive for HIV.

100,000: Client visits to harm reduction services in 2015.

1.9 million: Clean needles distributed in 2015.

84% to 96%: Respondents to online survey who identified benefits to safe-injection sites.

4% to 36%: Respondents who identified concerns over safe-injection sites.

3: Safe-injection sites proposed for Toronto.

2: Safe-injection sites operating in Vancouver.

90: Safe-injection sites operating worldwide.

Source: City of Toronto