In a report released Friday, the city of Montreal's public health agency recommended that the city create four safe injection sites for hard drug users, including one that would be mobile. The mayor's office said the same day it agreed with the proposal.

The city must now seek funding to operate the sites from the Quebec provincial health department and then seek an exemption from the federal Controlled Drugs and Substances Act to be able to legally operate the sites.

The Conservative Harper government is not friendly toward safe injection sites, but its effort to shut down Canada's only existing safe injection site, Vancouver's Insite, was rejected by the Supreme Court of Canada in September. The court held that shutting down Insite would violate drug users' rights to life, liberty, and security.

Montreal public health director Richard Lessard said that ruling "opened the door" for Montreal's proposal and that it was desperately needed.

"There is an abnormally high death rate among intravenous drug users in Montreal and an epidemic of infections of hepatitis and HIV," he said on Friday.

Lessard's report found that 68% of intravenous drug users in Montreal are infected with hepatitis C and 18% are infected with HIV. It also found fatal overdoses on the rise. While an average of 51 users overdosed each year between 2000 and 2005, an average of 72 users overdosed each year between 2006 and 2009.

"We are convinced -- and all the scientific studies back us up on this point -- that supervised injection sites do not create new problems," Lessard told The Montreal Gazette. "On the contrary, they reduce the problem of syringes found on the streets and in the parks, and they reduce the number of overdose deaths."

There are still obstacles to overcome, ranging from federal hostility to local NIMBYism, but if all goes well, Montreal could join Vancouver in providing safe injection sites as a public health measure by next year.