Pubdate: Thu, 09 Feb 2017
Source: London Free Press (CN ON)
Copyright: 2017 The London Free Press


A startling dissection of drug use in London - with the personal
illnesses and public ills exposed - has laid on the table a compelling
case for a supervised injection site in the city.

But the sticky questions of exactly where the site or sites should go,
whether the city can take the other steps necessary to make a site
worthwhile, and how crystal meth and fentanyl will play a role remain

The lead researcher of a study on providing supervised injection in
London did have one answer for residents still questioning the sanity
of giving people a place to inject their illicit drugs.

"Typically, there's a lot of concern that all hell is going to break
loose, that there is going to be all this crime," Dr. Thomas Kerr said
Wednesday in London. "It just doesn't happen. All hell is not going to
break loose."

In fact, the opposite has occurred in cities with supervised injection
services, he said.

"Communities are a little cleaner, a little safer, and people who use
drugs are getting the health-care services they need. And it's cost

People don't use more drugs and more people don't start using drugs
because of injection sites, Kerr added.

The study released Wednesday by the Ontario HIV Treatment Network
concluded supervised injection services should be established in
London, preferably in downtown and/or Old East London.

Researchers surveyed 199 Londoners who inject drugs, and found 86 per
cent said they would use a supervised injection site.

Previous experience and research shows people usually follow through
on that willingness, said Kerr, a B.C. addiction researcher and
professor of medicine at the University of British Columbia.

The London study also assessed the support of city organizations for
supervised injection service.

"Basically all the stakeholders we talked to expressed support, but
some people had very firm conditions and preferences," Kerr said.

There was no consensus among community groups on where

The study

* 199 study participants

* 62% male

* 57% homeless, or in unstable housing

* 19% involved in sex work

* 57% never accessed addiction treatment Drug use, type 83%: crystal
methamphetamine 79%: hydromorphone 64%: morphine 54%: ritalin or
biphentin Where they used 53%: in Old East (Dundas and Adelaide area)

26%: downtown service should go, with some preferring decentralized
services and others a site near the core, but almost all supported
24/7 help and many supported additional "wraparound" health care and
social aid.

The study built its case for the need of a supervised injection site
with alarming statistics about drug use in London and the harm it's

Rates of injecting opioids are higher than the national average, and
there are high rates of injecting crystal methamphetamine, cocaine and
crack, as well as borrowing of syringes and sharing of needles, the
study said.

The damage is clear: high rates of hepatitis C, a record number of new
HIV cases in 2016, and a rate of opioid-related deaths higher than the

The study indicated as well the impact on the public. Of the 199
people surveyed, 72 per cent said they'd injected in public in the
last six months, including public washrooms, parks, parking lots,
alleys, stairways, doorways and hotels.

The study noted that London experiences higher than Ontario rates of
opioid-related visits to emergency departments and higher than Ontario
averages for treatment of crystal meth.

It costs about $1.3 million to treat one HIV patient over their
lifetime, Middlesex-London's associate medical officer of health, Dr.
Gayane Hovhannisyan, said at the presentation of the study to an
audience of several dozen community leaders.

"It is pouring money down the drain," Kerr said of allowing the
situation to continue. "Here is an opportunity for very simple

A supervised injection site offers a rare opportunity for treatment
workers to connect with the hardest to reach group of drug users, Kerr

"For a lot of people, active addiction is a full-time job. You wake
up, you hustle the money to try and get drugs. You use, you recover
from that use and you start again," he said. "These services provide a
unique opportunity because they accommodate the cycle of active drug
use . . . and a unique opportunity to connect with that segment that
mainstream health care often misses."

But Kerr warned London needs to ensure other addiction services are in
place before establishing an injection site.

"Supervised injection services are by no means a panacea. They are one
small part of a larger response to the problems of substance use and
injection drug use."

The next step in considering an injection site will be consulting a
wider range of people, said Brian Lester, executive director of
Regional HIV/AIDS Connection and a co-ordinator of the drug strategy.

Establishing a site would have to follow federal guidelines that have
shifted as the Canadian public seems more willing to accept the service.
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