Dangers of inhaling drugs lead to push for more supervised sites

Dominicus Anamacha says until recently, he often smoked "dragons" by heating heroin on a sheet of tin-foil and inhaling the vapours. 

He's one of many drug users who has inhaled illicit substances, rather than injecting them.

It's a common way to get high, especially for those who are too afraid to inject for fear of overdosing, experts say — but inhaling can be just as dangerous, especially since fentanyl has entered the drug supply.

However, despite the growing number of supervised injection sites, supervised inhalation sites are still a rarity — and there isn't one yet in Victoria, where Anamacha lives in a local homeless shelter.

"I've been through 153 overdoses in 12 months. That's directly related to not having an inhalation site [downtown]," said Anamacha, who added that he's been seeking help from Our Place Society, a non-profit organization dedicated to the homeless, for almost three years.

Grant McKenzie, director of communications for Our Place, said he's seeing more users than ever inhaling drugs like heroin, crystal meth, and crack cocaine.

"It's the majority of people here," he said, adding that these drugs are cheap and easily available.

"A lot of people [believe] that inhalation is safer than injection and it really isn't," he said. "It does just as much damage to your lungs and your brain."

City motion could soon be passed

In February, Victoria city Coun. Sarah Potts put forward a motion asking the province to move forward on safe inhalation sites in B.C.

After being passed by the city and the Association of Vancouver Island and Coastal Communities, the motion could be passed by the Union of B.C. Municipalities late this month, which could then lead to provincial funding for Victoria to build a properly ventilated safe inhalation site.

A UBCM document shows that the City of Victoria is the only B.C. municipality in 2019 to submit a resolution for supervised inhalation sites. A site was established in Lethbridge, Alta, in 2018, and an outdoor site has been run by Vancouver's Overdose Prevention Society on the Downtown Eastside since April 2017.

Potts said she didn't know when a facility would actually be built in Victoria.

But she said it's strange that the issue "isn't totally on everyone's radar yet" when 39 per cent of drug users have died from an overdose while smoking, according to recent investigation by the B.C. Coroners Service.

That document also says that smoking is the most common way men have overdosed, and the most common way users aged 15-29 have died while overdosing.

While Victoria doesn't have an official supervised inhalation facility, the Victoria Cool Aid society operates a site in a tent fixed in the Rock Bay Landing courtyard, in an industrial area outside the downtown.

There, peers can monitor each other as they consume drugs.

The society's Don McTavish said the tent is "well attended" and that more safe sites need to be set up in the city.

"We haven't had any deaths," he said. "The fact is that people smoke. I'd say it's about equal [to people who inject]."

However, he said it's challenging to find large outdoor spaces that are close to city services, and it's costly to maintain proper indoor ventilation space. This would make it difficult to incorporate an inhalation site into things like supportive housing.

Finding space and ending stigma

McKenzie said Victoria is "nowhere" in terms of setting up an indoor inhalation site because of the complications in doing so.

"They have to basically put in a sealed room with... fans and filters to remove the smoke," he explained. "The outreach workers … would have to make sure they [were wearing] top-end biohazard gas masks."

McKenzie said Victoria's urban landscape poses a challenge in that there isn't enough space to build a site where smoke wouldn't interfere with surrounding buildings.

To build a site further away from the downtown would result in drug users feeling marginalized and would be a disservice to those who couldn't wait the time it takes to travel before using, he said.

Potts disagrees. "I think we need an equitable distribution. Not everyone wants to be downtown," she said.

However, she said having a properly designed indoor space downtown could hopefully alleviate stigma and misunderstanding.

"We have to be community focused and think about what will really work for everyone," she said.