A life-saver

By Leslie Campbell, July/August 2015

Will Victoria take responsibility to provide safe consumption services?

Did you know that our fair city has the highest number of street deaths per capita in BC? I didn’t, until a panel discussion in June called Moving Forward: A Public Forum on Supervised Consumption Services in Victoria.

The panel made alarmingly, indisputably clear that a relatively simple measure would prevent those deaths and provide other benefits to individuals and communities. I’m speaking of safe consumption services (SCS), likely integrated into existing services. These have been endorsed by everyone from the Canadian Medical Association, numerous nurses’ associations, the Public Health Physicians of Canada to municipal and provincial governments, academic researchers and so on. Everyone it seems but the federal government.

Victoria also boasts higher rates of people injecting drugs in public than Vancouver. This honour, along with our higher death rate, can be credited to Victoria’s lack of SCS, whereas Vancouver provides them through InSite and the Dr Peter Centre.

In a Globe and Mail op-ed this spring, Dr Perry Kendall, BC’s Provincial Health Officer, and two top doctors with Vancouver Coastal Health succinctly summed up the realities around the issue: “Our experience in Vancouver shows these sites do not increase crime, do not divert drugs, and do not threaten the safety of neighbourhoods. These are health services. They prevent overdose deaths, open a door to drug detox, keep HIV and hepatitis from spreading and used needles off the streets, treat wounds and infections, and decrease the use of police, ambulance, and emergency medical services.”

At the panel discussion, Bernie Pauly, a nurse and scientist with Centre for Addictions Research of BC, told the audience that research shows harm reduction strategies work. For instance, we have been handing out clean needles since 2003. Over the ensuing 10 years, new cases of HIV dropped dramatically—from 30-35 in 2003 to only one in 2013.

But during that same period, deaths from overdoses almost doubled, from 33 to 64. Safe consumption sites, like those in Vancouver, used by many addicts to keep safe, have had no fatalities from overdoses; and many of their clients seek addiction treatment. 

Pauly’s research showed that 90-100 percent of drug users in Victoria said they’d support SCS, largely because “fewer friends would die.” They also noted that the community in general would be a safer place with “rigs off the streets.” 

Fellow panelist and assistant professor of social work Bruce Wallace, who serves on the board of YES2SCS, told the audience about the long history of commitments unmet. Twelve years ago the City of Victoria, the Victoria Police and VI Health Authority created an action plan for the establishment of a safe consumption site. Further reports, studies and commitments came in 2006, 2007, and beyond, all recommending the City move forward. In 2008, Dr Kendall, on behalf of the Province, said: “The time has come to take the necessary steps forward towards bringing a SCS program to Victoria.” 

So what happened? “Nothing,” deadpanned Wallace. In fact, since that 2003 announcement by the City of Victoria that it would establish safe consumption services, 500 people have died on Vancouver Island from illicit drug overdoses. 

The federal government’s rabid anti-drug crusade doesn’t help matters. It fought against Vancouver’s InSite—despite endorsement from the Canadian Medical Association—all the way to the Supreme Court of Canada. In 2011 that court ruled unanimously the facility should remain open. The Conservative government then came up with Bill C-2, which passed last spring. Dr Kendall and his colleagues wrote: “This law is a thinly veiled attempt to end supervised injection services. Period.” Among the obstacles the legislation puts in place, Kendall cited a few, including this one: “[F]or any staff working in the facility, the applicant must provide police records going back 10 years showing that the potential worker has not had a conviction for a drug offense, conspiracy, money laundering, or terrorism. While most staff will be registered nurses who have already passed police checks just to work as nurses, others may well be recovered addicts who have succeeded in treatment and who the scientific literature shows are among the most successful peer educators.”

Bernie Pauly said, “The federal government is going to have to answer at some point for not acting on what we know to be good practice. If you know something prevents death and you knowingly ignore that evidence, doesn’t that seem like you are accountable?”

But the City of Victoria has something to answer for as well. While it has paid lip service to the need for safe consumption services for over a decade, it has not taken real action to prevent deaths from overdoses. Marianne Alto, representing the City of Victoria on the panel, noted that safe consumption is part of the City’s new three-year strategic plan and it will facilitate conversations among all the players in the fall. This is good news. Communities will have to take the lead, fighting the feds on moral and health grounds. Montreal’s mayor recently committed to implementing four supervised injection sites in that city by fall of this year—regardless of federal support. “What are we waiting for? People are dying,” said Mayor Denis Coderre. Alto seemed to agree, saying “…if we don’t [help provide it], we’re complicit. No one needs to die from unsafe drug use.”

 

A FEW DAYS LATER, I talked with the fourth panelist, Katie Lacroix, chair of and peer outreach worker with SOLID (Society of Living Illicit Drug Users) in the organization’s office directly across from VicPD’s. Katie is 27, vibrant, articulate, and knowledgeable. But four years ago she was also strung out on opiates every day and living in an apartment that had no hot water or heat. A high school drop-out, she had arrived in Victoria from Ontario. She felt incredibly isolated. “You feel like you’re the only person [who’s in that situation]; you start to believe the names people call you—‘you’re just a junkie,’” Katie recalled. 

One day, sitting in front of Aids Vancouver Island, she was handed a pamphlet and encouraged to go to a group on dealing with the stigmatization that comes with drug use. It didn’t sink in right away, but she still credits it with changing her life, because she did, over time, get involved in classes there and started to feel less isolated, and to find a purpose beyond her next fix. Because someone reached out to her and involved her, she met a whole community of people who understood and cared. Many of those are former and current drug users. Others are “allies” like Pauly and Wallace.

“It’s been an incredible experience—to go from the worst year of my life to now speaking at conferences across Canada, teaching leadership classes…It blows my mind that someone who didn’t know how to do anything—I had no idea how to make a poster or run a meeting—can do all this. I feel so blessed to have people who believed in me.” In the last few years she’s watched other drug users become empowered through peer-to-peer support. But she also knows others have died of overdoses that could have been prevented through safe consumption services.

SOLID and others in the harm reduction field support people to take care of themselves. “It’s not necessary they get off drugs,” explains Katie. “When basic human needs are being met, then you can start delving into the deeper issues that keep them using. I wouldn’t dissuade anyone from getting treatment, but it’s not the first priority.”

People like Katie (I met others) are glowing examples of why we need to embrace wholeheartedly harm reduction in this city—even, perhaps especially, in the face of the federal government’s reluctance.

Leslie Campbell notes that the fall federal election will allow us an opportunity to voice our feelings about Bill C-2. Meanwhile: I wish you all a great summer!