Pubdate: Tue, 21 Jun 2016
Source: Ottawa Citizen (CN ON)
Page: A1
Copyright: 2016 Postmedia Network Inc.
Author: David Reevely


Board of Health Nearly Unanimous in Its Support for Supervised Facilities

Ottawa's board of health voted 10-1 Monday night to encourage 
supervised-injection sites to open in the city. "Listen to, more than 
anything, the people who live this," Capital Coun. David Chernushenko 
told skeptics. He'd come into the health-board meeting not knowing 
how much he didn't know about addiction, and treatment, and what it's 
like to be a drug addict, he said.

The board heard from several, all begging the board to say it 
supports the notion of opening supervised facilities where addicts 
can inject drugs in the presence of nurses who can rescue them from overdoses.

People like Darren Noftall, twitchy, tense, out of place at the 
formal table in city hall's committee room, who said his life had 
been saved twice at Vancouver's InSite. He overdosed at Canada's 
first safe-injection site and the nurses saved him.

He left Vancouver, thinking he'd be better at home in Ontario. It 
hasn't worked out that way yet.

"I live alone. I use alone. That puts me at high risk to die alone," 
he said. "When I go home, I'm going to do that hit tonight, I don't 
know if I'm going to be alive in the morning."

Ray Harrison, 18 months clean from multiple drugs, said he believes 
his life was saved by the Somerset West Community Health Centre. "I 
feel very strongly on this," he told the board. "The more doors you 
have open for people to come in to get help, the greater the chance 
we have to save decades of their lives."

That, ultimately, was what convinced the board: The idea that chronic 
users of injection drugs on the streets, some of the most troubled, 
needy people Ottawa has, could die - are dying - because they don't 
have safe places to use the drugs to which they're addicted. So they 
use in stairwells, in bathrooms, in parks, even on buses in the 
winter because they're warm and have some light. They don't know the 
purity of what's in their needles, they don't know whether there'll 
be anybody to help them if something goes wrong.

People have died within sight of needle exchanges because although 
they can get clean paraphernalia in them, they can't use drugs in 
them, the board heard. "It's a matter of public health. ... This is 
not a matter of criminality any more than when our paramedic services 
show up at the scene of an accident, they don't wonder what that 
driver was doing before. They treat the patient first," Somerset 
Coun. Catherine McKenney said, her voice thick.

The one dissenter was the chair of the board, Stittsville Coun. Shad 
Qadri, who said his skepticism of safe-injection sites was hardened 
during a visit to Vancouver, where he was going to visit InSite and a 
cabbie wouldn't take him closer than a couple of blocks away.

Perhaps he could still be convinced, Qadri said. But he wants a 
summer of wide consultations to have the issues aired fully.

Coun. Mark Taylor said six years ago he'd have voted against the idea 
of a supervised injection site. He thought sites like Vancouver's 
were just "enabling bad behaviour," he said.

But he's read the studies of Vancouver's experience. He's listened to 
the Ottawa public health unit's experts. He's looked at the evidence, 
projected on an overhead screen, that more Ottawans are using opiate 
drugs like heroin and morphine and especially fentanyl, and dying 
from overdoses.

"That line that keeps moving on that graph? It doesn't give any 
weight to what our philosophical objection is. It just keeps moving," 
Taylor said.

Injection sites are a point of contact with the health system for 
severe addicts who might have literally nowhere else to go. Treatment 
for drugs almost never means quitting cold turkey, said addictions 
doctor Lisa Bromley, urging the board to back injection sites. For 
the deeply addicted, it can mean making one better choice one day - 
to use a clean needle, to simply be around people - and hope to build on that.

"I think (an injection site) would capture those people who are 
scared, who are apprehensive, who are intimidated," Bromley said.

There is, the board heard, no scientific evidence that injection 
sites promote drug use; addicts won't go far to reach them. There's 
no scientific evidence they promote crime, according to the health 
unit's experts, who spent the spring studying them.

Neither the city nor the health unit would run any injection sites 
directly, at least according to everyone's current plan. The Sandy 
Hill Community Health Centre is well into planning to add a 
"micro-site" to its existing needle exchange and methadone clinic in 
its building at Rideau and Nelson streets; three other health 
centres, serving Centretown, Somerset West and Carlington, are in 
earlier stages. They cobble together funding from multiple sources, 
but mainly the provincial government.

Meanwhile, it's the federal government that has to approve each 
place's separate injection site plan, granting exemptions to national 
anti-drug laws. That's an involved process that will go much more 
smoothly if each place can demonstrate it has cooperation from local 

The city's support will have to come site by site; the board's vote 
just encourages the possible operators to pursue their plans.
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