Pubdate: Tue, 04 Jun 2019
Source: Calgary Herald (CN AB)
Copyright: 2019 Postmedia Network
Author: Marilou Gagnon


The 2011 Supreme Court of Canada ruling on Vancouver's Insite clinic
clearly established 1) that supervised consumption sites are part of
health-care services that should be made accessible to people who use
drugs, 2) that these sites contribute to reducing the harms associated
with drug use, and 3) that denying access to these sites increases the
risk of death and disease.

In addition to saving lives every day, these sites act as an essential
point of contact for people to access much-needed health-care services
that have been proven effective to reduce overdoses, blood-borne
infections (hepatitis C and HIV), infections (i.e., skin, soft tissue,
heart and blood infections) and other medical complications. They also
help connect people who use drugs with social services and support to
address housing and food insecurity, mental health issues, trauma and

It has been well established that the care provided in supervised
consumption sites falls within the legislated scope of practice of
registered nurses. In these sites, nurses work with harm reduction and
peer workers to establish a trusting relationship with clients, assess
their health needs, offer care that reduces potential harms associated
with injection drug use, provide harm reduction education and
supplies, monitor for signs of overdose or other acute health
complications, and intervene in emergency situations. They also
provide primary care to clients and acting as a first point of contact
with the health-care system. Primary care services include
immunization, point of care HIV and hepatitis C testing, wound care,
screening for sexually transmitted infections, counselling and so
forth. Based on their assessment, they can also refer clients to
addiction care and facilitate linkage to services, which are often
difficult to access for people who use drugs (i.e. housing, income
assistance, food support).

Canada is in the midst of a public health emergency with more than
10,000 overdose deaths since 2016. Alberta is the second province most
affected by this overdose crisis. In 2018, Alberta hit a record high,
with close to 800 overdose deaths including 165 in Edmonton and 289 in
Calgary. As a response to this crisis, the previous NDP government
accelerated the implementation of supervised consumption sites.
Despite this initiative, pressing needs were still unmet prior to the

On Friday, we learned that the newly elected United Conservative
government is launching a review of existing supervised consumption
sites and putting a hold on new locations. This has important
implications for sites under development in Medicine Hat, Red Deer and
Calgary, which will not receive further funding until the review is
completed. It will also slow down or potentially stop the creation of
new potential sites. For communities like Red Deer, this decision will
result in many more overdose deaths. Red Deer has the highest number
of fentanyl-related overdoses and overdose deaths, double the
incidence recorded in the province.

Now is not the time to halt funding for supervised consumption sites.
In fact, it is time to scale them up. As nurses, we have an ethical
obligation to provide safe, compassionate, competent and ethical care
based on empirical evidence. In Canada, nurses who work with people
who use drugs are expected to provide care based on a harm-reduction
approach. In fact, the Canadian Nurses Association, which represents
135,000 nurses across 13 jurisdictions, has adopted a clear policy on
this: harm reduction is the gold standard in nursing and should be
implemented across the health-care system. Halting funding to
supervised consumption sites will prevent nurses from providing care
they are ethically obliged to provide to people who use drugs. It will
also limit their ability to respond to the overdose crisis and save

As experts in the field, we call on the United Conservative government
to make policy decisions based on empirical evidence, not ideology.
Supervised consumption sites work and closing them would be a death
sentence for hundreds of Albertans who desperately need access to
health care.

Alberta Coalition of Nurses for Harm Reduction and the board of 
directors of the Harm Reduction Nurses Association:

Marilou Gagnon, president; Tim Gauthier, vice-president; Leigh
Chapman, candidate, secretary; Scott Harrison, treasurer; Trish
Dribnenki-Pennock, regional representative west; Bryce Koch, regional
representative central; Kimberly Wilbur, regional representative east.

The Harm Reduction Nurses Association is a Canadian national
organization with a mission to advance harm reduction nursing through
practice, education, research and advocacy.
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