Pubdate: Wed, 28 Jun 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: Andrea Woo
Page: S1

TWO SUPERVISED SITES APPROVED FOR TAKING NASAL AND ORAL DRUGS

Two sites in the Vancouver region have become the first in Canada to
receive federal approval to allow users to snort or swallow drugs
while under supervision.

Until now, supervised drug-consumption sites have been limited to
injection drug users. Two sites have been operating in Vancouver for
more than a decade, while others have recently received approval in
the Vancouver area, Montreal and Toronto.

The two sites approved to expand services to non-injectable drugs are
in Surrey, south of Vancouver. The public SafePoint
supervised-consumption site, located on what's known as the "Surrey
Strip," opened three weeks ago. The Quibble Creek Sobering and
Assessment Centre began offering supervised consumption for clients
one week ago.

"We want to make sure that our services are providing as big a reach
as possible," said Dr. Victoria Lee, chief medical health officer for
Fraser Health. "We also wanted to ensure that others in the country
have a better and more streamlined process for them to get approval
for intra-nasal and oral substances.

The approval for oral and nasal consumption lasts for one year. Dr.
Lee said health agencies opening similar sites elsewhere in the
country have told her they weren't aware it was an option.

When the two sites first opened earlier this year, Dr. Lee said the
health authority had asked for permission to allow oral- and
nasal-drug consumption, but Health Canada only approved them for
injectables. At the time, Dr. Lee said the health authority saw trends
of people dying of drug overdoses after consuming drugs in different
ways.

Staff received two weeks of classroom training followed by two
additional weeks shadowing staff at Insite, Vancouver's public
supervised-injection site, prior to the sites opening.

Smoking, however, is still not permitted. While illicit fentanyl in
smoked drugs, such as crack and crystal meth, has resulted in overdose
deaths and is concerning health officials, the ventilation
requirements and additional safety hazards that come with smoking
rooms pose major barriers.

Mark Lysyshyn, medical health officer for Vancouver Coastal Health,
has previously said that health authority would in theory like to
supervise all modes of consumption, but is currently focused on
injection, as it presents the biggest risk.

"Smoking would probably be the next highest risk, and we've looked
into providing safe spaces for that, but the occupational

health and safety, and the sort of engineering of those types of
facilities, have made them prohibitively expensive," he said in an
earlier interview with The Globe and Mail.

One "overdose prevention site" in Vancouver's Downtown Eastside,
sanctioned by the province but not the federal government, does
supervise smokers. The province opened about 20 of these unofficial
supervised consumption sites in December as an emergency measure and
Ottawa has quietly let them exist.

Sarah Blyth, who started and runs that site, said roughly half the
users - and half the overdoses - there are smokers. People who inject
drugs do so inside a trailer, while smokers smoke outside under a tent.

At least 935 people died of illicit drug overdoses in B.C. last year
and the province is on pace to surpass 1,400 deaths this year. Illicit
fentanyl and its various analogues have been detected in both opioid
and stimulant street drugs, including cocaine, crack, heroin and
methamphetamine.

Since opening on June 8, SafePoint has logged 1,079 visits by 203
people. Staff reversed 19 overdoses.

Dr. Bonnie Henry, B.C.'s deputy provincial health officer, said health
officials in British Columbia want to be able to approve
supervised-consumption sites on their own, without the need to ask the
federal government for permission.

"We would like to see them give the province an exemption to monitor
and to open supervised-consumption sites according to a provincial
program, like we do for everything else in health care, essentially,"
she said. "Some of the regulations are set federally, but we manage
the programs."

Dr. Henry said the overdose prevention sites show B.C. can develop
needed services amid a public-health emergency that was declared in
April, 2016.
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