Ottawa’s health unit supports prescribing heroin to treat severe addicts and at least one treatment clinic is considering it as the city fights the rising rates of overdoses from it and similar opioid drugs.

“We really see it as more an extension of our opiate substitution therapy program than part of our supervised injection efforts,” said Rob Boyd, the head of the drug-treatment programs at the Sandy Hill Community Health Centre on Rideau Street. Boyd has been leading the charge to add an injection site to the centre’s existing methadone clinic.

Methadone is the standard way of treating people addicted to opioids — especially heroin but also fentanyl and oxycodone. It tickles the same receptors in the brain but you drink it rather than shooting it with a needle. With standardized dosages and pharmaceutical quality, it’s safer. But it doesn’t work for everybody.

“I’m not sure if I understand completely the chemistry behind it all, but we would look at people who are on the other opiate-treatment programs, who continue to supplement their medication with street-level opioids,” Boyd said.

About 150 people in Vancouver are in a prescription-heroin program after finding methadone and buprenorphine, a similar drug, didn’t help them. Boyd guesses the number of Ottawans who’d benefit from prescription heroin is in the low dozens.

Ottawa Public Health “supports the use of prescribed heroin and it should be incorporated — where clinically appropriate — as a harm-reduction option,” the city’s top public-health official, Dr. Isra Levy, said through a spokesman Wednesday. “Opioid substitution therapy is part of the continuum of care needed to improve health outcomes and is part of the available options to support people in Ottawa wherever they are on the spectrum of substance use.”

The $2.5 million in funding the province has promised the City of Ottawa to deal with its opioid crisis is not enough, according to some community health officials on the front lines of the fight against the potentially lethal drugs.

Ontario, and other provinces, are about 10 years behind on properly addressing the issue, according to Rob Boyd, executive director of the Oasis Program at the Sandy Hill Community Health Centre.

"We've got a system that's been chronically underfunded for decades, and we are not prepared for what has come upon us," said Boyd.

Advocates for drug users gathered on Parliament Hill Tuesday afternoon to demand concrete action from the federal government in response to the fentanyl overdose crisis that's plaguing communities across the country.

The National Day of Action on the Overdose Crisis was organized by the Canadian Association of People Who Use Drugs, with rallies in eight Canadian cities including Vancouver, Toronto, Montreal and Halifax.

"If you can't live, you can't recover. You can't do anything in life. The first thing that we have to do is keep people alive," said Rick Sproule with the Drug Users Advocacy League in Ottawa.

Sproule, who helped organize the event, said he would like to see immediate government action to combat fatal overdoses.

"The federal government is talking about new injection sites [and] that would help very much with this overdose crisis. But they haven't done anything yet. They can talk all they want, but we're dying on a daily basis."

According to Ottawa Public Health, there were approximately 50 overdose deaths in the capital in 2015. Twenty-nine were due to opioids, and 14 of those involved fentanyl.

Dozens gathered Tuesday on Parliament Hill to push the government to deal with opioid overdoses.

It was one of eight protests organized across the country by the Canadian Association of People Who Use Drugs, an organization of past and present drug users, and their allies.

“Many people in this community know someone that has died,” said Rick Sproule, a member of the Ottawa-based Drug Users Advocacy League and the organizer of this protest.

He said that’s why he and many other Canadians are pushing hard for an end to the “war on drugs.”

He said he wants to see drug prohibition completely repealed.

“I know it’s an extreme position, but it’s the only permanent way out of the overdose crisis,” he said.

He said that would decrease illicit drug use and facilitate harm-reduction services, such as supervised injection sites and readily available kits with naloxone — the opioid antidote.

His fear remains fixed on the fact that counterfeit drugs often look like prescription drugs, meaning many aren’t always aware of what they’re consuming — or how deadly it could be.

“If we can regulate the drugs, we know how much is in them,” Sproule said, “Right now, the way the drug supply is on the street … you can never be sure how strong it is and what it is.”

In June 2016, the Board of Directors of Somerset West Community Health Centre (SWCHC) approved the possible expansion of the Centre’s harm reduction program to include supervised injection services (SIS).

SIS provide a safe space for drug users to inject pre-obtained drugs under medical supervision. Staff do not inject drugs; rather, they are an important point of contact with the health system for injection drug users who are typically not well connected to health care services.

Community Health Centres (CHCs) are the right fit for SIS because not only do we care about improving the health and well-being of all people – including those who use drugs – we also care about the health and safety of our community.

SWCHC and Centretown Community Health Centre (CCHC) believe that every person deserves access to the health services they need to improve their well-being. SIS are evidence-based: they save lives by reducing overdoses – because medical staff are on site to intervene in the case of an overdose – and the spread of diseases such as HIV and Hepatitis C.

For people who use drugs, supervised injection improves their well-being because it provides a safe space to inject and to connect with services.

The Sandy Hill Community Health Centre is one step closer to realizing its goal of having a supervised drug injection site after its board of directors voted Wednesday night to submit an exemption application to Health Canada.

Earlier this month, Ontario Health Minister Eric Hoskins expressed his support for the centre's plans in a letter to federal Health Minister Jane Philpott. Health Canada would have to approve an exemption under the federal Controlled Drugs and Services Act to open the facility.

Rob Boyd, the director of the centre's Oasis program, previously told CBC Ottawa that a supervised injection site could be open by the summer if funding negotiations go well. It would be the first site of its kind in Ottawa.

The Rideau Street community centre has proposed a facility that would provide supervised injections to between 80 and 150 people a day, many of whom already use the centre for other reasons.

On average, 48 people die in Ottawa of drug-related causes each year, according to the centre. Ottawa also has Ontario's highest rates of HIV and Hepatitis C among people who inject drugs, according to health unit statistics.

.@SandyHillCHC Board of Directors passes motion to submit exemption application to @HealthCanada #supervisedinjection #ottpoli #canpoli

— Rob Boyd (@rboyd6) January 19, 2017

A new poll suggests most Ottawa residents are in favour of a safe injection site, even though the seriousness of the opioid crisis has yet to register with many of them.

The Mainstreet Research poll, conducted for Postmedia, found that 53 per cent of those surveyed support the plan to open a safe injection site in Ottawa.

The pollsters found that 32 per cent of respondents disapproved of the idea; 15 per cent offered no opinion.

Officials from the Sandy Hill Community Health Centre have submitted a proposal to the federal government and hope to open a facility this spring that would allow clients to take drugs under medical supervision.

“Ottawans generally approve of seeing safe injection sites in their city as a tool for harm reduction,” said Quito Maggi, president of Mainstreet Research.

Now that the province has announced its support for a supervised drug injection site in Ottawa, the Sandy Hill Community Health Centre hopes to have one open before this summer if funding negotiations go well.

The health centre estimates it would cost about $1.4 million to run a site annually.

Rob Boyd, the director of the centre's Oasis program, told CBC Radio's Ottawa Morning Tuesday the estimate is based on an expansion of the centre's existing services.

The site would be open 12 hours a day, seven days a week, in order to give users access to other forms of help.

The centre still requires a letter from Ottawa police Chief Charles Bordeleau who has expressed some public safety concerns about supervised injection sites.

Boyd said Tuesday he believes the centre's proposal addresses some of Bordeleau's concerns and they hope a letter from the chief will come in the next couple of weeks.

After that, if funding negotiations with the province go well and move quickly, Boyd hopes the centre will have a supervised injection site ready before this summer.