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Naloxone kits are seen on Aug. 2, 2017.

Fred Lum/The Globe and Mail

It's little more than a table with three chairs and three yellow needle-disposal boxes crammed into a corner of Toronto Public Health's downtown addiction clinic. But it's now a front line in the city's fight against a wave of opioid overdose deaths.

At 4 p.m. on Monday, Toronto opened its first officially sanctioned supervised drug-use site. The facility will allow those addicted to heroin or other substances to get high under the watchful eye of a nurse who can intervene in the event of overdoses, which are rising as street drugs are increasingly likely to be laced with the potent opioid fentanyl.

It's an interim site, being opened in the same harm-reduction clinic – known as The Works, just off Yonge-Dundas Square – where Toronto Public Health is building a permanent supervised drug-use site set to open in the fall, one of three sites approved by Health Canada for Toronto clinics.

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Federal officials inspected the new interim site late last week.

One of the other Toronto clinics working on a permanent supervised-injection site, South Riverdale Community Health Centre in the city's East End, has decided it cannot naviagte the logistics to open its own interim site.

The other clinic, Queen West Central Community Health Centre, has said the idea was still under consideration.

The rush by Toronto health officials to provide one or more interim sites comes not only as a rising number of overdose deaths made headlines over the summer, but as a group of volunteer activists – made up of front line harm-reduction workers – took matters into their own hands and opened an unsanctioned "pop-up" supervised drug-use site in a tent in Moss Park in the East End.

City officials and police have so far allowed that site to operate, provided it shuts down by 10 p.m. and harm-reduction workers clean up any needles left behind. Mayor John Tory has said he wanted it taken down once the city's own, legally approved, supervised drug-use site opened.

But activists with the Toronto Harm Reduction Alliance behind the clinic say they plan to keep operating their pop-up. They argue drug users in Moss Park are unlikely to make the trek to Yonge-Dundas Square. And they say volunteers at the site have reversed three overdoses there since it opened over a week ago.

But the group is also exploring the possibility of finding a nearby indoor site on private property, said Matt Johnson, an activist with the pop-up site.

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Asked whether it will be shut down, Mr. Tory said in an e-mailed statement that the city, Toronto Public Health and other officials were still trying to "find a solution that responds to this public health crisis" and also deals with "the broader needs and expectations" of neighbourhoods, residents and businesses.

"My goal as mayor and the goal of the Toronto Harm Reduction Alliance is the same: to save lives," the mayor said. "I have said, and I will repeat, that I do not believe a public park is an appropriate place for supervised injection services."

Giorgio Mammoliti, one of just three city councillors to vote against the supervised drug-use sites last summer, warned on Monday that Toronto Public Health's clinic at Yonge-Dundas Square would attract drug dealers and criminal activity as well as encourage people to do drugs. "It is going to be disastrous," Mr. Mammoliti said.

Nick Boyce, another harm-reduction worker involved in the pop-up site, challenged Mr. Mammoliti's claims. "We're working with people who already have severe mental-health [problems], severe addictions," Mr. Boyce said. "I've been down at that site this week. I watched people inject drugs into their neck because that's all they could do, okay? They are so desperate. We're trying to reach out to those people."

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