Pubdate: Thu, 16 Jun 2016
Source: Ottawa Citizen (CN ON)
Page: A1
Copyright: 2016 Postmedia Network Inc.
Author: David Reevely


The city councillors on Ottawa's board of health seem ready to back 
the city's top public-health doctor in approving the idea of a safe 
injection site for drugs here.

Their views aren't identical, but in separate interviews on Wednesday 
all six said they're open to the idea, pushed forward by the Sandy 
Hill Community Health Centre, to add a facility to its existing 
health programs for drug users.

A safe injection site typically provides clean needles and other 
works to prevent the spread of diseases, and has nurses on hand who 
can respond immediately to overdoses.

The additional hope is that giving chronic users of hard drugs 
regular contact with health workers will give users chances to get 
help with their (usually very complicated) problems when they're ready.

What's on the table at a health board meeting next Monday is a 
recommendation from the city's chief medical officer of health, Dr. 
Isra Levy, that the health unit adopt the position that a safe 
injection site should be part of the panoply of drug-treatment 
options available in Ottawa. Levy believes Ottawa has an incipient 
drug-overdose problem and a safe injection site is an important way 
of addressing it.

Strictly speaking, it's not up to the board of health: what the Sandy 
Hill centre needs is a federal exemption from national drug laws, for 
a particular site run by a particular authority. But no politician 
wants to be seen foisting such a thing on an unwilling community, so 
they all kind of edge forward, eyeing one another nervously, nobody 
wanting to get too far ahead. There's no plain process for opening 
one, which complicates everything.

Vancouver has its well-known stand-alone injection site in the 
Downtown Eastside, which is run jointly by the provincial health 
authority and a non-profit housing corporation that's edged into 
providing health care for street people. Plus it has a newly approved 
one (which had been operating semi-secretly for years) in a 
clinic-shelter-community centre for HIV patients.

In Edmonton, a non-profit needle-exchange agency wants to open one. 
In Toronto, the public-health unit is looking at operating three 
injection sites under its own authority.

They're different - funded differently, answering to different 
authorities, with different mandates.

Ontario Health Minister Eric Hoskins has said the province will take 
it up if "a municipality were to come forward with a proposal," but 
Ottawa's not coming forward with a proposal: a stand-alone health 
centre is. What will he do with that? He'll let the municipal process 
sort itself out first.

Ottawa's board of health, and especially the half-dozen councillors 
on it, are the city's voice on the idea. What they think matters.

Stittsville Coun. Shad Qadri, who chairs the board, said he'll follow 
everyone else's lead. He's previously been against a safe injection 
site here, but Levy's report is compelling, he said.

Qadri pointed out that although it recommends the health board 
support a safe injection site in principle, it also calls for 
citywide consultations on just what form one should take.

"We'll go out and do further consultation with the (health centre) 
partners as well as within the entire city, and let's see what that 
tells us," Qadri said. Maybe Ottawans will want no site, or one, or 
two or three.

"I'm very much on an open mind basis at the present time and looking 
at the opinion of the board," Qadri said. Yes, he's been reluctant, 
he acknowledges. He still is. But: "I have to look at these issues 
from a new perspective in my position as a board chair ... My 
position may have to be revisited."

Rideau-Vanier Coun. Mathieu Fleury, in whose ward the Sandy Hill 
facility would operate, said he'd prefer to see safe injection 
services spread out, not concentrated in one spot.

"In my community, people say, 'Yes, we have drug users, but we 
shouldn't have every drug user,'" Fleury said.

The nature of the application for a federal exemption to drug laws 
requires a single operator to propose a single site, he said, which 
is inherently bad when you're trying to address a complicated problem 
that isn't in just one place. If the city's health unit is involved, 
that should make it possible to co-ordinate services offered in 
different neighbourhoods, not to keep them restricted to one place, he said.

"I'm curious to get Isra's perspective on how they intend to achieve 
that," he said.

Fleury also wants a firmer understanding of the waiting lists for 
detox and rehab programs, information he expects at Monday night's meeting.

Somerset Coun. Catherine McKenney supports a safe injection site 
unequivocally. The Sandy Hill centre has demonstrated the need for 
one in its community and is capable of running it, she said. She'd 
support one in her ward, too, she said, if a health centre believed 
it were needed.

"The time has passed where we treat people who have addiction issues 
as people who need to be dealt with criminally rather than as people 
who have a health issue," McKenney said. "I'm happy that we have 
reached a point as a board that we see this as a health matter."

Bay Coun. Mark Taylor said he has reservations but backs the 
principle of opening a safe injection site here.

"I understand why there are folks who would have challenges looking 
at the idea of an SIS in Ottawa, and certainly I'm one of them. But 
at the same time, I think we have a board of health for a reason, we 
have a chief medical officer of health for a reason, and that reason 
is to make sure when we have these sticky situations that wrap up 
what we perceive to be criminality and morality with health issues, 
we can divorce that a bit and look at them with an evidence-based, 
science-based approach," Taylor said.

He's read Levy's report and recommendations and they're pretty about 
what that approach ought to be, he said.

Taylor wants to know more about how an injection site can be 
connected to treatment programs, so that it doesn't just maintain 
addicts as addicts in a safer environment. "I'd like to hear if there 
are programs like this operating elsewhere in the world if there has 
been, even albeit small, if there has been diversion in the program - 
where a percentage of the people coming through the doors do end up 
transitioning away from that addiction," he said.

Gloucester-South Nepean Coun. Michael Qaqish has a view that's almost 
the mirror image of Taylor's: He's against safe injection sites in 
general and doesn't think they should be part of the Ottawa health 
unit's anti-drug strategy, but he's willing to let the Sandy Hill 
Community Health Centre add one.

"I'm open to the idea of having it there as a pilot (project)," 
Qaqish said. "I think the concept can be there because they have the 
infrastructure, they have the relationship with their clientele, they 
have a facility that already has programs along these lines."

He'd prefer to see public resources spent on drug treatment and 
preventing abuse, he said, but "I'm open-minded to the specific experiment."

Capital Coun. David Chernushenko said he's long supported the idea of 
a safe injection site in Ottawa, though he wants to know how a 
particular one would operate before voting for a specific proposal.

"I agree, based on the evidence. Whenever I've been asked about this, 
at election time and others, I say I'm an evidence-based guy and the 
evidence I see is that this is harm-reduction, a more humane 
approach, and it's cost-saving, if that's important to people," 
Chernushenko said.

At Sandy Hill, "they've identified the need and, for want of a better 
word, the clientele there. They are a very well-run and knowledgeable 
centre," he said. But he wants careful consideration of the views of 
the centre's neighbours as the plans come together.
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