A long-awaited city report on supervised injection sites says Hamilton would benefit from a facility where drug users could more safely inject substances like opioids and crystal meth.

Now, it's up to councillors to decide if the city should apply to the federal government to make that recommendation a reality.

The report, which was released today and goes before the local board of health on Dec. 4, says Hamilton would benefit from "one or more" supervised injection sites, where people could inject drugs without fear of legal consequences, and under the care of medical professionals.

It also says the site should be in the lower city, located in the area flanked by Queen Street, Barton Street, Ferguson Avenue and Main Street.

Are we perpetuating a drug culture? I don't think that we are. This is about saving lives. - Mayor Fred Eisenberger

The study also says additional sites should be considered, with an eye to the east end and the Mountain. "Areas outside of Hamilton's downtown core could be serviced with a mobile supervised injection site," the report reads.

"I think this confirms the need and the value of a safer injection site in Hamilton," Mayor Fred Eisenberger told CBC News. "I'd rather face this in a proactive way rather than burying it in the back alleyways and train tracks."

Nearly half of people surveyed had overdosed

The city study, which was performed in conjunction with McMaster University, includes data from police and emergency services, social services, businesses — and a survey of 106 people who inject drugs.

The data outlines the stark realities that people with addictions are living with in Hamilton today. In 2016, 43 people died in Hamilton due to accidental opioid poisoning, which is above the provincial average. That number has more than quadrupled since 2002.

Former opioid addict Nicole and Debbie Bang, the manager of St. Joseph’s Healthcare Womankind addiction service, explain prescription painkiller addiction. 3:57

Nearly half of the 106 people who participated in the survey said they had experienced an overdose, and three in five people said that an opioid was involved when they did.

The most frequently injected drug in Hamilton, according to the people who spoke with the city, was crystal meth, followed by hydromorphone, and cocaine.

"Most survey participants (82%) reported that they had obtained a drug that they suspected was contaminated ("cut") with another substance, most commonly fentanyl and crystal meth," the report says.

A majority of the surveyed drug users also said that they had injected drugs in a public or semi-public place, and that they would use a supervised injection site if it was available.

'This is about saving lives'

Eisenberger said that getting people out of a public place and into a place where they are supervised by a medical professional is crucial.

"The status quo just doesn't work anymore."

Prescription opioids like fentanyl are contributing to a spike in overdoses, the city says. (CBC)

Supervised injection sites are becoming more common in Canada, as an opioid addiction crisis clutches the country. Health Canada has approved three supervised-injection sites put forward by Toronto city council, with two operating now and the third set to open later this year.

Meanwhile, harm reduction advocates have opened an unsanctioned site in a downtown Toronto city park that's been running for months. The city is hoping to move that site indoors, however Health Canada has yet to approve that.

Hamilton city council would need to make a similar ask to Health Canada, should councillors decide that's what is best for the city. Eisenberger said there will likely be some differing opinions about "accepting drug use" in debates about the issue, but added that he really doesn't think that's the case.

"Are we perpetuating a drug culture? I don't think that we are. This is about saving lives."

adam.carter@cbc.ca