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.
The capital is on the brink of an injection-drug crisis, the city’s top public-health doctor believes, and now is the time to open a safe drug-injection site to try to head it off.
“In Ottawa, we are on the cusp of this larger trend, and we have dodged it because we have been lucky so far,” says Dr. Isra Levy, the city’s medical officer of health.
Monday night, after years of equivocating, his health unit released a report saying the city should have at least one supervised facility aimed at chronic users of injection drugs, where they can shoot up with clean needles and have nurses on hand to help if they overdose.
Ontario’s new attorney general says Ottawa should heed the advice of its top doctor, who is publicly urging the city to support supervised injection sites.
In his first interview since Monday’s cabinet shuffle, Ottawa Centre MPP Yasir Naqvi expressed support for the controversial sites as a means to reduce harm to drug addicts.
“I believe in evidence-based solutions,” Naqvi told Metro on Tuesday morning.
“If the officer of health is telling us that the evidence results in better care and ensuring people get the treatment and that we reduce the harm to the individual and to others through reducing the risk of the transfer of HIV and Hepatitis C, then we should pay close attention to that expert advice.”
More than half of Ottawans polled back a safe injection site downtown for intravenous drug users with the young, affluent and well educated most likely to be behind the plan.
The numbers are in line with results from Canada’s biggest city, where a drive is also underway to establish safe injection sites aimed at preventing overdoses and disease.
“There is clearly a sentiment in urban centres in favour of harm reduction over sanctions and enforcement,” Forum Research president Lorne Bozinoff said. “Vancouver already has InSite, and Toronto and Ottawa are both contemplating similar centres. “These results bode well for a successful outcome.”
In a random sampling of 890 Ottawa voters, 54 per cent approved plans for a safe injection site, 37% disapproved and 9% did not have an opinion.
Organizers of a campaign for a supervised injection site at the Sandy Hill Community Health Centre are hopeful their proposal will become a reality soon even as canvassers encountered some opposition while promoting the idea in the neighbourhood on Saturday afternoon.
Bill Muirhead who described himself as a "pensioner," said he has found needles on his lawn in Sandy Hill but is philosophically opposed to the idea of a publicly-funded supervised injection site.
"I'm not totally in favour of this," he told canvassers on Saturday afternoon. "Those drugs are illegal to start with and I don't think we want to sort of encourage people to do this and go in that direction. And, of course, these places are all funded — publicly funded. Somebody has to pay for them."
He added that he was concerned making it easier to use injection drugs might encourage more people to use them.
But canvasser Karim Alameddine explained that showing compassion to people who have addictions and feel marginalized might actually have the opposite effect.
With support from health workers, people who use drugs can decrease their doses in the ultimate goal of quitting altogether, if they choose, canvasser Chris Dalton said.
"They did find, as well, in Vancouver, that there actually was cost savings," Dalton said, as he handed Muirhead pamphlets with more information.
"When you factor in medication for HIV, for Hepatitis C, for hospital visits, for policing — that actually when you look at the larger costs to society of drug use, especially drug use among the homeless population, that those are actually more expensive than just creating a site to reduce these things," Dalton added.
Volunteers from the Campaign for Safer Consumption Sites in Ottawa will be canvassing the Sandy Hill neighbourhood on Saturday to raise awareness about safe injection sites.
Starting in the afternoon, volunteers will be going around with information to keep residents informed and to banish any misconceptions they may have about safe injection sites.
The canvassing coincides with International Harm Reduction Day, which aims to raise awareness and promote services to help drug users.
“We’re trying to be as open and as honest as possible,” said Catherine Hacksel, an organizer with CSCS Ottawa. “It’s always good to hear what concerns people have.
“Just from my experience talking to people in the area, once we get the conversation going in a respectful manner, people are generally open to the idea, once they can get their minds wrapped around it.”
The Sandy Hill Community Health Centre has expressed an interest in adding a safe injection site to its list of services, and held public consultations in April. The hope is to have the service up and running by spring 2017.
Ottawa’s medical officer of health says a supervised injection service is the consummate example of health care that puts the needs of patients first.
Dr. Isra Levy told the Ottawa Board of Health on Monday that the harm reduction service fits squarely into the provincial government’s recently unveiled plan to build a patient-centred health care system in Ontario.
“I suggest that if ever there was a ready example of the need to put patients first, health first, this is the issue and this is the time,” said Levy, whose comments represent his most spirited defence to date of a supervised injection site in Ottawa.
Levy said a proposal by the Sandy Hill Community Health Centre represents a “logical extension” of the addiction and counselling services it now offers drug users. Such sites, he said, should be part of any comprehensive and modern approach to drug treatment.
“These services are known to save lives and they offer many other positive impacts for addicted individuals, their loves ones and the community at large,” he said, adding: “I believe that what we and our partners and the other heath agencies have been doing to prevent addictions and to minimize their harms has not been enough.”
The Vancouver politician who championed supervised injection sites in that city says Mayor Jim Watson should try to understand drug addicts before rejecting a plan that would keep more of them alive.
“I just get annoyed at politicians who don’t go out into the field and talk to the participants and find out what’s really going on,” former Vancouver Mayor Philip Owen said in an interview with Postmedia. “You can’t always rely on reports from your staff.”
Watson attends hundreds of community events each year, but Sean LeBlanc, chair of the Drug Users Advocacy League of Ottawa, said the mayor has yet to accept one of his invitations. “We have invited Mr. Watson to several events over several different years. He has attended none of them,” said LeBlanc.
Watson is a longstanding opponent of the Sandy Hill Community Health Centre’s plan to open a supervised injection site in downtown Ottawa. He has said tax money is better spent on drug treatment programs.
Owen said Watson’s position is “ridiculous” and perpetuates the notion that drug use is a crime rather than a health issue. “You’re not encouraging people to use drugs by opening a supervised injection site,” he argued. “You’re assisting people who need help.”
Conversations about supervised injection sites, such as the one that might come to Sandy Hill, can get polarized fast.
On one side, you have the people who say, “How can you ignore all the evidence that supervised injection sites save lives and might even make the neighbourhood safer?” On the other, you have the people who say, “How can you honestly be arguing that the state should be paying to help people shoot up?”
The issue divides people along fundamental philosophical lines: those who trust the evidence, and those who trust their guts.
Politicians tend to fall onto one side or the other, too, but some of the more wily politicians hedge their bets. Ottawa Mayor Jim Watson, for example, has long argued that supervised injections sites simply aren’t the best use of scarce resources, which should fund rehab programs instead.
This is, from a political perspective, nice and safe. Nobody is going to argue against funding rehab programs.
From a policy perspective, though, it’s incredibly damaging. It perpetuates the false notion that treatment and harm reduction are two distinct paths. In fact, they’re often part of the same journey.
“We think of addiction treatment as anything that can move someone toward stabilization,” says Rob Boyd, director of the Sandy Hill Community Health Centre’s harm reduction program. That means something different for every person, depending on where they’re starting.