As Dave Pineau’s injection drug use snowballed in the early 1980s, harm reduction amounted to a matchbox and a bottle of Aqua Velva.
Pineau regularly shared needles with four members of a close-knit group of friends, all of them homeless on Vancouver’s Downtown Eastside.
The men were partial to cocaine and speed, a powerful amphetamine that jacks up the central nervous system. They’d mix the drugs with water, draw the solution into a needle, and slam it into their veins.
They knew the practice came with risks: that hepatitis B and other diseases could be passed in a needle tainted with infected blood. But new needles cost $10 each, while used ones were $5.
So the men adopted rudimentary safety measures.
They’d buy new needles when there was money to spare, and sharpen old ones on the side of a matchbox then sterilize them with cheap aftershave. (Sometimes, Pineau would forget to rinse the Aqua Velva from a needle and would “taste” the aftershave with his first hit; research suggests he likely smelled volatile compounds being eliminated through his respiratory system.)
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.”
Mayor Jim Watson is refusing to soften his rock-hard stance against supervised injection sites in Ottawa, despite one group's plans to hold consultations on the controversial model in Sandy Hill next month.
Toronto is the latest city after Montreal to officially explore supervised injection sites, with its chief medical officer of health outlining his recommendations Monday for three possible locations.
The sites let users bring their own drugs to inject themselves under the supervision of health professionals to prevent overdoses and infection from unsterilized equipment. They also include treatment programs for users who wish get help with addiction and take people who are shooting up off the street.
Watson has been vehemently opposed to bringing the model to Ottawa, in spite of its documented success at Vancouver’s InSite, which says on its website there have been no overdose deaths there since it opened in 2013 and there has been a 35 per cent reduction in overdoses in the surrounding area.
“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.
His opposition comes as overdoses in the city continue to rise.
Federal health minister says the more people know about them, the greater their support
Toronto's medical officer of health is calling on Canada's largest city to move one step closer to opening three safe drug-injection sites.
In the report, Dr. David McKeown calls for three sites to be located at The Works Needle Exchange Program, the Queen West Community Health Centre and the South Riverdale Community Health Centre.
Federal Health Minister Jane Philpott told the CBC last week that supervised injection sites are among a number of strategies the government has put forward to cope with drug abuse and overdose deaths.
"From a public health point of view it makes a tremendous amount of sense," she said. "Sites like Insite in Vancouver and others like them have the possibility to save countless lives."
Intravenous drug users run the risk of higher rates of HIV and hepatitis infections, as well as the ever-present danger of overdose. A straightforward policy that could save lives and money across Canada, and has already been cleared by Canadian courts: supervised injection facilities. In a 2011 ruling on their legality, the Supreme Court of Canada declared that there is little or no evidence that they will have a negative impact on public safety.
But in 2016, no legal supervised injection sites exist anywhere but British Columbia. People who’ve been advocating for an expansion of safe injection beyond the two legal sites in Canada — Insite and the Dr. Peter Centre, both in Vancouver — say it's urgently needed.
“For me, it means less of my friends are going to die,” says Sean Leblanc, chair of Ottawa’s Drug Users Advocacy League. “We lose 40 people a year in Ottawa to overdose deaths, and a lot of those could be prevented with supervised injection.”
Safe injection sites save lives. Five small words, an indisputable truth. But Mayor Jim Watson won’t see one on city streets in Ottawa, nor will police Chief Charles Bordeleau.
Under current federal law, the process to get an exemption under the Controlled Drug and Substances Act — needed to open a place where people are going to shoot up — requires consultation with mayors, local politicians and police. There’s that, and a whole slew of other conditions that make it practically impossible to open a supervised injection site.
It’s time for that to change.
Last week, Federal Health Minister Jane Philpott was in Vancouver for a meeting with provincial health ministers, and she said she was moved by a visit to Insite, the safe injection site in the city’s desperately impoverished downtown eastside. Good. She should be moved. But she should also move quickly to amend legislation, making it easier to open safe injection sites.
Given that some powerful local figures oppose them, it’s going to require proper leadership from the federal government to look out for the most desperate in Canadian cities. It is, it must be said, to Ottawa’s shame that we can’t all get our act together to help drug users.
It's been just a little more than two years since Donna May, the mother of a dead drug addict, came to Ottawa to plead for a safe injection site in the nation's capital.
Her message couldn't have been more clear or more heartbreaking.
"Mine is a hard story to tell. If you have already formed an opinion, based on what you've been told, or educated by what your community leaders have guided you to believe, I used to be one of you," she said back in October 2013.
"There is no worse blind man than the one who does not want to see. I changed my opinion completely and my hope in sharing my story is to at least open your mind."
May, who lives in Toronto, was feeling safe in her suburban lifestyle when her daughter began taking drugs.
With her story, she could have been speaking directly to me -and to many of my suburban friends and thousands of others who just inherently feel without any real justification that safe injection sites are absolutely wrong.
The good news about her appearance calling for safe injection sites is that May did cause many of us in the room to think more thoughtfully about our somewhat instinctive and very negative reaction to safe injection sites.
Opening two supervised injection sites in Ottawa would save the health system money, new analysis suggests.
Ahmed Bayoumi, a medical researcher with St. Michael’s Hospital in Toronto, called supervised injection sites a “good investment in health dollars.”
He is among authors of a report looking at the potential cost-effectiveness of supervised injection facilities in Toronto and Ottawa. The study was published Monday in the journal Addiction.
Bayoumi and others updated analysis they conducted in 2012 in light of dramatic new treatment for hepatitis C. Drugs that treat and even cure hepatitis C are now available, but they are costly, which means strategies to reduce the spread of hepatitis C by injection drug users could save the health system substantial money, said Bayoumi.
That is a key issue in Ottawa where transmission rates of hepatitis C and HIV among injection drug users are higher than Toronto.
The research found that over 20 years, one supervised injection facility in Ottawa would avert 358 HIV infections and 323 hepatitis C infections. One facility would cost $31.5 million in operating costs and save $32.3 million in health care costs, the analysis found.
Opening five safe-injection sites in Ontario makes financial sense, says a medical researcher who based his study on a Vancouver clinic where drug users shoot up under supervision.
Dr. Ahmed Bayoumi of St. Michael's Hospital in Toronto said establishing facilities such as Insite in that city and in Ottawa would save money and reduce the incidence of diseases such as HIV and hepatitis C.
"Three facilities for Toronto and two for Ottawa represent a good investment compared to other things that we ordinarily invest in in health care," he said in an interview Monday.
The study follows up on earlier research that said safe injection sites in Toronto and Ottawa would improve the health of intravenous drug users. The latest information takes into account new treatments for hepatitis C which, though effective, are also much more expensive.
A typical six-month course of hepatitis C treatment costs about $60,000, Bayoumi said