CSCS Ottawa

Thank you for supporting safer consumption sites in Ottawa

Greg — Tue, 24 Apr 2018 15:41:46 +0000

Since 2011, the Campaign for Safer Consumption Sites in Ottawa has advocated for safer, healthier services for people who use drugs in our community. Over the years, we've had the pleasure to engage with so many of you at events we've hosted and participated in, as well as through our website and social media. The response to our campaign has been overwhelmingly supportive – from the thousands of signatures on our paper and online petitions, to the hundreds of emails sent to the mayor, city councillors, and health ministers.

The actions we've taken together have helped pave the way for the establishment of multiple supervised injection services in Ottawa. Your show of support has demonstrated to politicians and policy makers that when it comes to public health, the vast majority of people in our city believe in harm reduction and evidence-based policies.

Thank you for joining us in our campaign, and continuing to stand up for the dignity and well-being of people who use drugs. Together we can build healthier and safer communities for everyone.

City's first permanent supervised injection site opens at Sandy Hill Community Health Centre

Greg — Tue, 17 Apr 2018 04:00:00 +0000

The room is spotless, the tabletops gleaming of polished stainless steel that matches the sleek, stylish desk lamp. At each of the five booths, a round cosmetics mirror is affixed to an adjustable arm.

“We wanted these mirrors here in case people wanted to do some neck injections,” says Rob Boyd, director of harm reduction at the Sandy Hill Community Health Centre, site of Ottawa’s first permanent supervised injection site.

“We don’t encourage people to do that — it’s a very dangerous place to inject. You slip up and you could be paralyzed. But we’re not going to turn people away from here because of it. If it’s going to happen, it’s better that it happens here.”

Seven years after it began lobbying for a supervised injections site in Ottawa, the Sandy Hill Community Health Centre accepted its first clients on Monday, hours after getting the official go-ahead from Health Canada. The site was to have opened last October, but delays in getting final approval and provincial funding for renovations pushed the opening back six months.

“I don’t feel like celebrating — that’s the wrong mood — because we are seeing an escalation in overdoses and escalation in overdose deaths,” Boyd said. “Relieved is the word. We just need to get in there and do our part.”

When it is up and running at full speed, the site will be open from 8 a.m. to 8 p.m., 365 days a year.

Though it was first site in Ottawa to get conditional approval from the federal government to open back in 2017, the delay makes the clinic the third official safe injection site. Ottawa Public Health operates an interim site on Clarence Street, and Inner City Health runs one in a trailer near the Shepherds of Good Hope on Murray Street. (A rogue, “pop-up” injection site ran for more than two months under a tent in Raphael Brunet Park in Lowertown before closing in November.)

The Clarence and Murray Street sites will remain open and a fourth site at the Somerset Street West Community Health Centre is awaiting its final approval to open from Health Canada.

Visitors to the Sandy Hill clinic at 221 Nelson St. are greeted by an intake worker and must complete a form — anonymously — that goes over their history of drug use. They are then asked to wait until one of the five booths in the injection room is available. Boyd hopes no one will ever have to wait more than 15 minutes for their chance to inject.

“The biggest risk we face is the waiting time. We don’t want people leaving just because they’ve been waiting too long.”

Once in the injection room, a nurse will do an assessment of the person’s general health and level of sobriety and offer advice, if needed. The goal is to complete the injection within 15 minutes and clients are asked to wait a further 15 minutes afterward to be sure there is no risk of overdose. There is naloxone on hand as well as oxygen and a defibrillator and a nurse to oversee the clients. Clients will be given clean needles to inject with but will supply their own drugs.

“We’re expecting that when we have overdoses, they will happen very fast, right in the booth,” Boyd said. “This is due to the high toxicity of the drugs that are out there right now.”

The clinic is prepared to deal with multiple overdoses at the same time, he said, knowing that some users will be injecting from the same batch of drugs. Staff are all trained to deal with overdoses and have a protocol that includes calling 911 for paramedics if necessary.

The advantage of the Sandy Hill site has is that it offers an integrated service all under one roof, with counsellors, case managers, a methadone program and health care, Boyd said.

“It connects people to services. The nurse might notice some people have an abscess and say, ‘Hey, we have a clinic right across the hall. Why don’t you drop in there?’”

The supervised injection sites help reduce the amount of public drug consumption in places like public washrooms, parks or alleys, Boyd said. They also have been shown to reduce risky behaviours that can lead to HIV or hepatitis infections and also keep drug users from discarding their needles and syringes in public places, since all sharps are disposed on site.

The ultimate goal, though, is to save lives, Boyd said.

“The reality is that people who inject drugs don’t want to be doing this in public spaces,” he said. “We’ve seen a spike in overdoses that we think is connected to the illicit fentanyl that’s now in the drug market. We need this as an intervention that can save people’s lives.”

By Blair Crawford
Source: Ottawa Citizen

The harm reduction model of drug addiction treatment

Greg — Mon, 16 Apr 2018 04:00:00 +0000

"We know that if recovery is ever going to happen, we have to keep people alive". When it comes to combatting drug use, Mark Tyndall believes sanctions aren't enough, and that they sometimes hurt more than they help. As Executive Medical Director for the British Columbia Centre for Disease Control, Mark has come to see the importance of providing drug users with all different types of support.

From supervised injection sites to methadone clinics, Mark has been an early adopter and leader of various harm reduction efforts in Vancouver, BC. Tune in to his 2017 TEDMED Talk to learn more about how these models have not only saved lives, but have also become the first step to recovery for many suffering from drug addiction.

Opioid overdoses on decline in Ottawa

Greg — Wed, 14 Mar 2018 04:00:00 +0000

Six months after a spike in opioid overdoses raised alarms across the city, the numbers are down. But Ottawa Public Health says it is too soon to claim any victories in the opioid crisis.

According to preliminary public health statistics, drug-related emergency room visits have dipped from more than 40 a week in September to closer to 25 a week in late January. Monthly opioid overdose emergency room visits have steadily declined since last summer.

OPH and service agencies rallied last summer after rising rates of overdoses and deaths related to opioid use in the city and the introduction of fentanyl into the drug supply.

In late summer, a group called Overdose Prevention Ottawa set up a pop-up supervised injection site in a tent located in a Lowertown park in response to the opioid crisis.

OPH subsequently opened a small, supervised injection site in offices in the ByWard Market. The Shepherds of Good Hope set up another approved supervised injection site in a trailer next to its shelter on King Edward Avenue.

Meanwhile, naloxone became more available and widely used throughout the year.

But Jason Haug, program development officer with OPH, said it would be premature to link the naloxone availability and supervised injection site programs with the lower number of emergency room visits in recent weeks.

“While it does vary in some years, the number of emergency department visits appears to be somewhat lower in winter months.”

Other factors that could be affecting numbers likely include drug availability and whether the drug supply is contaminated — as it has been at times during the year.

According to community service agencies, some members of the drug-using community leave the city for warmer regions during the winter.

In 2017, the highest number of emergency room visits came during the summer.

“We will be watching closely to see what happens during the summer months,” he said.

There were eight overdose deaths in Ottawa last August. That number rose to 10 in September and went down to three in October, according to the most recent statistics on opioid overdose deaths from OPH.

There were about half as many opioid-related emergency department visits in December of last year in Ottawa as in October.

Ottawa’s increase in overdoses and deaths reflected the picture across the province. Ontario saw a spike in deaths to 1,053 in 2017 compared with 694 opioid-related deaths in 2016.

By Elizabeth Payne
Source: Ottawa Citizen

RNAO releases best practices guideline on implementing supervised injection services

Greg — Mon, 12 Mar 2018 04:00:00 +0000

The Registered Nurses' Association of Ontario has just published its Best Practice Guideline on Implementing Supervised Injection Services. We're very proud to have contributed as stakeholders in the development of this guide, along with many other nurses, harm reduction professionals, and advocates.

"These approaches promote engagement, support positive health outcomes, and help reduce harms associated with injection drug use."

Ottawa Public Health looks to expand Clarence Street injection site

Greg — Wed, 31 Jan 2018 05:00:00 +0000

An Ottawa Public Health staff report is recommending that the Clarence Street supervised injection site be made permanent and turned into a supervised consumption centre, where people would be able to ingest drugs in ways that aren't just intravenous.

The Lowertown site opened in September 2017 after authorization from Health Canada. Between the day it opened and Jan. 22, 2018, 174 people made use of the site, with the total number of visits sitting at 2,714, according to the report, which was tabled Monday in advance of the Ottawa Board of Health's next meeting on Monday, Feb. 5.

Eighty-five per cent of clients used services such as counselling and health education, according to the report. Medical intervention was only required in 19 cases — 0.7 per cent of the total visits.

Feedback from clients and staff at the site has been overwhelmingly positive, said Andrew Hendriks, director of health protection at OPH.

"What we heard from clients was that the service makes a difference for them," Hendriks said. "A large number of people say they're less likely to inject in public [and] they're less likely to inject alone because of the services that we're providing."

If the site is given the green light to become permanent, OPH will seek approval from Health Canada to add new services and will work with the Ministry of Health and Long-Term Care to apply for funding, Hendriks said.

Hendriks said it currently costs around $75,000 a month to operate the Clarence Street site.

"That's predominantly staff costs to have nurses and outreach workers and people with lived experiences in the facility," he said.

The only other legal supervised injection site currently operating in the city is at the Shepherds of Good Hope Shelter at 256 King Edward Ave.

A site at the Sandy Hill Community Health Centre was supposed to open in October, but was delayed while waiting for provincial funding.

A fourth site at the Somerset West Community Health Centre in Chinatown has been approved, but an opening date hasn't been announced.

Overdose Prevention Ottawa ran an unsanctioned supervised consumption site at Rafael Brunet Park last fall, but they never received an exemption from Health Canada to operate and closed in November when temperatures dropped well below zero.

After hearing from people using the facility, OPH is now suggesting of the possibility of a wider supervised consumption site, Hendriks said.

A consumption site, as opposed to an injection site, would provide a supervised environment for people to use drugs both intravenously and in other ways, such as ingesting them nasally or orally.

Services offered would include safe drug use education, overdose prevention, counselling services, and referrals to treatment and other support services, the report said.

In order to go from an injection site to a consumption site, the OPH report proposes making minor renovations to their current facilities.

These proposed upgrades include adding three more booths and an "after-care" area, where clients can speak to nurses and social workers about treatment and counselling, Hendriks said.

The current facility offers two injection booths.

City counsellor Mathieu Fleury, who represents the Rideau-Vanier Ward, said he supports expanding the services offered at the site.

"It's an entry point into treatment and at the same time it removes the pressures from communities," he said. "We're seeing less [drug] use in our community."

Source: CBC News

High demand for naloxone training at Centretown session

Greg — Wed, 24 Jan 2018 05:00:00 +0000

It took three rooms to accommodate nearly 60 people who attended a free naloxone training session in Centretown organized by a community health organization for gay men.

Max Ottawa, which focuses on holistic health programs for men who have sex with men, had been anticipating a small session of about 20 people, but said the response was overwhelming.

"There's a concern we have that [opioid overdoses] can happen to anyone in our network: our friends, ourselves, our sex partners," said executive director Roberto Ortiz.

"This is the responsibility of all of us to take care of each other. So we're super happy to know that there are so many people that want to be ready in case something happens."

Participation was not limited to gay men and included a broad range of people. Each took home a naloxone kit at the end of the training session, where they were shown how to use the syringe and nasal spray.

Bryan Quinones, a Capital Pride organizer, said drug use is prevalent in the LGBTQ community and he wants to be prepared despite never seeing an overdose himself.

"But I have friends who have been in those kinds of experiences and, unfortunately, one of my friends lost one of his friends because of an overdose," Quinones said.

Anne-Marie Urli, a University of Ottawa criminology student, said she experienced a similar loss when a friend-of-a-friend died of an overdose because there was fentanyl in cocaine.

"Sometimes you don't know that you're using opioids and it's unexpected. It could happen to everyone," she said.

Amy Moen, who lives near Rideau Street in Sandy Hill, said she decided she wanted to be trained after the supervised injection site opened.

"If something happens I want to be prepared and able to help if I can," Moen said.

Eddie Chow, who identifies as a member of the gay community, said he doesn't know if his friends use opioids but he wanted training because of stories of the effect and reach of the overdose crisis.

"It's no different from learning CPR or first aid," he said. "At least I'll be able to use [the kit] ... if I never get to use it, I'll be happy."

A volunteer group called Communities Organizing for Harm Reduction and the AIDS Committee of Ottawa helped provide the training.

Courtney Davis has been providing volunteer training for more than a year.

"When we started doing stuff like this, it was really people downtown, people who party. But now we're getting all kinds of people because all kinds of people are being touched by it," she said.

A second fully-booked training session with 60 people has been organized for February and a third is expected in March, according to Max Ottawa.

By Matthew Kupfer
Source: CBC News

Activists say death following presumed overdose at health centre highlights need for more supervised sites

Greg — Thu, 11 Jan 2018 05:00:00 +0000

A young woman collapsed in a bathroom at the Sandy Hill Community Health Centre earlier this week and died in hospital from what’s presumed to be a drug overdose.

The death happened Monday as the health centre continued its years-long wait to open a supervised injection site.

“We know that had this overdose happened in a supervised environment, they would have survived,” said Rob Boyd, director of the health centre’s harm reduction program.

The woman, who has not been identified, collapsed around 3 p.m. Monday in the centre’s public bathroom. As soon as she was discovered, she was given the overdose antidote, Naloxone, and administered oxygen by medical staff.

The woman did not respond to the medication which can quickly reverse the effects of an opioid overdose, and died later that day at The Ottawa Hospital.

The centre has never before experienced such a tragedy, Boyd said. Still, he was reluctant to draw a straight line between the death and the red tape that continues to frustrate plans to open a supervised injection site at the community health centre.

“We don’t have any way of knowing for sure, but we suspect it was an opioid overdose,” he said. “The second thing is we don’t know, even if we had an injection room open, that she would have used it.”

Drug users now have access to two supervised injection sites: one run by the Shepherds of Good Hope on Murray Street and another operated by Ottawa Public Health on Clarence Street.

The Sandy Hill Community Health Centre has been working towards opening a supervised injection site for years. The centre launched a public debate on the issue in April 2016 and, after overcoming opposition from the mayor and police chief, received federal government approval in July 2017. Two months later, it received $1 million in provincial funding, but the centre is still waiting for $200,000 in capital to finance renovations required to house the supervised site.

“I don’t even talk about when we’re going to open any more,” Boyd lamented. “We were hoping to be open last spring, then last summer and last fall. We keep passing these deadlines and it’s very frustrating …We have been working with provincial officials to move this along as quickly as possible. We’re very close.”

If the centre’s supervised site had been open, and if the woman had used it, staff would know much more about what drugs she was taking, Boyd said, and would have been in a better position to respond to a crisis.

The health centre, he added, has dealt with a handful of overdoses during the past few months, including one case that sent a drug user to hospital.

Activists pointed to the woman’s death as more evidence that political intervention is needed to address the opioid crisis. The Canadian Association of People Who Use Drugs urged Ontario Health Minister Eric Hoskins to work with his federal counterparts to open more overdose prevention sites in the province. “Because this is going to keep happening,” the group warned on Twitter.

“I don’t know if that would have been preventative in this case,” Boyd said, “but I know there’s a lot of people who would be helped by us having that service in place.”

By Andrew Duffy
Source: Ottawa Citizen

Here's why it's time to legalize all drugs in Canada

Greg — Tue, 09 Jan 2018 05:00:00 +0000

Picture this: You’re an injection drug user, and, you’re worried the next time you use, you might die. So, you head for the Shepherds of Good Hope, where there’s a special trailer. There, you can use your drugs – and someone will save you if you overdose.

Upon arrival, though, there’s a police cruiser outside. Apparently it’s there a lot, at least according to Ottawa Inner City Health, which runs the injection site, and officers are questioning staff and clients.

And so you turn around. You take your chances injecting elsewhere, to avoid being harassed by police. Maybe you’ll overdose and there will be nobody to save you. So it goes.

With between 130 and 170 people actually using the injection trailer daily, it’s got to be asked: How many are not showing up because they’re afraid of the police?

Since Ottawa’s mayor and police chief had both been openly hostile toward the idea before recently softening their views, it’s no surprise those tasked with enforcing the laws may not have, after years of hearing one thing, quite come ’round to the virtues of addicts having a safe environment in which to inject their drugs. (On Tuesday, the chief disputed this characterization of his position in a statement to the Citizen.)

And yet, this situation is a dangerous one. If injection sites are providing lifesaving medical care — and they are — then anything that keeps people away risks indirectly causing death.

This isn’t actually complicated. It’s worrisome if local cops can’t follow along.

And so, a solution: It’s time that drugs — all drugs — are decriminalized, then legalized and sold like alcohol or tobacco or (soon) marijuana. Decriminalization would remove criminal penalties for drug use — legalization would allow regulated use and sale.

The arguments in favour of pot legalization apply to other drugs, too, including improved quality, the end of the black market as well as a reduction in crime, desperation and overdoses.

It’s also the right thing to do. It’s up to each of us to decide how we treat our bodies.

What the Shepherds struggle shows is that, at present, humane drug policy relies too much on police acquiescence. A safe-injection site only works if police abide by a gentleman’s agreement to not arrest or harangue people coming in and out.

Apparently, it worked fine for the first little while that the site was open. But something has gone wrong fuelled, no doubt, by the fear of a no-go zone where cops can’t arrest drug dealers and users smash and grab everything they can to finance their habit. (Such a no-go zone does not exist in Ottawa, says the police force.)

The evidence that crime goes up around injection sites is weak at best, but that certainly hasn’t stopped the promulgation of this fear.

If police aren’t going to play ball with supervised injection, which has the potential to save some of the hundreds and hundreds of people who died from fentanyl overdoses in Canada last year, then it’s time police are removed from this equation as much as possible.

Decriminalization and legalization would kill many birds with one stone. In December, Dr. Theresa Tam, chief public health officer of Canada, described “a very toxic drug supply” in Canada, with fentanyl expected in a majority of all opioid-related deaths. This is not a problem that policing can fix. It make it worse — certainly police do by keeping people away from injection sites.

If drugs are regulated, they’re safer. If they’re bought in stores, it eliminates seedy areas or dealers. If drug use isn’t criminalize and the stigma goes down, it becomes easier to get people into treatment, if they want to.

Jagmeet Singh, the new NDP leader, has floated decriminalization. While this would be the right thing to do, it’s not likely to be a vote-getter, so it’ll stay on the outskirts of Canadian politics. It’s a shame, really, but perhaps Singh will change our political culture. It’s more of a shame that drug users and the people who care for them feel the police in Ottawa are endangering them.

Even if the police think they aren’t responsible here, that doesn’t make it so; the consequences, even if unintentional, require the police to do a serious re-think about how they’re policing near injection sites.

By Tyler Dawson
Source: Ottawa Citizen

Ottawa supervised injection trailer squeezed by extreme cold and fire damage

Greg — Fri, 05 Jan 2018 05:00:00 +0000

The supervised injection service that operates in a trailer next to the Shepherds of Good Hope shelter is struggling to meet client demand due to the extreme cold and a loss of space because of recent fire damage at the shelter.

The 40-foot construction trailer with fogged up windows and a narrow entrance is the only supervised injection site in Ottawa that operates overnight.

It has far exceeded the expected flow of 50 clients a day, according to Anne Marie Hopkins, supervisor of the peer outreach program at Ottawa Inner City Health, which operates the supervised-injection service.

"With three staff working and even with a handful of clients, it's tight in there," Hopkins said. "We're putting through 150 [to] 170 people a day in that small trailer so we have to move people along, but it's really hard when it's so cold out. They're freezing."

Hopkins said the core mission of the trailer is medical care — monitoring drug use to prevent and treat opioid overdoses as they occur. Shepherds of Good Hope, which has a partner drug program, handles shelter for people before and after drug use in the trailer, she said.

Targeted Engagement and Diversion (TED), the space for the drug program at Shepherds, was damaged in a fire before Christmas, said Hopkins. People would be sent there to be monitored in case of an overdose that happened more than an hour after they used.

"Someone would come in, they would use drugs and we would supervise them and then we would move them along to the TED program in Shepherds. But we don't really have that option right now, so it's been really challenging to provide proper care to our clients," Hopkins said.

Steve MacIntosh, a senior assistant manager at Shepherds of Good Hope, said shelter staff have been working to make due.

"There's been an issue with space, but that's what Shepherds does best," he said.

MacIntosh said mats have been rolled out in the place of mattresses and clients have been taken to the Ottawa Mission, Salvation Army and women moved to the community space across from the men's shelter after they use drugs in the trailer.

"We just basically deal with what we're given. If people need a warm, safe place then we do everything we can to ensure that," MacIntosh said.

Hopkins said there has been a slight spike in the number of overdoses related to opioids since Dec. 29 and they encourage people to come to the trailer, where they'll have a safe space.

"We want people to be safe. We want them to be using with us if they're going to use so that we can handle the overdoses and hopefully we don't have any deaths this weekend," she said.

Shelter staff have helped fix a heating issue in the trailer that surfaced during the last cold snap, Hopkins said. One half of the shelter remained freezing while the other was being warmed up.

The first floor is expected to be back in full operation by Saturday afternoon, a spokesperson said Friday.

Both MacIntosh and Hopkins are encouraging donations of socks, warm clothes and handwarmers, which are always in needed during extreme cold situations.

By Matthew Kupfer
Source: CBC News