Pubdate: Fri, 09 Dec 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: Andrea Woo
Page: A1

B.C. OPENS DRUG INJECTION SITES AMID OPIOID CRISIS

British Columbia has opened several government-sanctioned
drug-injection sites, without waiting for legislative changes or
approval from Ottawa, to combat the province's worst overdose crisis
on record.

The move puts pressure on the federal government to amend Harper-era
legislation posing barriers to opening new supervised drug-consumption
sites and provides a possible blueprint for other provinces that have
long asked for federal permission to open such sites with no response.

Three sites opened in Vancouver's Downtown Eastside on Thursday at
existing social service sites. Victoria and Surrey will each open two
next week, and more are planned for Vancouver and Victoria.

B.C.'s top health officials decline to call the locations "supervised
injection sites," opting instead for "overdose prevention sites." Like
Insite, Vancouver's 13-year-old public supervised injection site,
users bring their own drugs and are revived by staffers in the event
of an overdose. Some facilities, if not all, will provide
harm-reduction supplies such as clean needles.

The move comes as overdose deaths in B.C. reach a level not seen in
more than 30 years of record-keeping. As of the end of October, 622
people had died of illicit drug overdoses, with the synthetic opioid
fentanyl being detected in 60 per cent of them. Carfentanil - a
large-animal tranquilizer many times more toxic than fentanyl -
reached B.C. this fall and is suspected to be behind another recent
surge in overdose deaths. From 2000 to 2010, B.C. recorded an average
of 273 illicit drug overdose deaths each year. The death toll for this
year is expected to surpass 750)

B.C. Provincial Health Officer Perry Kendall said the new sites are
simply bringing injection drug users and the growing number of people
trained to administer naloxone - a drug that reverses the effects of
an opioid overdose - together, indoors, as temperatures drop.

"I think if we had sat back and had not done anything to respond …
that we would actually be culpable, because we know there are things
that we could have done," Dr. Kendall said Thursday.

Since September, activists have operated two "pop-up" supervised
injection sites in the Downtown Eastside - bare-bones tents in back
alleys with folding tables attended by volunteers with naloxone.

Dr. Kendall described this latest initiative as simply putting a roof
over their heads.

Patricia Daly, chief medical health officer and vice-president of
public health for Vancouver Coastal Health, underscored that people
who are severely addicted will continue to inject and that the new
sites serve to ensure they do not die.

"We are very concerned that with the cold weather, they will go
indoors, to single room occupancy hotels," she said. "They won't be in
a place where someone will see them if someone overdoses."

The idea of "overdose prevention sites" was first raised in guidelines
developed by Vancouver Coastal Health over the past year, and B.C.'s
Joint Task Force on Overdose Response discussed the idea at a meeting
two weeks ago.

 From a hotel room in Victoria in the early hours of Wednesday morning,
B.C. Health Minister Terry Lake decided it had to happen.

"I woke up between 4 and 4:30 a.m. and I could feel the cold in the
hotel room," he said in an interview Thursday.

"It's not the first time I've been kept awake by the fentanyl crisis.
I started thinking about people on the street and the pop-up tents and
was almost overcome by how inhumane that is. We need to do something
that will keep people warmer and safer."

A flurry of phone calls followed that morning; the first sites opened
the next day.

Under the Respect for Communities Act, any group seeking to open a
supervised consumption site must go through a lengthy and costly
process of applying for an exemption from federal drug laws.

The legislation, enacted in June of 2015, is widely seen by critics as
a deliberate effort to curb all supervised consumption sites. The
Harper government had introduced it after fighting Insite all the way
to the Supreme Court, which sided with the Downtown Eastside facility.

Rona Ambrose, the previous Conservative health minister, said at the
time the legislation was necessary to ensure community members are
consulted "when groups want to allow addicts to inject dangerous and
addictive street drugs in their neighbourhoods."

Liberal Health Minister Jane Philpott signalled for the first time
last month that legislative changes are forthcoming but there has been
no apparent movement to date aside from promises to prospective site
operators that applications would be expedited.

British Columbia sought legal advice before proceeding and was assured
the sites would not run afoul of the federal Controlled Drugs and
Substances Act, Dr. Kendall and Mr. Lake said. Health Canada did not
weigh in on the matter on Thursday, but pointed to a statement from
January that said supervised consumption sites require federal
approval to ensure public health and safety requirements are met.

Reached for comment on Thursday, Dr. Philpott's press secretary,
Andrew MacKendrick, said the federal Health Minister had just learned
of British Columbia's decision and recognizes that the province feels
a need to take action amid an extraordinary situation.

Mr. Lake said Premier Christy Clark supports the initiative; Dr. Daly
said Vancouver police are "100-per-cent supportive" as well.
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MAP posted-by: Matt