Pubdate: Tue, 15 Mar 2016
Source: National Post (Canada)
Copyright: 2016 Canwest Publishing Inc.
Author: Chris Selley
Page: A7
Bookmark: (Supervised Injection Sites)


Downplay Odds of Many Users Taking Advantage

More than 12 years ago, Insite began offering needle drug users a 
sterile, safe environment on Vancouver's Downtown Eastside. Hundreds 
of people have overdosed there since; none have died.

Now Toronto may be headed down the same road. A report from the city 
's medical officer of health, David McKeown, released Monday, 
envisions three safe-injection sites in areas of high drug use 
concentration, incorporated ( unlike Insite) into existing health 
services: at Toronto Public Health's The Works clinic, at Yonge and 
Dundas; the Queen- West Central Toronto Health Centre at Queen and 
Bathurst; and the South Riverdale Community Health Centre in Leslieville.

"We recognize that not all individuals are ready or are able to stop 
using drugs," said Angela Robertson, executive director of the Queen 
health centre. "Therefore, integrated supervised injection services 
are an important part of a public health approach that can reduce the 
harms associated with injection drug use while increasing access to 
health services."

"All lives are important and nurse-supervised injection services save 
lives," she added.

We are talking about a lot of lives. In 2013 in Toronto, there were 
149 accidental drug-induced deaths - more than any year in the 
previous 10. The trend wit hop io ids like heroin and oxycodone is 
even more alarming: in 2004 there were about 45 accidental deaths; in 
2013 there were 123.

By no means were all needle-related. But "these are essentially 
preventable deaths," McKeown said Monday.

A lengthy process lies ahead. Notably, like Insite, the city would 
need an exemption under the Controlled Substances Act. While Ottawa 
will likely be more amenable to that under a Liberal government, 
Justin Trudeau can't help with the biggest informal obstacle: public 

Fifteen years ago, it is safe to say, this idea would have sparked a 
NIMBY rebellion. Certainly, there will be pointed questions. But I 
suspect this time around it will be different.

McKeown and other proponents have crafted their case carefully. 
Unlike Insite, Toronto's clinics would have no exterior signs. Three 
booths per location would be "discreetly embedded" in existing 
facilities. The supporters cite evidence from Vancouver suggesting 
safe injection-sites lead to fewer people shooting up in public, 
fewer discarded needles in the streets and less transmission of HIV 
and Hepatitis- C.

And, somewhat perversely, they argue not too many people will avail 
themselves of the services.

"There is... no anticipated in flux. People will not travel more than 
a few blocks to inject their drugs," said Lynne Raskin, head of the 
South Riverdale centre. "The focus will be on existing and known clients."

"Drug use is in our backyards right now," said Coun. Joe Cressy, 
chairman of the Toronto Drug Strategy Implementation Panel, and he's 
right. It is in our public washrooms, and in the apartments down the 
hall, and in the alleys outside, and in the houses next door ( some 
of them very nice houses). For reasons both selfish and noble, many 
who live in these neighbourhoods may welcome these safe injection sites.

There will be lingering resistance from those who believe trying to 
manage illegal drug use is inherently to encourage it - but then, 
people used to say that about handing out clean needles. If you 
believe needle exchanges do, in fact, encourage drug use, you should 
have a tough time arguing against having a nurse on hand to monitor 
the effects.

And there will be lingering resistance from those who believe the 
state mustn't interact with drug users except to steer them into 
treatment - an instinct that is, at best, naive as to how incredibly 
difficult that is to do, even for people of considerable means.

"If people want to stop using, they will. If they don' t, they won' t 
," said Cindy Reardon, a peer outreach worker at t he Works who was 
partially paralyzed by an infection contracted while shooting drugs.

She speaks from experience: "I have a job, I went to school, I have a 
home," she said - but she still uses. "You get people in the door, 
and if they ... choose to stop using, then there's room for that 
conversation. But if they don't want to, harm reduction dictates that 
we approach people where they're at."

I have never had to deal with a loved one's drug addiction, but I can 
try to imagine the sleepless nights. And I imagine knowing he or she 
was shooting up in the presence of a nurse would be an incalculable 
comfort. Every day he or she didn't die alone in an alley might be 
the day before he or she could, maybe, get clean.
- ---
MAP posted-by: Jay Bergstrom