Pubdate: Tue, 24 Oct 2017
Source: Edmonton Journal (CN AB)
Copyright: 2017 The Edmonton Journal
Authors: Elaine Hyshka and Cameron Wild
Page: A8


The evidence points to an urgent need, say Elaine Hyshka and Cameron

Last week, Health Canada issued the approvals to establish supervised
consumption services in Edmonton. Scientific evidence consistently
supports the individual and community benefits of these services, and
local data demonstrate an urgent need for them in our inner city.

Unfortunately, some people allege ("Safe injection sites will hurt
vulnerable communities," Oct. 21) the scientific evidence used to
support Health Canada's decision is biased and not credible. We write
to correct this misrepresentation of facts.

Four years ago, we received funding from Alberta Health and the
Edmonton Homeless Commission to study substance use in the inner city.
After securing University of Alberta Research Ethics Board approval,
we surveyed 320 people, 91 per cent of whom reported recent injection
drug use. Participants answered dozens of questions about their health
and social conditions.

We were alarmed by what they said.

In the six months preceding our study, 80 per cent of participants who
injected drugs reported doing so in public, 26 per cent reported
sharing syringes, and 23 per cent experienced one or more non-fatal
overdoses. Most (85 per cent) study participants told us their
addiction and mental health care needs were going unmet.

While our study was completed in 2014, it appears the escalating
opioid crisis has only increased suffering and harm for this
population. The latest data indicate that, between January and March
of this year, 39 Edmontonians died from opioid overdose. About
one-third of these deaths occurred in Edmonton-Eastwood, which
encompasses the central neighbourhoods home to, or adjacent to, the
approved medically supervised consumption service sites. This area
also accounted for 30 per cent of our city's opioid-related ambulance
calls in the first six months of this year.

Edmonton isn't the only city to experience a concentration of public
drug use in its central neighbourhoods. Supervised consumption
services first developed in 1986 to address this phenomenon, and the
related public health consequences.

Readers should know that approximately 90 of these services have been
established in 65 cities internationally, and 23 are currently
approved across Canada. These services take injection drug use out of
downtown alleys, doorways, and parks. They provide emergency overdose
care, sterile injection supplies, and safe disposal of syringes to
prevent HIV and hepatitis C, alongside other health and social supports.

A large, compelling body of evidence, published in the world's top
medical journals, clearly shows these services prevent overdose death,
reduce syringe-sharing, and contribute to reduced public drug use.

Importantly, supervised consumption services also connect people to
addiction treatment, and other health and social supports. In our
survey, 91 per cent of participants who injected drugs indicated their
willingness to use supervised consumption services, if implemented in
the core.

Opponents of Edmonton's planned supervised consumption services have
suggested the research illustrating the need for such services is
biased and undermined by conflicts of interest. On the contrary, we're
academic faculty members and employees of the University of Alberta.
Neither of us had any personal financial interest in the study that
supported Edmonton's successful application to Health Canada, nor will
we benefit financially from any future related research or evaluation.

We'd like to acknowledge all three levels of government for taking
time to review our research findings in depth, and heed our
recommendations to support supervised consumption services in
Edmonton. Injection drug use is a highly stigmatized and misunderstood
behaviour, and it takes immense courage and compassion to put evidence
over stigma and discrimination.

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Dr. Elaine Hyshka is an assistant professor at the University of 
Alberta's School of Public Health and Scientific Director of the Royal 
Alexandra Hospital's Inner City Health and Wellness Program. Dr. Cameron 
Wild is a professor at the University of Alberta's School of Public 
Health and principal investigator of the Canadian Research Initiative on 
Substance Misuse - Prairie Node. Both are members of the Access to 
Medically Supervised Injection Services Edmonton coalition.
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