Pubdate: Sat, 19 Mar 2016
Source: Globe and Mail (Canada)
Copyright: 2016 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Jill Mahoney

NEIGHBOURS READY TO ACCEPT INJECTION SITES

Many residents and business owners see such supervised programs as a 
pragmatic response to long-standing community realities

In the alley behind Dave Osborne's hair salon, there's a filthy 
alcove with a locked gate that does little to stop drug addicts from 
grabbing a bit of privacy.

Mr. Osborne worries about what goes on in there - not about whether 
people do drugs, because it's clear they do. His fear is that someone 
will overdose.

"If something happens in there and then nobody sees or knows or hears 
about it, somebody's going to die," he said, standing in his garage 
off the graffiti-covered laneway near Queen Street West and Bathurst 
Street in downtown Toronto.

The closet-sized nook, with its scalable chain-link fencing, is a 
popular spot among drug users drawn to the free supply of clean 
needles at the community health centre across the alley. On a recent 
visit, a used syringe was visible among trash strewn on the ground.

Under a plan proposed by Medical Officer of Health David McKeown, the 
nearby Queen West-Central Toronto Community Health Centre could soon 
become one of three downtown clinics in the city to allow addicts to 
inject illegal drugs under the supervision of nurses. The others are 
inside a clinic known as The Works opposite Yonge-Dundas Square and 
the South Riverdale Community Health Centre in Leslieville, in the east end.

Since it was announced earlier this week, the controversial idea - 
there are currently only two supervised injection sites in Canada, 
both in Vancouver - has been largely been met with resigned 
acceptance in the Queen West neighbourhood. The proposal goes before 
the city's Board of Health on Monday, the first of several approval processes.

Many residents and business owners, including Mr. Osborne, see a 
supervised injection site as a pragmatic response to the area's 
long-standing drug problem, a facility that would help reduce the 
risk to everyone - from curbing the number of dirty needles in public 
spaces to increasing safety for addicts.

The board of the West Queen West Business Improvement Area is even 
considering endorsing the plan, executive director Rob Sysak said. 
"The needles are there and my members have to sweep them up, clean 
them up from the laneways and in the bathrooms, so a lot of them are 
hoping that this will stop that," he said.

Unlike in Vancouver, where the city's main supervised injection site 
is in the downtrodden Downtown Eastside, the area near the Queen 
West-Central Toronto Community Health Centre is a vibrant urban 
neighbourhood proclaimed by Vogue magazine as one of the world's 
coolest. Trendy home-furnishing stores and ethnic restaurants 
co-exist with a drop-in centre for homeless people, and the area's 
artists, professionals and drug users generally tolerate one another. 
On a rainy day this week, a man clearly under the influence stumbled 
down the sidewalk past a mother pushing her baby in a stroller and 
professionals absorbed in their phones.

But living or working in this area means encountering ever-present 
reminders of illegal drug use - discarded needles, tiny baggies, 
addicts passed out on the sidewalk.

Mr. Osborne, who co-owns The Loft-Toronto hair salon, regularly scans 
the pavement behind his business for dirty syringes, fearful that his 
two dogs will step on them, and usually finds a couple each week. 
Workers at a nearby Starbucks and Tim Hortons say they are on guard 
when emptying the garbage cans in the washrooms, where people 
sometimes shoot up and leave their needles behind.

A few blocks away, staff members at the Scadding Court Community 
Centre make a point of searching the playground for syringes before 
they take their young charges outside to play. Every couple of weeks, 
they find one.

"That's just one of the realities that we have downtown," said Kevin 
Lee, executive director at Scadding Court, who says that "it's about 
time" that a supervised injection site is created.

Some local business owners have asked whether an injection site would 
attract an influx of drug users from other parts of the city and 
increase crime, Mr. Sysak said.

Advocates, including the area's city councillors, point to a 2012 
feasibility study that found about half of addicts said they would 
not travel more than 10 blocks to use such a program. They also argue 
that a safe haven wouldn't cause crime to spike or encourage drug use 
among non-users, citing the experiences of more than 90 similar 
programs around the world.

"There is an existing need," said Angela Robertson, executive 
director of the Queen West-Central Toronto Community Health Centre. 
"People will not be busing in to line up to use the site. So we're 
looking at a service that is going to be responsive to folks who are 
already in the community, who are already using but who are sometimes 
using in spaces where there isn't safety, there isn't supervision and support."

There are an estimated 350 to 700 injection-drug users in the Queen 
West health centre's catchment area, Ms. Robertson said. As a group, 
they take significant risks. According to the feasibility study, 27 
per cent of adult and 41 per cent of youth injection-drug users in 
Toronto said they injected at least once a day. And 18 per cent of 
those who injected drugs - typically cocaine or opiates, including 
heroin - said they had shared needles. About half said they injected 
in public places, including washrooms, stairwells or alleys.

For Ms. Robertson and other harm-reduction advocates, establishing a 
supervised injection site is personal. In 2014, 10 of the centre's 
clients died from drug overdoses. There is often a photo display 
memorializing a familiar face in the building's lobby and staff 
members talk about how they have "become proficient as kind of 
funeral planners," she said.

Citywide, overdose deaths hit 206 in 2013, an increase of more than 
40 per cent in the span of a decade.

"We see this as a crisis," Ms. Robertson said. "For us, it brings a 
certain urgency for action to halt that and to give people a chance 
for this thing that folks call recovery that can only be made 
possible if folks are alive to have access to that opportunity."

The three proposed supervised injection sites - which must still go 
through public consultations and approvals from the city, province 
and federal government - would feature a room with three booths for 
drug users to inject pre-obtained drugs while being watched by a 
nurse. Afterward, users would go to a "chill-out room" to be watched 
for adverse reactions. Staff members would assess clients and make 
referrals to support services.

Together, the centres proposed for the sites already account for 
about 75 per cent of the 1.9 million needles given to drug users every year.

For Diana VanderMeulen, a freelance artist who was painting props for 
a fashion show in a garage off the alleyway beside the Queen West 
health centre, there is little question about the benefits of 
providing local drug users with a supervised place.

"This neighbourhood is pretty crazy anyways. There's a lot happening 
and I think as neighbourhoods become gentrified ... it's really 
important to respect the people who already exist in that 
neighbourhood. So I don't really think it would cause further 
disruption at all," she said. "They're already here, is what I'm 
saying. It's their neighbourhood."
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MAP posted-by: Jay Bergstrom