Safe injection sites a small step but big milestone in saving lives

Coalition of agencies is working to provide 24/7 service, Shelley Williams writes.

Access to Medically Supervised Injection Services Edmonton, known as AMSISE, is a coalition of 25 individuals and groups, including people with lived experience, community agencies, medical, academic, and public sector representatives.

AMSISE started as a conversation with Edmonton’s harmreduction needle distribution service, Streetworks, in January of 2012 and continues to be a community-driven initiative.

The focus is on people with severe and chronic addictions, usually homeless, whose chaotic and furtive injection-drug use takes place in unsafe environments, including parks, back alleys, behind dumpsters, along fences, and in agency and public washrooms. Multiple studies have established a direct link between unstable housing and public injecting. Communities will benefit by reducing unsafe needle debris as an unintentional hazard.

Building on indisputable evidence on the effectiveness of supervised consumption services (SCS), we developed a tailored strategy in Edmonton that embeds micro-sized SCS within three community organizations. Rather than building a standalone, storefront facility, such as Insite in Vancouver, the model adds small-scale (micro-sized), dispersed services within agencies that already work with this population, providing health and social supports, to reduce harm and connect people with a variety of wrap-around supports.

The intent is to offer as close to 24/7 coverage as possible across the agencies, aligned with the agencies’ normal operating hours, and involve nurses, addiction counsellors, and harmreduction support workers.

None of the three community organizations has the space, staffing, or hours of service on their own to meet the level of need for SCS in Edmonton’s inner city without a costly and time-consuming expansion. Each organization is unique and has program strengths and trusting relationships among people with problematic substance use. They will offer medically supervised environments for consuming drugs with emergency medical assistance if needed, and co-ordinate their resources to connect people with a wide range of health and social supports.

We are pleased to now have the federal approval from Health Canada and the financial support from Alberta Health to offer supervised-consumption services in Edmonton. This service is long overdue and AMSISE will be moving forward in finalizing capital improvements and starting the services in each of the organizations.

AMSISE is fully aware that this is but one thread in a blanket of services needed to support people with addictions. Comprehensive

AMSISE is fully aware that this is but one thread in a blanket of services needed to support people with addictions.

individualized services within a harm-reduction framework are crucial for meeting people where they are at and supporting change.

We are eager to see harmreduction services and strategies continue to develop to meet the ever-changing needs of our communities.

While supervised-consumption services will remain our key focus, we also know that this one type of service will not solve the complex social issues related to addictions, poverty, mental health and homelessness. Members of the coalition will continue to work on provincial, municipal and community-based initiatives to help create healthier communities.

This one small step is a huge milestone in saving lives and providing an opportunity for people to come out from the shadows of back alleys and other public spaces and access a safe environment. We are removing some of the stigma and offering a health service with the dignity and respect that every person deserves.