Four Ottawa health centres plan safer injection sites
Three more Ottawa community health centres are making plans to open safe-injection sites for drug users, following the lead of the one that serves Sandy Hill.
The boards at the Somerset West and Centretown community health centres have voted to have their respective staffs figure out the logistics of adding a supervised facility for chronic users of hard drugs to use them in a clean place with trained staff ready to respond to overdoses.
That puts them behind (but not by much) the Sandy Hill Community Health Centre on Rideau Street, which has similar plans.
The Carlington Community Health Centre on Merivale Road is a step behind them. Its board supports the idea of safe-injection sites and is expected to vote in the fall on whether to closely examine prospects for opening one at its centre.
All four centres have medical clinics aimed specifically at drug addicts and run “harm reduction” programs such as needle exchanges. They’re calling their concept “micro-sites,” a few cubicles within their much larger, multipurpose health facilities, rather than a large dedicated injection site like the InSite site in Vancouver’s Downtown Eastside. They would need permission from the federal government.
“It wasn’t good enough for us to simply support Sandy Hill taking the lead,” said Jack McCarthy, the executive director at the Somerset West centre near Somerset and Booth Street. “We do support that, but we’re on board as well. It makes sense, I think, that there be a number of sites, because injection-drug users are not concentrated in one area.”
On Monday, responding to the Sandy Hill centre’s intention to ask the federal government for permission to add a safe-injection site, the city’s board of health is to vote on whether it supports such sites in principle, and whether to examine how many Ottawa might need and how they should work. The city’s medical officer of health, Dr. Isra Levy, says Ottawa is facing an incipient overdose crisis because of relatively new street drugs like injectable fentanyl; safe-injection sites are part of the solution, he says.
There’s no debate at the Somerset West centre about the general idea, McCarthy said. The centre has previously sent board and staff members to Europe to see safe-injection sites that have been operating for years.
“It took public injecting off the streets and back alleys and washrooms and put it into a more safe, manageable, controlled area,” he said. The questions are all about logistics.
“Would it be every day? What hours would it be? What kind of staffing component would we need to support it? Could be harmonized into the walk-in clinic we operate here? How would we organize our space? Would it be a separate area?” he said.
The health centre already serves a lot of drug users, he said. That hasn’t created problems with its other programs, including prenatal classes and play groups and services aimed at new immigrants, but they’re keen to make sure it stays that way.
“We really need to take the time to think it all through,” McCarthy said. Once they have an idea of how they’d like to operate a site, they’ll put their thinking up for discussions with the centre’s neighbours. “We’ll have consultations and consultations and consultations.”
Simone Thibault, his counterpart at the Centretown community health centre at Bank and Cooper, said her staff are working on the same questions.
“At this point, we’d have to do consultations with staff, community, and I think we’re going to look at how Public Health is going to do their consultations and see how that might incorporate us and our plans,” she said. One thing that might delay a safe-injection site in Centretown is a major renovation of the centre that’s due to start in about a year: the centre will stay open throughout but might have trouble adding a new service.
The board at the Carlington centre is foursquare behind safe-injection sites in principle, said its executive director Cameron MacLeod but hasn’t ordered any work yet on just how one might work there. He said he hopes to get a vote on that in September.
“We’re not quite as advanced as Somerset West,” MacLeod said. But the Carlington centre has a well-used needle-exchange program, swapping thousands of needles every month, and adding safe-injection facilities makes sense, he believes.
“Micro-sites is coming up as potentially the way to go and that’s what we would be looking at,” he said.
Somerset Coun. Catherine McKenney backs the health centres’ plans in her ward, she said this week. Her position is firmer than Rideau-Vanier Coun. Mathieu Fleury’s; he’s not rejected the Sandy Hill Community Health Centre’s site but he’s raised a lot of questions about how exactly it would work. Among his concerns is that if it runs Ottawa’s only safe-injection site, his ward will be a magnet for drug addicts. It already has a large percentage of the city’s drug users and overdoses, according to Ottawa Public Health’s research, but obviously not all of them.
Somerset ward is No. 2 — second in drug users, in overdoses, in emergency-room visits related to drug use, in new cases of HIV. On most of these measures, Rideau-Vanier is way out in front, Somerset markedly back, and all the rest of the city’s wards in a messy pack beyond.
The prospect of multiple small sites in different neighbourhoods should help with worries that a single site would blight Sandy Hill and Lowertown. On the other hand, for people who object to safe-injection sites on moral grounds, because they imply that drug use is something society tolerates, more probably wouldn’t be better. Allow one in Sandy Hill and before long they’ll be all over.
By David Reevely
Source: Ottawa Citizen