Supervised drug consumption site sought for city
Opioid overdoses higher in South Zone than elsewhere in the province
ALethbridge coalition on opioid use is preparing an application to establish supervised drug consumption services in the city to reduce harm and help save lives.
Supervised consumption services provide a clean, safe space for people who use drugs to do so under the supervision and care of health professionals without fear of arrest or overdose. They also provide access to support services such as counselling, education and treatment for drug addictions.
The move comes after a sixmonth comprehensive needs assessment was completed by the Lethbridge Executive Leaders Coalition on Opioid Use, which includes ARCHES Society. A total of 207 drug users were interviewed from a variety of demographics.
The needs assessment verified what was already known, said Jill Manning, ARCHES managing director.
“Everyone within the community has seen that the visibility of public drug use has increased rapidly over the past year and a half or so,” she said. “What goes hand-in-hand with that is we have increased numbers of needle debris and drug-use debris within the community, as well as increased calls to EMS/fire/ambulance and police. All of our systems right now are feeling the crunch of what’s happening because we don’t have somewhere for people to go and use drugs safely.”
Manning estimates there are 3,000 drug users in Lethbridge, and double that number within southwest Alberta.
Overdose rates are 24 per cent higher in the South Zone than anywhere else in the province, she said.
Overdose deaths in Alberta are at “crisis levels,” she said, and a supervised consumption site will reduce the number of local fatalities.
“We are losing more people currently to overdose fatalities than we ever did at the height of the HIV epidemic. We are losing more than one person per day through the 2016 year, and we anticipate that going up.”
A total of 559 Albertans died last year from opioid-related drug overdoses. Of those deaths, 363 were attributed to fentanyl or carfentanil.
In the first quarter of 2017, 117 Albertans died from a fentanyl or carfentanil overdose, almost double from the same time last year.
“If that continues, and we expect that it will, we’ll be at rates of losing two or more people per day,” said Manning. “We’re on track for that for 2017.”
Fire/EMS Chief Rich Hildebrand said they’ve seen firsthand the increasing number of overdoses in the past few years. The life-saving drug Naloxone is being administered more frequently, although he didn’t have the exact numbers.
“We see that, year over year, the trend is increasing quite dramatically. I think what strikes my staff most profoundly with this opioid issue, it’s the nature of the deaths — a lot of youth involved and just the frequency we’re seeing these overdoses occur.”
Emergency responders not only assist during a medical call, but are also one of a few agencies deployed to clean up needle debris in public areas. It’s impacting resources on a regular basis.
“We think a facility like this would have a positive impact and reduce those responses,” he said.
The coalition was formed in November to improve the coordination of services to respond more effectively to the opioid crisis. It includes representatives from the health, police, justice, emergency medical, post-secondary, municipal, education and social service sectors. They’ve conducted a number of stakeholder interviews and are moving into the public discussion phase next month.
Due to the epidemic, much of the coalition’s focus has been on enhancing harm reduction efforts. They also support prevention, early intervention, treatment and rehabilitation.
The province has earmarked funding for potential supervised consumption sites. There are only two operating in Canada, both n Vancouver. Health Canada has received more than a dozen applications, including from Calgary and Edmonton.
Similar sites have been in use in numerous cities throughout Europe for the past 30 years, with the first one in Switzerland in the 1980s. ARCHES had the opportunity to visit that site, and nine others across Europe, a couple months ago. It was a good opportunity to take away best practices from those sites as they have operated for many years, said Manning.
“Also it’s really reassuring to the community as we have evidence that supports these are effective and that they can make a difference.”
While many provinces are moving ahead with supervised consumption sites, Alberta is lagging a bit behind in understanding what harm reduction is, said Dr. Karin Goodison, AHS Medical Officer of Health, South Zone.
“I think it’s really important as we move to look at a safe-consumption site in Lethbridge that people really truly understand what harm reduction is about,” she said. “Harm reduction is very evidence-based. It’s the process where we meet people where they’re at and try to offer them services. It does show that we have a lot of people actually move away from using in an unsafe way to using in safer ways, less medical issues, and accessing services in a more healthful manner.”
People cannot obtain drugs at these sites, rather it’s a safe place to do drugs without fear of arrest, she explained.
“There are staff that are observing for symptoms of overdose and they can actually apply an intervention. In the case of an opioid overdose for example, they would give Naloxone and call 911 to make sure that person gets to hospital for appropriate care.”
Supervised consumption services also allow access to supports that drug users might not otherwise connect with, such as housing or employment services, addictions counselling, general health and mental health care.
“This service is along a spectrum. It exists in partnership with other services and supports like prevention, early intervention, rehabilitation treatment. All of those exist together — this is only one aspect of that,” said Manning. “We certainly aren’t trying to make the argument that harm reduction or supervised consumption services are going to be the solution for this. This is a multi-faceted crisis that we’re facing, so this is one mechanism we can do to try and fight back.”
A list of potential sites for Lethbridge is being developed and will be narrowed down through the application process. The facility would require a federal exemption to allow drug use inside the building.
The cost to run the facility is estimated at $1.5 million per year. There has been some pushback from those who say they don’t want to see their tax dollars go toward supervised consumption sites, said Manning.
“The reality is our taxpayer dollars are already covering these expenses. So whether it be through providing a facility for people to consume drugs under supervision, or whether it be through increased costs to our emergency systems... By providing easier access to these services, we’re really doing a lot of preventative stuff, not only from a treatment/recovery/rehabilitation perspective, but also simply from a mental and physical health-care perspective.”
Nine community discussion sessions are planned between July 4-20 to provide information and answer questions from residents. There is limited space, so those who wish to attend must register in advance by contacting scs@lethbridgearches.com.
ARCHES will send the application to Health Canada by the end of July.
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