Canada’s next supervised injection site: Ottawa?
An Ottawa group aims to open Canada’s first supervised injection site since a landmark Supreme Court ruling gave Vancouver’s Insite the right to offer addicts a safe place to shoot up.
By all accounts, the odds are against them: They don’t have the backing of the city, the police or the province; they’re racing against the clock to apply for an exemption from federal drug laws before new legislation makes it tougher.
But proponents argue they can’t afford not to pursue it: Canada’s capital boasts sky-high hepatitis rates and Ontario’s highest rate of HIV infection among injection-drug users.
Blocks away from touristy Byward Market, unsafe injecting is spreading disease to an extent that’s alarming public health officials who are trying to figure out why.
“I could sit here for 20 minutes and tell you people that’ve died”
Sean LeBlanc just wants fewer funerals.
He came to Ottawa from small-town Nova Scotia a decade ago, hoping to escape the drug scene fuelling his addiction.
It didn’t work.“The city was just loaded with drugs.”
LeBlanc’s been off injection drugs for three years, thanks to a methadone program and “a really good doctor.” But he stuck around to advocate for the city’s users. He’s seen too many friends die not to.
“My god, I could sit here for 20 minutes and tell you people that’ve died. That’s why I do this work,” he said. “I’m just tired of losing these beautiful, young people to stuff that’s so preventable – so easily preventable.”
Part of the problem, many argue, is a lack of resources because it’s something people would rather not discuss.
“I think there’s a lot of denial in this city that the problem is as great as it is. And it’s that apathy that allows the problem to fester,” LeBlanc said.
It was the frustration of seeing unnecessary deaths that drove Emma Ferguson, a registered nurse, to join Ottawa’s Campaign for Safer Consumption Sites.
“A lot of us have been working with people that unfortunately have bloodborne illnesses that could have been preventable if the health infrastructure was already in place,” she said.
“It’s just frustrating to see the consequences on real, live human beings that come from this lack of resources.”
High infection rates prompted Ottawa Public Health to review its harm reduction policies several months ago. They’re still at it.
“We’re really trying to understand, what are some of the local issues that are contributing to that?” said program manager Andrew Hendriks.
A supervised injection site is “not a priority,” Hendriks said. “What we are focusing on right now is … gaps in services in terms of our existing harm-reduction services.”
That could include, for example, extending hours at needle exchange facilities or working with other groups to pick up where city services leave off.
“The case for supervised injection has already been made”
But a supervised injection site has become a priority for some, especially after a report last year recommended such sites – several of them – for Toronto and Ottawa.
Bill C-65, which would add dozens of new requirements to applications for exemptions from federal drug laws, provided additional impetus.
“We’re far more likely to get it before C-65.”
Sandy Hill is preparing its application now. In theory, filing it before C-65 becomes law means Health Minister Rona Ambrose would have to consider it under old legislation.
A Health Canada spokesperson said a hypothetical application submitted before the bill comes into force wouldn’t have to be resubmitted and would be considered under the rules of the day. “Exemption applications related to activities at a supervised consumption site would be assessed on a case-by-case basis,” a department statement read, “taking into account relevant considerations as well as the factors set out by the Supreme Court of Canada in its decision regarding Insite.”
Either way, it appears unlikely the Health Minister say yes: The Tories have made no secret of their dislike for this brand of harm reduction. But observers say being considered under less stringent requirements could help Sandy Hill should it take the case to court.
Boyd wouldn’t speculate on that. Sandy Hill staff met with Health Canada representatives last winter, he says, and “I came away from that meeting feeling optimistic.”
“They said to us at that point that the case for supervised injection has already been made – the scientific case,” Boyd said. “What we need to demonstrate to them is that supervised injection is the right thing to do in this community at this time.
“They’re certainly open to it.”
An emailed statement attributed to newly minted Health Minister Ambrose says the government “respects that Canadians feel strongly about what happens in their local communities and want to be part of any decision to place a supervised drug injection site in their local neighbourhood.” Bill C-65, the email adds, “sets out a process that will ensure local voices are heard when the location for a supervised drug injection site is contemplated.”
‘They put needles in my toilet bowl’
And that, in theory, is the ultimate kicker: What will the neighbours think?
The assumed distaste for an injection site next door is a cornerstone of the Conservatives’ campaign against these facilities.
But Boyd and his allies are betting on the opposite – that people living beside addicts would much rather have them inject indoors than in doorways.
“If you live in a drug-affected community and you don’t want people to inject in your backyard any more,” Boyd said, “you say, ‘Yeah I accept it.’”
And for some Lowertown and Byward Market residents, that’s the case: In a survey the Campaign for Safer Consumption Sites conducted of 107 residents in April, 64 per cent said they’d support the opening of a supervised consumption site in their neighbourhood. (Results of a more recent survey of local businesses haven’t yet been analyzed.)
When Ewald Friesen and his girlfriend moved to the neighbourhood almost two years ago, they were looking for something a little grittier than the Glebe. And they love the area, he says – it’s diverse, it’s charming. But they’re also keenly aware of its drug problem; it’s hard not to be.
“I interact with it every day: On my walk to get groceries or to go to the liquor store. … You face it, front and centre,” he said.
In his mind, harm reduction and supervised injection sites make sense.
“If a project like this is blocked, it’s a bit of an insult to the people who like this neighbourhood and want to stay here and call it home.”
Aman Razzaq owns the Pizza Pizza restaurant beside the centre on Rideau Street, near the Sandy Hill health centre. The centre is a “big problem” for business, he says: Users ask customers for money or shoot up in the bathroom.
“They put needles in my toilet bowl.”
But he doesn’t want to see a supervised injection site, either.
“They should use a separate place – go to a hospital,” he said. “It needs to be out of the city.”
“People think [a supervised injection site is] a free-for-all. … That’s not true”
Boyd faces an uphill battle trying to change Razzaq’s mind, not to mention getting others on-side. He hopes to get Sandy Hill’s exemption application on the health minister’s desk by mid-fall. But he’ll also need funding from the province and cooperation from a local police force that’s been lukewarm to the idea so far.
“People think [a supervised injection site is] a free-for-all, that people can do anything they want. And that’s not true,” he said. “We wouldn’t open a place where you just come in and inject and there are no other health services available.”
Patrick Tobin figures supervision could’ve saved him from an abscessed arm, infected from shooting up behind shelters; from a near miss when he set fire to his apartment while high; from a decade or so of overdosed friends.
“If we had a safe injection site it would be huge,” says the 42-year-old Newfoundland native, who’s been on and off heroin and morphine for almost 20 years. “It would be a really positive step for Ottawa.”
Just because Insite has been shown to work in Vancouver doesn’t mean the model fits anywhere: Many have noted that Toronto and Ottawa don’t have Downtown East side equivalents – concentrations of destitute addicts that lend themselves to a central injection site.
But Boyd argues a site would still serve a need in downtown Ottawa.
“I think it’s harder for people to see the public health crisis. It’s kind of happening in slow motion here, whereas it was not in Vancouver at that time,” he said.
Would it be preferable to get people off drugs altogether? Sure. But that seems less likely when you have a dozen detox beds and thousands of addicts in your city.
Some people dream of eventually making supervised injection “standard of care” – included as a matter of course with any clinic offering health services to addicts. That’s likely a long way off.
In the meantime, Boyd hopes for the chance to open a site and show it isn’t as scary as it’s made out to be.
“What we want to do is really be able to demonstrate that this works, that all the fears that people have around this are untrue, they’re unfounded,” he said.
“I think having some good local experience and success … makes it much easier to open a second one.”