A BACKSTOP FOR SITES
Safe-injection support
If the provincial government stops funding supervised druginjection sites in Ottawa and the federal government doesn’t step in, the city will have to find a way to pay for them itself, Mayor Jim Watson said Thursday.
This is a major turnaround for a politician who resisted these services in Ottawa for years.
“I think we have now four in Ottawa and they’re serving a very vulnerable population and we’d have to find, if the province cuts the funding — we’d have to go and see if the federal government can help us, because of course they started the initial approval process, from Health Canada — but otherwise, we’d have to find the dollars within our own budget,” Watson said, speaking with this newspaper’s editorial board.
“We’ll have to do what we can because the services are helping people and we need to ensure their continuity,” he said. “I can’t guarantee that we’re going to be able to establish more than we have now, because Public Health has many priorities,” but he’d look to preserve the four sites Ottawa already has.
This isn’t what he wants to see happen, he said: The provincial government should fund health services. “It’s another example of what I’ve fought all my political life, the downloading to municipalities,” he said.
Supervised injection sites are places where people who take drugs with needles can go and use them with trained health workers on hand to step in if they overdose. Vancouver has had a legally sanctioned one since the early 2000s, and for 15 years it was the only one in the country. But they spread quickly last year after fentanyl, a much more powerful synthetic drug in the same opioid family as heroin and oxycodone, started displacing other opioids in street drugs because it’s easier to make, transport and conceal.
One lab analysis of a drug sold as heroin in Ottawa last year found it contained no heroin at all — only fentanyl and fillers. Carfentanil, an even stronger alternative, seems to be following.
Statistics kept by Public Health Ontario, a provincial agency, show that the number of fatal opioid overdoses rose from 571 in 2010 to 1,265 last year. The number of visits to hospital emergency rooms for overdoses tripled from about 2,800 to nearly 7,800.
In Ottawa, fatal overdoses rose from 22 to 64 in the same period. Hospital visits climbed from 128 to 370.
Reversing overdoses can often be done easily with an opioid antidote called naloxone if somebody recognizes what’s happening and has some handy. But for a long time, Watson said he didn’t think supervised injection sites were a good use of money. He’d rather spend it on treating people for addictions than on preventing overdoses, he’d say.
Last year, though, Watson acquiesced when Ottawa’s health unit recommended that injection sites be permitted and even proposed opening one of its own. Then-premier Kathleen Wynne and health minister Eric Hoskins began approving them and funding them once the applications started coming in. Now Ottawa has two supervised injection sites in community health centres in Sandy Hill and west Centretown, one at the Shepherds of Good Hope shelter on King Edward Avenue, and the one run by the Ottawa public-health unit also in Lowertown.
The price of a supervised injection site can vary depending on how many people it serves, how it’s staffed and how many hours a week it’s open, but $1 million a year is a decent ballpark figure. That’s the amount of annual provincial funding for the one in the Somerset West Community Health Centre; the health unit’s small site, shoehorned into an office on Clarence Street, costs about $900,000 a year.
But the provincial government, now under the Progressive Conservatives, has frozen approvals for new sites and put existing ones on the bubble. Premier Doug Ford has said he personally opposes them but wants to get expert advice before he makes a final decision. Health Minister Christine Elliott took the summer to pull together evidence for him, but at the end of September said she wasn’t ready to deliver a recommendation.
There’s virtually no rigorous scientific work showing injection sites are harmful. One recent paper got a lot of attention for pooling results of other studies and concluding that it’s not clear they do any good; the editors of the International Journal of Drug Policy retracted it after a closer look concluded that the paper combined those other studies in a methodologically flawed way.
But anyway, Elliott asked the federal government for a sixmonth extension on a policy that lets the province approve supervised injection sites without submitting each one to Health Canada, which the feds immediately granted. Now everyone waits.
The city was practically shamed into this, mind you, by activists who set up a rogue injection site in a tent in a scrubby Lowertown park a year ago, protesting all the authorities’ slow movement while people died. Watson hasn’t changed his mind about them.
“I was not happy with this popup site in the community park. That was not helpful,” he said Thursday.
Well, it forced the issue onto the public agenda, demonstrated how badly these sites are needed and helped the mayor find his way to the right side of this thing. Call it a win.
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