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[Photo by Andres Rodriguez]

Rob Boyd, director of the harm reduction program at SHCHC, helped oversee the application process from start to finish. [Photo © Danielle Clarke]

On February 6, Health Minister Jane Philpott announced the federal government’s authorization of three new supervised injection sites in Montreal.

In addition to Vancouver’s two sites already in operation, the newly approved drug injection sites make Montreal the second city in Canada to have such facilities.

Looking to combat the ongoing opioid crisis and the growing number of overdose deaths, the federal government has stated its intentions to help bring more injection sites to a variety of cities throughout the country.

In Ottawa, Sandy Hill Community Health Centre’s board of directors voted in January to send an application to Health Canada seeking approval for a local supervised injection site.

Until the decision is made final by the federal government, it seems it’s only a matter of time until Ottawa is granted its very first safe injection site.

Local outlook

Sandy Hill Community Health Centre (SHCHC) sits steps away from Ottawa’s Byward Market.

The exterior of Sandy Hill Community Health Centre, the potential future location of Ottawa’s first supervised injection site. [Photo © Danielle Clarke]

For more than 40 years, it’s assisted the surrounding area with a variety of public services, including health-care facilities, low-income housing and homeless initiatives.

In June 2012, the centre’s board of directors first tasked senior management to launch an exploration into the possible benefits of having a supervised site in the area.

At the time, the health centre had seen a local increase in drug overdoses. Additionally, surveys from Ottawa Public Health and I-Track had found a high prevalence of hepatitis C and HIV in Ottawa users who injected drugs. Studies showed these results had to do with sharing infected needles.

Lynne Leonard, an assistant professor and research scientist at the University of Ottawa, has studied HIV prevention in Ottawa. She said a supervised injection site will help decrease the high level of infection in users who inject drugs while also being a safer option than injecting in the streets.

“It’s absolutely the way to go if we’re going to cut down on the high level of community infection that we have in Ottawa, and also the high number of overdoses,” she said.

After recognizing the need for a supervised injection site, SHCHC senior management spent roughly four years exploring options, hosting consultations and working on an application to present to Health Canada.

“We spent … [some] time kind of in silence mode, where we were plugging away at the application,” said Rob Boyd, the director of the Oasis program at SHCHC, which provides harm reduction services for drug users.

“We were just working in the background, keeping our feet moving on this,” he said.

A political marathon

North America’s first supervised injection site, Insite, opened as a pilot project in Vancouver in 2003.

The site needed an exemption from Canada’s Controlled Drugs and Substances Act, which it received in September 2003 under the Liberal government of Jean Chrétien. In 2008, the Conservative government denied the site’s application to extend the exemption, citing the use of illicit drugs.

Insite started legal action to stay open and eventually won a landmark decision from the Supreme Court in 2011 to make the operation of supervised injection sites legal in Canada. According to the court, failure to allow such sites was in violation of drug users’ constitutional rights.

In response to the ruling, the Harper government passed the Respect for Communities Act, which introduced a set of 26 different conditions that must be satisfied for a clinic to be approved federally. The conditions range from scientific information that supports the need for a site, to local and provincial opinions that may be in opposition to the site.

“It was really an attempt to send a clear message to organizations saying ‘don’t bother,’ ” said Boyd, in response to the conditions.

“The overall thing was to create any and every opportunity for the [Health Minister] to deny an application,” he said.

Federal support for supervised injection sites began to change after the 2015 election of Justin Trudeau, who reaffirmed the expansion of supervised facilities while on the campaign trail.

In 2016, the ongoing opioid crisis brought more national interest in supervised injection sites.

Earlier in the year, British Columbia declared a public health emergency due to the staggering increase in fentanyl-related overdose deaths, while Alberta recorded a record-breaking 343 deaths due to the same drug. Fentanyl has also been found in Ottawa, prompting Ottawa Public Health to issue a public warning on February 13.

By the end of 2016, the crisis prompted the federal government to pledge to make changes to the Respect for Communities Act, and to explore more options for the expansion of supervised injection sites.

Neighbourhood concerns

Today, SHCHC is awaiting a response from Health Canada. They’re hoping to have the supervised injection site up and running by this summer, said Boyd.

According to its application, the centre is planning to have five booths intended for supervised injection, with a nurse’s station being able to convert into a sixth booth in case the site reaches maximum capacity.

The centre is asking for $1.4 million from the provincial government, which it says will allow it to stay open 12 hours a day, seven days per week.

While SHCHC is an active supporter of supervised injection sites, some local voices have expressed fears over the security of the surrounding neighbourhood, including police chief Charles Bordeleau and Mayor Jim Watson

Mathieu Fleury, city councillor of the Rideau-Vanier Ward, said he supports the possible supervised injection site.

“We have doctors who are advising us at Ottawa Public Health and even within the community, that highlight the importance in having that additional pillar in services for those suffering from addictions,” he said.

“If that pillar is important and can save lives, then let’s not object to them.”

According to a poll conducted in January by Mainstreet Research for Postmedia, 53 per cent of those surveyed in Ottawa support the idea of a supervised injection site.

In September, Ottawa Public Health released the results of a public consultation survey, which saw 77 per cent of those surveyed in the Rideau-Vanier neighbourhood thought supervised injection sites would be beneficial.

“What we have been told by people who’ve opened is that there’s usually a lot of fear in anticipation of an opening,” said Boyd. “After a couple of weeks, that all goes away because it just doesn’t happen in the way that people are afraid it’s going to happen.”

“I only see pluses, I have to say,” said Leonard. “And the fact that it’s going to be in a community health centre where there are more services available is an absolute plus.”

As for the future, both Boyd and Fleury suggest there will likely be more supervised facilities in Ottawa, once the first is approved. Somerset West Community Health Centre is currently in the process of creating an application for submission.

“Yes, there will be more,” said Boyd, “From a strictly access point of view, we need more.”

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