Pubdate: Thu, 30 Nov 2017
Source: Hamilton Spectator (CN ON)
Copyright: 2017 The Hamilton Spectator
Contact:  http://www.thespec.com/
Details: http://www.mapinc.org/media/181
Author: Joanna Frketich
Page: A1

HAMILTON'S PROPOSED SUPERVISED DRUG SITE TO BE INJECTION ONLY

Handful in B.C., Alberta permit snorting or orally taking drugs

A PROPOSED SITE for supervised illicit drug use in Hamilton's core
would only allow for substances to be injected and prohibit snorting,
smoking or taking narcotics orally.

The Board of Health will decide Dec. 4 if it supports a supervised
injection site (SIS) to be located between Queen Street North and
Ferguson Avenue North and bordered by Main Street East and Barton
Street East.

"There have been rising deaths, emergency department visits,
hospitalizations and paramedic responses related to drug use," states
a needs assessment and feasibility study by Hamilton Public Health
Services in partnership with McMaster University. "In particular,
harms from opioid use are a growing urgent concern among the community."

The report released Wednesday warns: "Accidental fatal and non-fatal
overdoses due to opioid misuse are increasing yearly in Hamilton at an
alarming rate."

It recommends "one or more" supervised injection sites as part of the
solution.

The east end and Hamilton Mountain would be monitored for potential
future sites as well as the possibility of a mobile unit. "We're
kidding ourselves if we believe that there are no unsafe sites all
around our city," said Coun. Jason Farr who represents Ward 2 where
the site is proposed to be located.

"Unsafe sites propose greater risks for the person addicted and the
general public at large," he said.

"If we're trying to pretend that doesn't already exist behind the
bushes or in the dark laneways, that's the first thing we need to overcome."

The study did not consider a supervised consumption site which would
have allowed for drugs to be consumed in other ways as well as injection.

The majority of Canada's more than two dozen approved supervised sites
are injection only, but a handful in British Columbia and Alberta will
allow other types of use such as snorting or taking drugs orally.

While injection drug use carries the most risks, overdoses and deaths
occur from taking opioids in other ways as well.

As a result, Health Canada has recently provided exemptions from the
Controlled Drugs and Substances Act for supervised consumption sites
as well as supervised injection sites. It also amended Bill C-37 in
May to streamline the application process for both types of sites.

So far, Ontario has just provided funding for injection-only sites but
it is open to receiving applications for those that would allow other
types of consumption as well.

The supervised sites are considered by the federal and provincial
governments a key part to battling the growing nationwide opioid
overdose crisis.

They are locations where people can take pre-obtained illicit drugs
and use them in a clean and supervised place. The staff can respond
quickly to overdoses and connect drug users with addiction, health and
social services.

The proposed site in Hamilton is recommended to be linked with an
existing health or social service agency that already provides harm
reduction services to people who inject drugs. Those services would
also be offered at the site itself.

The community organization running the site would ultimately determine
its hours but the preference would be at least 8 a.m. to noon and 8
p.m. to midnight.

The report anticipates some pushback from the community particularly
around concerns about neighbourhood safety, a feared increase in crime
and enabling drug users.

"There are several misconceptions," concludes the report, recommending
educating Hamiltonians on the benefits of the sites.

The positives for the community include moving drug use out of public
areas and cutting down on injection drug litter.

Far from encouraging drug use, evidence shows the sites tend to result
in an increased uptake of detox and other addiction services. It's a
big step forward considering one study showed those visiting a site
had been injecting drugs for a median time of nearly 16 years.

It could also help curb another disturbing health trend of a rise in
blood-borne infectious diseases in Hamilton that has seen the rate of
hepatitis C here increase to 32 per cent higher than the provincial
average. Rates of HIV have also been climbing.

"The vast majority of people completely understand that there is more
benefit to a safe injection site than allowing the status quo," said
Farr. "We have to try to address in whatever ways we can - and this is
one way - the issue of mental health and addiction."

Hamilton is considered a hot spot of the epidemic in Ontario, with
opioid-related accidental deaths climbing four times higher in 2016
from 2007. Half of the deaths were associated with fentanyl.

Opioid-related hospitalization rates and emergency department visits
here are close to double the provincial average and that is likely an
underestimation of the real problem. Only half of the injection drug
users surveyed by Hamilton Public Health Services and McMaster's
master of public health program said an ambulance was called when they
last overdosed.

There is hope a supervised injection site could make a real difference
with 80 per cent of the 106 recent injection drug users surveyed for
Hamilton's study saying they would access a site if it was available,
and a further 9 per cent agreeing to consider it.

Similar programs in the city have had success with Hamilton's Needle
Syringe Program doubling the number of clean needles distributed from
2012 to 2016.

The Hamilton Overdose Prevention and Education (HOPE) program gave out
about 1,382 naloxone kits since January with at least 362 people revived.