Sandy Hill Community Health Centre plans injection-site consultations in April

The Sandy Hill Community Health Centre is planning to consult the public this spring about adding a safe-injection site to its building at Rideau and Nelson streets, says the man who runs the Centre’s drug-treatment programs.

“We’re basically on the same path as Toronto,” Rob Boyd said Monday morning following the news that Toronto’s board of health is going to consider three specific sites — two at community health centres and one run by Toronto’s public-health unit itself.

“We are planning on beginning our own consultations, probably in the month of April,” said Boyd. “(They’ll take place) over about six weeks, to allow as much access as possible.”

Jim Watson has always been against such a site and doesn’t care to discuss it, thank you. “Mayor Watson’s position on supervised injection sites has not changed. Mayor Watson prefers to see a continued focus on investment in treatment programs,” wrote his press secretary Livia Belcea in an email on Monday. “Mayor Watson will be unavailable to comment further in the upcoming days.”

That’s unfortunate but not the end of anything, said Boyd, who runs a needle exchange, a methadone and suboxone clinic, and other services for people with HIV or hepatitis C. Adding a small safe-injection facility to a health centre that already does all these things would improve people’s health and probably nobody outside the clinic would notice, he said. “This is really core stuff with us.”


Ottawa’s public-health unit has studiously avoided taking a side on the usefulness of a safe-injection site, though its own work has shown that more than two-thirds of the city’s injection-drug users have hepatitis C and about one in six has HIV. These illnesses spread in blood, they’re fantastically expensive to treat, and they kill people. The rates of disease among drug users are markedly higher here than in Toronto. Ottawa also sees about 40 drug-overdose deaths a year (injection-drug deaths aren’t all of them, but a large fraction), amid 1,000 paramedic calls for suspected overdoses.

Canada’s one functioning facility, InSite in Vancouver, is easy to dismiss if that’s what you want to do.

Drug deals went on openly in the Downtown Eastside — notoriously “Canada’s poorest postal code” — before InSite opened. Addicts cleaned their needles with puddle water and died of overdoses in alleys. A conservative mayor, Philip Owen, saw that the city’s traditional approach was failing and came to support a safe-injection site as part of a different philosophy that saw reducing harm as a philosophy that worked better than prohibition.

Since InSite opened, serious scholarly science has found that drug-related deaths have declined sharply in its neighbourhood, along with ugly nuisances like litter and open drug use. People who shoot up at InSite are more likely than other addicts to sign up for detox and rehab. They get treatment for other health problems that go along with addiction and living on the street, thanks to having contact with the health system through doctors, nurses and social workers they come to trust.

If you want to cast all that aside, you point out that although the peer-reviewed studies have appeared in world-class journals like the Lancet and the New England Journal of Medicine, the same researchers’ names appear on them over and over again — Julio Montaner, Thomas Kerr, Mark Tyndall. People who called for InSite in the first place, in the main, and who really want to demonstrate that it’s been a success.

Whatever the quality of their work (and it convinced the Supreme Court, which stopped a federal government attempt to close InSite in 2011) they’re looking at Canada’s worst, poorest, most drug-damaged neighbourhood. If InSite has been a success there, well, so what? Our fair city has no neighbourhoods like the Downtown Eastside, does it?

This makes for bad health-policy thinking, but it’s good enough for politics. Evidence from a second city, from squeaky-clean Toronto, would be harder to reject. It’s a bigger city, sure, but it’s in our province. More Ottawans know it than know Vancouver. New names will be on the research.

Boyd thinks the evidence is already in, and new information from Toronto won’t convince people who are determined to blow it off, so there’s no point in waiting.

“I don’t think it’s a matter of waiting for more evidence,” he said. “I think it’s a matter of giving a local community local experience.”

By David Reevely
Source: Ottawa Citizen