Expect to hear more about a drug injection site in Ottawa soon

Remember the snarky debate about a safe drug-injection site in Ottawa? writes Citizen columnist Kelly Egan.

Well, because it’s 2015, because of sunny ways, because a new, shaggy-haired sheriff’s in town, expect to hear more sound and fury on the issue, and real soon.

It was the one topic that spontaneously drew applause at the 12th annual community forum sponsored by the Alliance to End Homelessness Ottawa yesterday at the RA Centre. While the Conservative government of Stephen Harper hated the idea and wanted to shut Canada’s only such site in Vancouver, the Liberals are more welcoming.
“With the new Liberal government, there is definitely an appetite to look at it,” said Rob Boyd, director of Oasis, a drug treatment program run from the Sandy Hill Community Health Centre.

Boyd has spent some 25 years treating the drug addicted and is one of city’s most respected voices in the field.

There is a plan to establish the site at Oasis, tied in with other services (methadone clinic, needle exchange, HIV care), but the application wasn’t brought forward because of the hostile regulatory climate.

The Conservatives went so far as to pass Bill C-2 in March, which set up a rigorous set of conditions, effectively blocking the creation of any more safe injection sites in Canada.

Boyd said advocates are hoping the bill will be amended or repealed.
The optimism is not misplaced.

During the election campaign, Liberal leader Justin Trudeau supported the opening of just such a site in Montreal.

Boyd said he expects the proposal will get a community airing in 2016. Though both the mayor and police chief oppose the idea in principle, he hopes a proper explanation will help to persuade them of the health benefits and cost savings.

“I would like to have the opportunity to present the model we’re looking at. I’m not sure it’s well understood because we haven’t articulated it very well yet”— Rob Boyd

There is ample evidence that Vancouver’s safe injection site has prevented overdoses, curtailed the spread of infectious diseases, and steered addicts into treatment. And the Supreme Court of Canada supported its existence. But it has always been contentious because some see it as the government enabling drug addiction and turning a blind eye to criminal activity.
The forum was fascinating for its snapshot on the health of the homeless and the city’s drug scene, the two often intermingled.

Every year in Ottawa, about 50 users die of a drug overdose, and paramedics respond to roughly three calls of suspected overdose every day. It is a fluid situation.

Counsellors have noticed lately, for instance, that opioid users are turning to a powdered form of fentanyl, sometimes with disastrous effects.

Boyd said the fentanyl is mixed with other drugs, like heroin, in such a way that the user doesn’t know the potency of the product. (In August, Vancouver had 16 overdoses in one day from a set of street pills thought to be spiked with fentanyl, which can be 50 times more potent than morphine.)

He estimated there are between 1,500 and 2,000 intravenous drugs users in Ottawa and presented the crowd of about 150 people with a chart that showed overdose deaths in Ontario have soared from 91 in 2000 to 513 in 2013.

There was already a signal that the road to a safe injection site in Ottawa will not be a smooth one.

The city’s medical officer of health, Dr. Isra Levy, attended the forum. His department has taken a neutral position on the issue, “monitoring” the public discussion about safe sites.

“The safe consumption site concept, for me, is a distraction from the larger discussion,” he told the Citizen during a break.

The morning featured a presentation from Dr. Travis Baggett, a physician and researcher who works with the homeless in Boston. One piece of research involved looking at mortality and disease rates among 28,000 patients between 2003 to 2008.

It found that tobacco and alcohol were responsible for a great deal of mortality, much higher, depending on the age group, than drug addiction. In fact, if street people live into their 50s, smoking and booze will likely kill them before drug use does.

And, traditionally, smoking has been viewed as “the least” of their problems — cigarettes even being handed out to street people in the old days as “carrots” to treatment. Yet, as their drug addictions are brought under control, it is the cancers from tobacco and alcohol that may well kill street-involved people.

Many drug programs today, however, include smoking cessation.

Story by Kelly Egan.

Ottawa Citizen, November 25, 2015.

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