Ontario Health Minister Eric Hoskins supports the Sandy Hill Community Health Centre’s request for a supervised injection site and says there will be provincial money available to help set it up.
Hoskins sent a letter Monday to federal Health Minister Jane Philpott, saying the Sandy Hill health centre’s proposal “appears logical and supported by evidence.”
“Given the importance of this issue, we are also developing a provincial framework in order to respond to the safe injection site proposals from Toronto and Ottawa, as well as other municipalities or other applicants that may request similar programs for their cities in the future and will provide full details within the next few weeks,” Hoskins said in a written statement released by his office.
That’s a big boost for the Sandy Hill health centre, which wants to open an injection site at its Nelson Street facility. The health centre needs a federal exemption to allow drugs at the site and plans to submit an application this month, if its board approves the initiative on Jan. 18.
Ottawa’s public health authority is trying to curb drug overdoses with new vending machines that will dispense clean needles and pipes — one of the first harm reduction efforts of its kind in North America.
The plan comes as the opioid crisis continues move across Canada toward eastern cities that are bracing for a similar rise in overdose deaths recorded in Alberta and British Columbia, which has declared a public health emergency over the matter.
“We are definitely seeing an increase in overdoses due to opioids, not the same as Vancouver, but we are aware that that’s possible here,” Vera Etches, Ottawa’s deputy medical officer of health, told VICE News.
She said the five vending machines are part of a pilot project that will complement existing harm reduction services and clean needle exchanges in the city that are generally open only until 4:30 PM. There’s also a mobile van that does outreach from 5 PM until midnight, but that still leaves significant gaps in time.
Council politics have been sucked out of the debate over supervised injection sites with Mayor Jim Watson declaring the public health board as being the ultimate authority.
According to a letter Watson wrote in response to an anticipated application for a supervised injection site, Ottawa Public Health’s board has the final say on the issue.
The Sandy Hill Community Health Centre is close to submitting a request to the federal government to have a site at its Nelson Street facility.
The health centre needs the City of Ottawa to write a letter responding to the application.
Watson wrote the letter last month as chief executive officer of the city. His office provided a copy to the Citizen on Wednesday.
In the letter, Watson details the legal rationale for the health board having “jurisdiction and governance” to establish a “formal position” on supervised injection sites in Ottawa.
That means the matter is unlikely to land on city council’s agenda and have politicians debate the merits and weaknesses of supervised injection sites, even though Ontario Health Minister Eric Hoskins has suggested municipal governments must decide.
The city’s health board – though far from non-political, since six of the 11 members are city councillors – has voted in favour of supporting supervised injection sites in Ottawa.
The federal health minister is pushing cities like Ottawa to open supervised injection sites despite opposition from the capital city's mayor and chief of police.
"We will certainly encourage everyone to have that public health approach, to recognize that this is a health crisis and that we need to provide the appropriate resources," said Jane Philpott, responding to a reporter's question about local opposition to supervised consumption areas, also referred to as supervised injection sites.
Mayor Jim Watson has maintained the focus should be on providing additional treatment options for drug users, while Ottawa police Chief Charles Bordeleau has expressed concerns about public safety.
"The evidence is very clear that when they are well-established and well-maintained in communities that want and need them, supervised consumption sites save lives and do not have a negative impact on crime rates," said Philpott.
It’s too late to save the hundreds of Canadians who’ve already died this year from drug overdoses, but the Liberals’ proposed changes, which would make it easier to open safe-injection sites, will help cities come to grips with a crisis that’s cutting a tragic swath across the country. Absent full drug legalization (and the better health oversight it brings), the best we can do is try to minimize the harm of drug use.
“We need to take swift action on the opioid crisis to save lives,” said Health Minister Jane Philpott, having waited a year into her mandate to actually make it easier to open safe-injection sites.
The Liberals have proposed a five-step plan that, while repealing the more than two-dozen steps needed to open a safe-injection site, still maintains some troublesome elements from the last government’s policy, such as having to prove the need for a site (why wait for the body count to climb?) and gathering evidence about the effect on crime (rates haven’t gone up around injection sites already open).
The Sandy Hill Community Health Centre has asked the province for $1.4 million a year to operate a supervised injection site seven days a week, 12 hours a day in downtown Ottawa.
The estimated cost has more than quadrupled since a plan for the service was unveiled earlier this year.
Rob Boyd, director of the health centre’s harm reduction program, said costs have gone up as the service model changed in response to the public’s feedback — and to the quickening pace of the opioid epidemic.
Community members, he said, made it clear they want drug users to be able to access the centre’s medical, social and counselling services whenever they visit the injection site.
“They felt we needed to be open as many hours as possible: that this was not going to be a Monday to Friday, nine to five service,” he said. “What that does is scale up the cost of doing this.”
On Monday, the Liberal government tabled legislation that will remove many of the barriers to building safe injection sites that the previous Conservative government had established.
The current rules require a safe injection site to satisfy 26 criteria before getting federal approval, including a letter signing off on the proposal from the city and from the police chief.
But the new Liberal legislation will have just five criteria for approval, such as demonstrating the need for such a site, showing that community consultation was done, and assessing the effect it may have on crime in the area.
The federal Liberals are streamlining the process to allow communities to apply to set up supervised injection sites quicker, with less red tape and with less room for community objections.
Health Minister Jane Philpott introduced the bill that would clear out a long list of regulations and conditions for establishing sites that the previous Conservative government introduced.
Those conditions included a requirement to have the approval of a community’s council and its police chief. In Ottawa, both Mayor Jim Watson and Ottawa police Chief Charles Bordeleau have indicated they don’t support an injection site.
Philpott said the changes are necessary to deal with a public health crisis that is only growing.
“We need to take swift action on the opioid crisis to save lives. We need a renewed focus on harm reduction,” she said.
Before then, the Ottawa woman had been an off-and-on user since her fiancé’s accidental death in 1999. “I was in pain and I wanted to not be in pain. That’s how I started my journey with fentanyl,” she said.
She had been prescribed other opioids in the past, but very quickly turned to fentanyl, drawn to its potency.
“The fentanyl was everywhere and it was cheap at that time,” she said. “There were people getting prescriptions who didn’t quite know the street value of this drug. So I was able to obtain like 100 microgram patches for like $5. It was crazy. It was just crazy.”
If used as prescribed, one transdermal patch might last a patient 72 hours. Finnessy was using about one a day, she said, chewing it or extracting the drug and injecting it for a faster high.
Now she’s on methadone therapy and helping in outreach programs for other drug users. And from them, she’s hearing even more about fentanyl now than before – particularly the new form that’s causing so many deaths in Western Canada: powdered fentanyl.
Powdered fentanyl is a relatively new arrival to the nation’s capital, and it has local health authorities and outreach workers worried.
Thirteen years ago, Ottawa had 100 emergency room visits from unintentional drug overdoses. In 2015 it was 205 — something Ottawa Public Health attributes partly to fentanyl.