A polarizing solution to the opioid crisis

LONDON — Cambridge and Kitchener could soon be home to supervised drug consumption sites, where addicts can inject, snort or ingest their drug of choice.

Region of Waterloo Public Health is considering three locations for permanent sites, with the expectation that two sites will open — one in Kitchener and another in Cambridge. Sanguen Health Centre is looking into establishing a temporary site.

More public consultation is planned, and it’s far from a done deal, but the opioid crisis is hitting municipalities hard and forcing them to combat spiking overdose rates.

In 2017, 1,125 people in Ontario died from opioidrelated overdoses with fenta-

nyl being the No. 1 culprit.

In Waterloo Region alone, 85 people died of opioid-related drug overdoses that year. So far this year, 22 have died of drug overdoses.

In downtown London, a temporary injection site has been in operation since February. The King Street site is housed in the city’s HIV/AIDS office, which has existed in the core area for 20-plus years on the main floor of an apartment building surrounded by businesses.

Staff at the office have run needle programs for years, last year distributing three million needles. People coming to the injection site, which is staffed by the HIV/AIDS personnel and public health, go to the back door on the main floor surrounded by parking lots. The area is free of garbage, and passersby on King Street would be hard-pressed to know an injection site is located there. London’s temporary site will close when the two permanent supervised consumption sites open later this year just outside the downtown core area.

One permanent site will be located on York Street across from the Men’s Mission, where a guitar shop currently sits. They are moving and leasing out their building. The second is set for the main floor of a public housing apartment building on Simcoe Street. London’s public health unit has a provincial grant of $1.2 million to run each facility, and there is $1.5 million in provincial capital funding to convert the buildings into consumption sites.

Residents near the Simcoe Street site are challenging the decision. They have hired a lawyer and taken their fight to the city, saying there has been an inadequate notice of public meetings and a lack of consultation.

“People worry ‘Oh, you are going to cause this massive drug problem.’ Well, no actually, we have a massive drug problem,” said London’s medical officer of health Chris Mackie. He says the evidence collected from around the world where 100 similar consumption sites already exist, mostly in Europe, lowers needle waste, public injecting and drug dealing. The first injection site opened in Switzerland more than three decades ago and numbers point to a marked decrease in syringe sharing, HIV transmission and overdose deaths. It’s money well spent, said Mackie, considering it costs the health system $3.2 million to treat a single case of HIV. He said hospitals often see young men with an infection on the lining of the heart, which is caused by unclean needle practices.

“These are serious impacts that are hitting our community hard right now,” he said. It often leads to hospitalizations and serious surgery — heart valve replacement, costing the system $7 million a year, he said.

At the injection site, they can coach users on practices that kill bacteria and stop hepatitis C, HIV and other infections.

But injection sites are a polarizing issue pitting people against each other. Mackie said “time after time” landlords turned down proposals of leasing property for a consumption site.

“Even when we had someone on board, they caved under public pressure,” he said. “Our whole approach to drugs for generations is to stigmatize, blame the person who is addicted and punish,” he said. “We have this belief that it is going to somehow improve the problem. It hasn’t.” Mackie said this simplistic view is not solving the problem.

“We need to strengthen people, building connection to the community so they can put their lives back on track and help prevent addiction,” he said.

Mackie said the consumption site is a harm-reduction approach — a safe place for addicts, making them feel as if they belong and giving them the choice to get help. “We treat them like a human being, not an animal,” he said. “The opposite of addiction is not sobriety. The opposite of addiction is connection,” Mackie said.