Here's how Hamilton's new supervised injection site will work

A person walks into Hamilton's new supervised injection site with a dime bag of heroin in their pocket.

They're greeted in the front room by a healthcare worker or a volunteer, likely someone with lived experience with drug addiction.

After a short wait, they move on to the site's "injection space" — another room with a sterilized table and chairs where they can access clean medical supplies and take drugs under the watch of a medical professional.

Then, after about 20 minutes in the site's "chill out chairs" and it's clear that they're okay, they're on their way again — with the opportunity to grab lifesaving naloxone kits and use a needle exchange.

This is what people can expect to happen at the city's first temporary supervised injection site at Hamilton Urban Core CHC's 71 Rebecca St. location. The province announced Tuesday it was supplying the city with funding, and organizers hope to have the space up and running within two weeks.

People aren't going to be able to make changes if they're dead.- Nick Boyce, director of the Ontario HIV and Substance Use Training Program

Shelter Health Network lead physician Dr. Jill Wiwcharuk told CBC News that the site exists to keep people alive in the hopes that they might access other parts of the healthcare system, either for treatment for underlying conditions, or addictions services.

"This is not a choice, this is a disease," she said. "The whole point is to keep people alive long enough that they can get some help."

Drug users not a threat, doctor says

But as the site is only temporary, it won't have quite as many resources available as a permanent location, which might have an addictions worker or trauma counselor on site. A temporary injection site is much more about using the primary services, she said.

There will, however, be additional resources on hand in the form of a harm reduction supply room, where a person hands out overdose-reversing naloxone kits as well as training on how to use them. They will also have narcan and oxygen on site in case of accidental overdose.

Don't expect dedicated security on site, though. Wiwcharuk says it's not necessary.

"I work with IV drug users four days a week in my practice … and only one time did I ever feel even slightly threatened," she said.

So will the neighbourhood around the site see a sudden influx of people once it opens?

Nick Boyce, who spent time volunteering with overdose prevention sites in Toronto and is the director of the Ontario HIV and Substance Use Training Program, told CBC News that it will take time to foster the trust necessary for the site to be widely used.

"These sites really are about building a point of connection with some of the most marginalized folks in society," he said. "It doesn't grow until people really know they can trust the service."

Hundreds of overdoses reversed

Boyce has spent time volunteering with Toronto's pop-up injection site in Moss Park, which has been operating since last summer with tacit approval from the city and police.

He said as of this week, the site has had 7,725 visits for injection and has reversed 212 overdoses.

He said it's important to remember that the site acts as a first contact point for people who could later be connected with social services for addiction and housing.

"People aren't going to be able to make changes if they're dead," he said.

And they are dying.

The Shelter Health Network says preliminary data shows there were 75 opioid-related deaths in Hamilton from January to October of 2017, compared to 41 over the same time period the year before.

Boyce says the success of these sites can hinge on the inclusion of people who use drugs being involved in their organization and operations. At the Moss Park site, nurses were often paired up with people with lived experience with addiction, which helps with trust, but also in understanding language and lingo.

"Who else could best know what's going to work?" Boyce said.

adam.carter@cbc.ca