Pubdate: Sun, 20 Mar 2016
Source: Edmonton Sun (CN AB)
Copyright: 2016 Canoe Limited Partnership.
Contact: http://www.edmontonsun.com/letter-to-editor
Website: http://www.edmontonsun.com
Details: http://www.mapinc.org/media/135
Author: Janet French
Page: 2

'Long Overdue'

SUPERVISED INJECTION SITES FOR THE CITY BEING DISCUSSED

An Edmonton group that's closely studied local drug use is working to 
establish the city's first supervised injection sites.

Elaine Hyshka, a University of Alberta public health researcher and 
core member of Access to Medically Supervised Injection Services 
Edmonton, said group members envision a network of supervised 
injection services offered through organizations already working with 
homeless and disadvantaged people in Edmonton's core.

"This is something that's long overdue in Edmonton and other cities," 
said Hyshka. " is service will literally save lives."

Data suggests injection drug use is on the rise, said Marliss Taylor, 
program manager for Streetworks, which coordinates needle exchange in 
Edmonton. The program handed out 1.4 million needles in its last 
fiscal year, and is on track to distribute 1.6 million this year.

"More and more over time I'm convinced that we do need (a safe 
injection service)," Taylor said.

To make her case, Hyshka completed a PhD project that offered one of 
the most comprehensive and current windows into the lives of 
street-involved Edmontonians who use drugs.

Supervised injection services provide sterile water and supplies to 
prevent spread of infection, and nurses on site to respond in event 
of an overdose.

Ninety-one per cent of the 320 people she interviewed in the spring 
and summer of 2014 had injected drugs in the previous six months. 
Although some used occasionally, most people who take opioids like 
morphine and hydromorphone inject drugs once or twice a day, and 
those who use stimulants, like crack cocaine or methamphetamine, can 
use seven or more needles a day.

Hyshka's survey was done before Alberta's spike in fentanyl 
overdoses, which killed 272 people in 2015.

A troubling finding for the public health researcher was the four in 
five people injecting drugs who did it in public, which substantially 
increases the risk of health complications. On the street, people 
often lack sterile water and supplies, which can cause infections 
leading to skin abscesses, hepatitis C, HIV, and other potentially 
fatal conditions.

More than a quarter of people Hyshka surveyed had shared a needle. 
That rate is nearly five times a recent count in Vancouver, which has 
two medically supervised injection sites.

Hyshka is more guarded when asked for the potential service's 
operational details, like, which organizations could host the 24/7 
service, how much it would cost, and who would pay for it. The group 
is still discussing options and finalizing the proposal.

Legislation introduced last year by the former federal Conservative 
government requires the group to complete a comprehensive checklist. 
It includes gathering community endorsements and providing evidence 
to gain an exemption under the Controlled Drugs and Substances Act.

Hyshka said the federal government has indicated its willingness to 
be flexible with the current legislative requirements.

Efforts to create supervised injection services across the country 
that froze under an unsupportive Conservative government are now 
heating up since the Liberals gained office last October.

"It's kind of a new world," said Streetworks' Taylor. She calls North 
America "constipated" in its approach to substance abuse compared to 
Europe, where supervised injection is widely available.

The proposal has fans on city council, including Edmonton Mayor Don 
Iveson. In an editorial board meeting with Postmedia Friday, he said 
evidence in favour of harm reduction is "crystal clear.

"In every single case you save money in the health-care system, (and) 
reduce social disorder, which allows our police to go chase actual 
bad guys, and then you get the opportunity to intervene for people 
who are in serious distress, and, once in awhile, they can take an 
off-ramp, more likely than they're going to take an off-ramp on the 
street," Iveson said.

Alberta Health Minister Sarah Hoffman recently said her government is 
reviewing evidence in support of supervised injection services, 
though she warned not to expect decisions soon.

"We will be looking at the evidence and working with our community 
partners to figure out, if we are going to move forward, where the 
best places might be for supervised consumption," Hoffman said.

More hesitant about the proposal is Maurice Brodeur, president of the 
Edmonton Police Association, which represents nearly 1,900 city 
police officers.

He questions where the drugs come from, what unknown substances could 
lurk in them, whether the surrounding community will have a say on 
where the services are located, and where people will go once they've 
used drugs. If a person has an overdose after using a supervised 
injection service, Brodeur wonders who would be liable.

Even if multiple sites offer supervised injection services, it's 
unfair to concentrate that activity in any area, the police sergeant said.

"The neighbours are not going to be happy."

The Edmonton Police Service did not respond to a request for comment Friday.

Supervised injection proponents say the perceived risk to 
neighbourhoods hosting the sites are overblown.

"There's clear evidence these services do not increase crime in the 
area and do not increase substance abuse," Hyshka said.

Building relationships with people who use the service can help 
redirect them into drug treatment programs. Vancouver's Insite 
program recorded 3,418 people referred to clinical treatment programs 
in 2012, the most recent year for which statistics are available.

Taylor said detractors should be willing to try supervised injection 
services for a trial period, since the status quo isn't working.

"It's coming at some point. It's just a logical, smart step that will 
help with public safety and public health."

- - With files from Max Maudie and Dave Breakenridge

- -------------------------------------------

[sidebar]

Sources: City of Edmonton, Streetworks, Insite

BY THE NUMBERS

1.4 million: Sterile needles dispensed in Edmonton in 2014-15

1.6 million: Sterile needles expected to be dispensed in 2015-16

804: Calls to 311 to collect discarded needles in 2015

12,304: Used needles collected in city drop boxes in 2015

9,259: People who visited Vancouver's Insite for services in 2012

193,764: Visits to Insite's injection room in 2012

497: Overdose incidents at Insite in 2012

3,418: Insite clients referred to drug treatment in 2012
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MAP posted-by: Jay Bergstrom