Pubdate: Wed, 20 Jul 2016
Source: Globe and Mail (Canada)
Page: S1
Copyright: 2016 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Andrea Woo
Bookmark: http://www.mapinc.org/find?142 (Supervised Injection Sites)

B.C. POISED TO OPEN NEW SUPERVISED DRUG-USE SITES

A steep and steady climb in the number of drug overdoses has put 
increased pressure on health authorities in British Columbia to open 
additional spaces for users to consume illicit substances under 
medical supervision.

Fatal drug overdoses have increased almost every year since 2009, 
spiking with the emergence of illicit fentanyl in 2012. Advocates 
have long called for more supervised-consumption sites - particularly 
in the Fraser Valley and on Vancouver Island.

And now, after being accused of dragging their heels, Fraser Health 
and Vancouver Island Health Authority (VIHA) appear poised to submit 
applications to Health Canada to open multiple consumption sites, 
which would include injection facilities similar to Vancouver's 
Insite, but could also allow people to inhale drugs such as 
crack-cocaine. Vancouver is expected to pursue additional sites as 
well. Just four months ago, the Fraser Health Authority said it had 
no plans to open such a site. That same month, the Vancouver Island 
Health Authority said it was working with stakeholders to look at 
what an appropriate supervised-injection model would look like.

But after 43 non-fatal overdoses in Surrey this past weekend, Fraser 
Health announced on Monday that it is "rapidly implementing an 
aggressive strategy to combat drug overdoses and deaths" in the 
region that includes "identifying priority sites for 
supervised-consumption services."

Meanwhile, VIHA said it is preparing to submit an application to 
offer supervised-consumption services at multiple sites in Victoria, 
likely integrated into existing facilities. Once service models and 
sites are identified, a community consultation process will take 
place, spokeswoman Kellie Hudson said.

Provincial Health Officer Perry Kendall declared a public-health 
emergency in April, warning that British Columbia could reach 800 
overdoses deaths this year. The latest figures from the B.C. Coroners 
Service show the province is on pace. In the first half of 2016, at 
least 371 people died of illicit drug overdoses - a 74.2-per-cent 
increase over the same period last year.

The top three cities where such overdoses have occurred, from 2007 to 
2016, are Vancouver, Surrey and Victoria.

In Surrey's most recent spate of overdoses, some users reported that 
they had taken crack cocaine and some reported using heroin, said 
Victoria Lee, chief medical health officer for Fraser Health. 
However, none knew they had ingested furanylfentanyl, a fentanyl 
analogue detected in some of the crack, and fentanyl, detected in 
some of the heroin.

Fentanyl and its analogues are many times more toxic than heroin and 
are particularly dangerous for people who do not use opioids daily.

Dr. Lee noted that supervised consumption is but one part of Fraser 
Health's overall plan. The health authority developed an overdose 
prevention and reversal strategy in the fall of 2015 - increasing the 
distribution of naloxone and other harm-reduction supplies, for 
example - and, this spring, enhanced it to include exploring 
supervised consumption and other services.

The sites, number and locations are still to be determined, but will 
also likely cater to more than just injection-drug users.

"Substance-use patterns have changed. We do know that more people are 
using different types of substances that do not include just 
injection drugs, so we want to make sure ... we are meeting the needs 
of our population," Dr. Lee said. "While injection drugs are one 
component of harm we want to mitigate and reduce, there's also crack 
and other substances that are smoked and consumed in different ways."

In late February, Victoria Mayor Lisa Helps wrote to federal Health 
Minister Jane Philpott seeking her advice, inquiring about her 
expectations regarding supervised-consumption services in Victoria. 
The Health Minister responded last month with information on how to 
apply, and a personal note of support for the service.

"As Minister of Health, I continually look for ways to keep Canadians 
healthy and reduce risks and harms to them," Dr. Philpott wrote. "For 
this reason, the government's approach to supervised consumption 
sites will be guided by evidence, which in this case is clear: When 
properly established and managed, supervised consumption sites can 
save lives and improve health without increasing drug use and crime 
in the area."

Toronto City Council recently approved three supervised-injection sites.

Shane Calder, a spokesman for Yes2SCS, a group advocating for 
supervised-consumption sites on Vancouver Island, called the slow 
process "shameful."

"The inaction, and seeming incompetence, of the provincial government 
and Island Health is bordering on the disastrous," Mr. Calder said. 
"People are dying and they meet to debate mandate and terms of 
reference. It's disgusting. The time the act is well past."
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MAP posted-by: Jay Bergstrom