Safe injection: Saving lives or ignoring addiction?

The crumpled figure in the picture is face down on the tiled bathroom floor. His legs are curled underneath him as though he toppled over from a kneeling or sitting position. The bathroom is clean but for wrappers and a tourniquet scattered over the closed lid of the toilet. A used needle lies on the floor behind the unconscious man.

“This picture was taken at Pizza Pizza, downtown,” says Sean Leblanc.

For Leblanc, a former addict and chairperson of the Drug Users Advocacy League (DUAL), the scene in the photo is all too familiar.

“There’s way too many people in our community who are dying of overdoses, completely avoidable overdoses,” he says. “Best friends and lovers and family. I’m just tired of going to funerals all the time.”

Leblanc and DUAL are working with partners, including the Sandy Hill Community Health Centre and doctors from the Ottawa Hospital, to propose an exemption to federal drug laws, which would allow them to set up a supervised injection site. The site would be modeled after the first and only legally sanctioned supervised injection site in North America, Vancouver’s Insite.

Since 2003, Insite has provided clean needles and a space for users to inject drugs they have purchased elsewhere. Nurses are on hand to provide immediate medical attention in the event of an overdose. Insite also offers referrals to counselling and drug treatment programs. Numerous studies have shown Insite has a positive effect on the health of its clients.

Proponents of  a supervised injection site for Ottawa argue the site is needed to combat overdose deaths, improperly discarded needles, and the city’s high rates of HIV and Hepatitis C. One in 10 injection drug users in Ottawa have HIV, while one in six have contracted Hepatitis C.

“All we want is a chance to live healthy lives, people that use drugs,” says Leblanc. “What’s going on right now isn’t working at all, so we’re going to have to try something different, even if it’s something they deem as radical as supervised injection.”

Leblanc says a supervised injection site is needed to give addicts a clean, safe place to use.

“There’s people injecting in every bathroom around here right now,” says Leblanc, sitting in his office in Lowertown. “Its really dehumanizing, you know, running around trying to find a bathroom somewhere so you can put a needle in your arm just to feel normal for that day. I don’t think people should have to go through that.”

Leblanc says while existing services that provide users with clean needles are good at combatting the spread of disease, they cannot prevent overdose deaths.

“I’ve overdosed, and I know you have,” says Leblanc, turning to Kelly Florence, another former drug user who now works for DUAL. “It’s all luck of the draw, having the right people there at the right time.”

Florence says in the past five years three of his friends have overdosed and stopped breathing while they were using together. If he hadn’t given them CPR he doubts they would be alive today.

The Toronto and Ottawa Supervised Consumption Assessment study (TOSCA), published in 2012, recommended that both Toronto and Ottawa would benefit from supervised injection facilities. Researchers recommended two in Ottawa and three in Toronto. The study was noted as the most comprehensive of its kind to date.

However, opposition to supervised injection is strong in Ottawa. Mayor Jim Watson and Chief of Police Charles Bordeleau have both voiced their opposition.

A grassroots organization, Campaign for Safer Consumption Sites (CSCS) conducted a survey of residents and businesses in the Byward Market and Lowertown area. CSCS claims results of the survey showed broad support for a supervised injection site in Ottawa, but some residents and business owners in the area have challenged these results.

Chris Grinham is a Lowertown resident and the founder of Safer Ottawa, an organization that promotes increased access to addiction treatment and education about the dangers of drug use. Grinham calls the CSCS survey “bunk.” He says he spoke to 30 to 40 businesses in the market and found that none of them were in favor of a supervised injection site in the neighborhood.

“From a business standpoint it worries them drastically,” says Grinham. A supervised injection site would lead to a migration of addicts and dealers to the area that would in turn lead to an increase in crime, he says, a concern that has been echoed by the police force.

Matt Skof, president of the Ottawa Police Association, recently returned from a trip to Insite in Vanouver and says supervised injection “derelicts an area.”

He laughs at the widely reported claim that crime has not increased in the area surrounding Insite. He says Insite has required the deployment of a massive number of additional officers to the neighborhood.

Skof also takes issue with the so-called “no-go zone” around Insite, a four-block radius where drug laws are not as strictly enforced.

“There’s no increase in drug crime? Well of course not, because drugs aren’t a crime. In fact, you’ll have a drop in crime because we won’t be reporting them,” Skof says.

Grinham and Skof believe the money needed to open a supervised injection site would be better spent on addiction treatment programs.

“We have very limited resources to deal with the situation of addiction and, by proxy, the situation of homelessness,” says Grinham. “We’re going to spend all of this energy, time and money for something that at best is going to be mostly ineffective in dealing with disease and overdose, and does nothing to address the issues of addiction or its root causes.”

The federal Conservative government has made no secret of their opposition to supervised injection. In 2011 they lost a bitter Supreme Court battle to close Insite. Supreme court judges ruled unanimously that not allowing the clinic to operate under an exemption from drug laws would be a violation of the Charter of Rights and Freedoms.

“Insite saves lives. Its benefits have been proven. There has been no discernable negative impact on the public safety and health objectives of Canada during its eight years of operation,” the ruling said.

In June of 2013 the federal government tabled the Respect for Communities Act. The bill, currently making its way through the House of Commons would require the government to consider a range of opinions including those of police and municipal politicians before allowing supervised injection sites to open.

Now the Sandy Hill Community Health Centre and its partners are racing to get their application in before the bill becomes law.

“The clock is definitely ticking,” says Greg Cameron, an organizer for CSCS.

Leblanc says they hope to complete the application by January and remains optimistic about the proposal’s chances. He’s standing in a mock supervised injection site built as part of the process of public consultation.

“We’re just trying to demystify it,” says Leblanc.

Four booths lined with mirrors face one wall of the room. The mirrors allow drug users to see themselves while they inject and for nurses to be better able to monitor for signs of overdose.

“The nurse would be here,” says Leblanc, gesturing to a chair on the other side of the room, a few feet behind the booths.

Florence looks around the room. “Something so simple could save so many lives,” he says.

Like Leblanc, his reasons for campaigning for a supervised injection site are personal. His ex-wife is homeless and addicted to heroin.

“It’s destroying her. I’m watching her die everyday,” says Florence. “For me, that alone – that one person – is worth fighting for.”

By Alison Sandstrom
Source: Speak JHR Carleton