Pubdate: Mon, 04 Sep 2017
Source: Globe and Mail (Canada)
Copyright: 2017 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Katrina Pacey
Page: S1

ONE SIZE FITS ALL IS NOT GOOD ENOUGH FOR HARM REDUCTION

Earlier this month, people in Canada witnessed the importance of
community resistance and activism on issues of drugpolicy reform.

Vancouver's lead organizers and front-line workers in Toronto pushed
Health Canada to do what is right and necessary in order to
effectively respond to the overdose crisis. A community of care,
driven to save the lives of friends, family and neighbours, set up two
white tents in Toronto's Moss Park. Inside, volunteers at this pop-up
"overdose prevention site" supervise drug use and save lives -
something the federal government should have been doing long ago, when
communities across Canada first began sounding the alarm. I visited
the site last week and was moved by the commitment and compassion of
the volunteers who were valiantly saving lives, day after day.

In Canada, supervised drug-use sites need a federal exemption to
protect staff and site users from drug-related charges and
convictions. Absent this immunity, harm-reduction workers who operate
the sites - and the drug users who use them - are in a legally
precarious position.

Fortunately, police departments in B.C. and the Toronto Police Service
have said they are not interested in shutting them down, presumably
aware of the life-saving services such sites afford.

Mere days after the pop-up site began operating, Toronto Public Health
received approval from Health Canada to open its own interim
supervised drug-use site. Mayor John Tory said he would have liked to
have seen the original pop-up site dismantled, but that didn't happen.
In fact, another pop-up site opened in Ontario, this time in Ottawa -
a bold statement to lawmakers in Canada's capital that federal drug
laws must not stand in the way of lifesaving health services. With
each successful opening, another community of activists and volunteers
is emboldened to brave the law and save lives in a similar fashion.

The reality is that the application process for Health Canada approval
remains far too slow and resource-intensive, especially in the context
of a crisis. Therefore, the need for communities to step up and
provide service will not end. Moreover, there will always be a need
for grassroots harm-reduction services, irrespective of whether formal
sites already exist in the same jurisdiction.

As a human-rights organization that has worked extensively in drug
policy reform, Pivot Legal Society believes there is an urgent need
for both government-sanctioned supervised drug-use sites and pop-up
sites run by the community. The latter should be fully funded and
supported as a key part of the continuum of care, as pop-up
community-led sites afford certain benefits to people who use drugs
that formal sites may lack.

Community-led sites are an effective means of reaching vulnerable
populations who might otherwise be prevented from accessing more
formal, higher barrier supervised sites. This is because exempted
sites may present barriers for people with disabilities, people who
use by means other than injection (i.e., inhalation) and people who,
for other sociocultural reasons, may not feel comfortable using
government-sanctioned sites. Even with the new interim site opened in
Toronto, a record 34 people used the Moss Park site last Saturday.
This need is real and must be met.

Harm reduction is not one size fits all. As with any population,
people who use drugs are diverse, with varied needs and abilities. It
is unreasonable to assume that one facility can provide adequate
service to an entire demographic of people, especially when taking
into account geographical restrictions, interpersonal relationships
and conflicts, and types of services offered.

Most pop-up sites are led by peers and community members who have
extensive experience when it comes to providing barrier-free
supervised drug-use services. They know how to reduce stigma and build
trusting relationships with people using the services, and the
importance of these relationships cannot be understated when it comes
to access to care.

Whereas many people who use drugs have reasons to avoid formal health
services, pop-up sites offer a low-barrier space staffed with people
who may already be fixtures in the communities of the populations
being served. Allowing pop-up sites to operate in tandem with exempted
sites reinforces and legitimizes the very necessary contributions
people who use drugs have made in the context of an unprecedented
opioid crisis.

The community at the heart of this crisis has the answers to it. The
rest of us must learn to listen.

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Executive director and founder of Pivot Legal Society, a law firm aimed 
at advocacy for communities affected by poverty and social exclusion
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MAP posted-by: Matt