Experts and advocates want supervised injection site for Ottawa

Researchers and harm reduction advocates are calling for supervised drug injection facilities for Ottawa.

The authors of the Toronto and Ottawa Supervised Consumption Assessment (TOSCA) presented their findings during an event at the Ottawa Public Library’s main branch on Metcalfe Street on Thursday evening. The event was held in recognition of AIDS Awareness Week.

The TOSCA report, released on April 11 2012, recommended opening supervised drug injection sites in Ottawa, as well as Toronto.

“There are a sizeable number of people who use drugs in both cities,” said Dr. Ahmed Bayoumi, one of the authors of the report. “Sharing of drug equipment is actually common in both cities. Injecting drugs in public spaces is also common.”

Dr. Bayoumi and his co-author Dr. Carol Strike predict a decrease in needle-sharing and HIV cases among drug users if supervised injection sites opened in Ottawa, based on studies from Vancouver’s InSite facility.

Dr. Mark Tyndall, head of Infectious Disease at the Ottawa Hospital, was personally involved with InSite in Vancouver.

He said such a site is necessary in Ottawa.

“It’s the most tried and true evidence-based intervention that we have available,” he said. “This is to me such an obvious thing to do. If it doesn’t happen, people will die needlessly.”

Tyndall said a supervised injection site would make Ottawa safer.

“Every injection that happens at a site is one that’s not happening on the street.”

Sean LeBlanc, chairperson of the Drug Users Advocacy League (DUAL) and formerly dependent on drugs himself, said most of Ottawa’s drug users would welcome an injection site.

“Almost across the board, I would say at least three quarters support it,” he said. “People don’t want to shoot drugs in the bathroom in the Shepherds of Good Hope [a charity and homeless shelter in Ottawa].”

According to the TOSCA report, overall support for bringing this kind of facility to Ottawa is around 50 per cent, varying according to what the stated goals of the sites are.

Dr. Tyndall said overwhelming public support isn’t always necessary.

“If we wait for 50 plus one per cent of the citizens of Ottawa to think this is a good idea, then it’ll never happen,” he said.

“I think the experience in Vancouver and many cities in Europe shows that you don’t need to convince the majority of the population that this is a good thing before you start […] Once you prove that it’s effective, then people start jumping on board.”

Rob Boyd, the director of the Oasis program for people with HIV/AIDS at the Sandy Hill Community Health Centre, agreed.

“People need to take some time to get comfortable with a new idea, especially one that’s maybe a little bit counterintuitive at first,” he said. “It’s very difficult for the public to have an opinion on something of which they have no experience.”

Boyd himself supports bringing these facilities to Ottawa.

“I think the evidence is really clear that Ottawa would benefit from having a supervised injection service,” he said.

He pointed out that Ottawa has one of the highest rates of HIV among drug users. Around 16 per cent of Ottawa’s approximately 6,000 injection drug users have HIV, compared to four per cent in Toronto.

“One of the main reasons is that we haven’t adequately scaled up harm reduction services in the city,” Boyd said.

Dr. Tyndall agreed.

“Rates of HIV are unacceptably high in the Ottawa area,” he said. “People aren’t getting the services they require in harm reduction.”

Another major problem is drug overdose. Boyd pointed out that three to four Ottawa residents die every month from an overdose, which is higher than traffic fatalities.

Rick Sproule, vice chair of DUAL and a former drug user, spoke about overdose fatalities during his talk at Thursday’s event.

“There’s been three overdose deaths in the last five days. Two of them were on Booth Street, just a couple of blocks from here. That kind of brings it home, doesn’t it?”

Tarah Heighton, who works with Youth Services Bureau Ottawa, spoke at the event about the importance of these services.

“Harm reduction as a policy exists because it acknowledges that some people are not ready or able to change their ways, and will choose to continue to use drugs.”

Heighton is herself a former drug user.

“With harm reduction services that were already in the community, I was able to build myself out of what choices I had made.”

Sproule was also helped by harm reduction services, when methadone treatments helped him get off heroine during his last relapse several years ago.

“Three and a half years later, I’m talking to you.”

Sproule and Heighton also commented on the harmful effects of stigmatization of drug users.

“When, in times of extreme pain, those people who choose to do drugs turn to a way to feel better, instead of offering a hand to help, we choose to ignore and judge,” Heighton said.

“There’s very little humanity out there. There’s so much stigma against the drug addict,” Sproule said during his presentation. “We’ve been criminalized. I mean, we’re thought of as less than human.”

However, not everybody is keen on bringing a supervised injection site to Ottawa.

Senator Vernon White, the former Ottawa police chief, is one of them.

“They’re supervised, they’re not safe. There’s nothing safe about shooting heroin or crack cocaine into your veins,” he said. “It does not make for a safe community.”

Senator White isn’t opposed to other services for drug addicts, such as methadone clinics and needle exchanges.

“I’m a big supporter of harm reduction programs,” he said. “Law enforcement alone cannot solve this problem.”

White doesn’t consider a supervised injection site part of a harm reduction strategy.

“Harm reduction shouldn’t cause harm to other parts of the community and I would argue that since InSite went into place, I think it has harmed other parts of that community,” he said. “We do have a challenge when a number of those drug users are also committing crimes to satisfy their addiction.”

Dr. Strike, co-author of the TOSCA study, expressed her bafflement that the Ottawa and Toronto police services support needle exchanges and methadone clinics, but not supervised injection sites.

“I could never really understand what made those two types of services acceptable, but the other service not acceptable,” she said.

White expressed fear that a site would increase drug use, saying that’s what happened in Vancouver with InSite.

“They have seen an increased amount of people in the area using drugs,” he said. “The police don’t apprehend traffickers in the area.”

Boyd said this is misleading.

“Drug use is happening. Nobody starts using drugs because there’s a supervised injection facility,” he said. “Starting injection drug use is based on a lot of very complex psychosocial factors. It’s not about access to needles or syringes.”

Dr. Tyndall questions the credibility of some of the critics’ opinions.

“The people who seem to be the most outspoken about it are those who know the least about it,” he said.

Ontario’s Minister of Health Deb Matthews said the province had no plans to pursue safe injection sites in a statement released in April.

“Experts continue to be divided on the value of the sites,” she said.

Dr. Tyndall strongly disagreed.

“That’s totally false,” he said. “I don’t know one expert who wouldn’t support this.”

He said if given the chance, he can turn anyone into a believer in safe injection sites.

“If I can sit in a room with somebody for 20 minutes, I can pretty much convince anyone.”

By Nick Ashdown