Pubdate: Thu, 17 Mar 2016
Source: NOW Magazine (CN ON)
Copyright: 2016 NOW Communications Inc.
Author: Walter Cavalieri
Note: Walter Cavalieri is director of the Canadian Harm Reduction Network.


Misguided politics have contributed to an epidemic in drug overdoses in Toronto

Overdose deaths, at levels in Toronto which surpass even motor 
vehicle deaths, are an epidemic: 206 in 2013, and growing every year. 
And we are responsible. All of us.

Counterproductive laws, inaccurate information, misguided leadership, 
institutional stigmatization, fear ... all play roles in keeping drug 
overdose deaths high in all populations, not just street persons.

Safe injection services is one important way of addressing the 
problem. This morning, the Toronto Board of Health will issue a 
report recommending the establishment of safe injection sites. The 
issue will be considered at the Board of Health's next meeting March 
21. They are not a new idea.

In the mid 1990s, the Goethe Institut brought a large delegation from 
Frankfurt, Toronto's sister city, to share its success in addressing 
its open intravenous drug scene, one of the most deadly in all Europe.

One tactic they employed was to set up sites where people could 
inject their drugs in a clean, well-lighted place, with new equipment 
and a knowledgeable staff to help out in case of emergencies. Alas, 
Toronto wasn't ready to do anything different about its drug problem, 
and we have seen the results of that missed opportunity year in and year out.

We cannot miss the opportunity now. There is too much need and too 
much evidence that these services are successful.

There are more than 90 supervised injection service facilities around 
the world, including two in Vancouver. More in Canada are coming. The 
research is clear - they improve the health of those who use drugs 
and the quality of life of the surrounding community.

As an ethnographer, I have had the opportunity to observe people in 
Toronto injecting crack cocaine. Remaining an objective observer was 
impossible. I struggled to keep tears and anger at bay.

Using drugs desperately, covertly and under duress is a matter for 
people without homes or safe places to use, and shooting up in 
laneways, abandoned building, parks, garages, janitors' cupboards, 
washrooms, etc., does not provide safety. No wonder there are so many 
illnesses and deaths. That said, the people I observed wanted to be 
safe, and they did their best to protect the safety of their partners 
and friends.

Not everyone who uses drugs is addicted, but many feel they cannot 
live without them. They use them for a variety of reasons. However, 
as long as the drugs they use have questionable levels of strength 
and purity, overdoses and damage to health are inevitable. The war no 
drugs has failed. It has, in fact, made things worse for everyone. 
It's time for another approach, and supervised safe injection 
services offer us that opportunity.

Will they increase drug use, crime, illnesses? No. They have not done 
this anywhere else they have been tried. What they can offer is a 
place where people who have been pushed to the edges can connect with 
dedicated healthcare workers.

In the mid 1980s, I had the opportunity to accompany a street 
outreach worker in Calgary handing out condoms to women working in 
the sex trade. We struck up a conversation with a local minister who 
was helping out. Alas, my inner wise-ass asserted itself. I decided 
to ask how he, a man of the cloth, could be openly condoning a 
"sinful" activity. He told me it was more important to him to keep 
the women alive now so he could save their souls later. He had given 
me my first real lesson in harm reduction, one which has guided me 
ever since. Harm reduction is not just about the now but about the future.

Safe injection services in Toronto can save lives now. Working to 
help the living is full of possibilities, but it is impossible to 
help those who are dead.
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MAP posted-by: Jay Bergstrom