Montreal supervised injection sites get $300K booster to fight 'unprecedented' opioid overdoses

New data obtained by Radio-Canada shows that the opioid crisis is reaching unprecedented levels in Montreal and Laval with paramedics responding to more overdoses.

In 2022, Urgences-Santé paramedics administered Naloxone a record 291 times, compared to 194 in 2020 and 136 in 2018. This year looks set to be worse, with 163 interventions recorded between January and June.

"It's worrying," says Urgences-Santé spokesperson Stéphane Smith. "On the other hand, giving Naloxone saves lives."

Naloxone is a fast-acting drug that temporarily neutralizes the effects of an opioid overdose.

"I'm not looking forward to July and August," said Smith, noting overdoses tend to spike in the summer.

More money from Quebec

Quebec Social Services Minister Lionel Carmant visited Spectre de Rue Friday, one of four supervised injection centres that opened in Montreal in 2017.

The site allows people to consume in safety and to be taken care of in case of overdose, but it has had to reduce its hours due to lack of funding.

Carmant announced each of the four sites — CACTUS Montreal, Spectre de Rue, Dopamine and L'Anonyme — will receive an additional $300,000 per year. Montreal's public health sector will also see an increase in funding to develop more safe consumption sites and methods.

Carmant said the government is earmarking $1.4 million to tackle the issue.

"These issues are complicated, so strong partnerships are necessary," said Carmant. 

"Magic-wand solutions don't exist. Homelessness is a chronic problem and a long-term process we all need to work on." 

Carmant said mental health services and housing will also play a big role in fighting the opioid crisis and he stressed that there is a lot of unnecessary stigma against homeless people and those with addiction issues. 

"I'm here to help them, not hide them," he said. "I'm convinced we're on the right track, but there's a lot of work."

But, Montreal's official opposition critic for homelessness, Benoit Langevin, was not impressed. 

"What was announced this morning is crumbs when we see the scale and devastation of the homelessness and opioid crisis in Montreal. The Quebec government is only restoring what was cut, not responding to the massive increase in needs," he said.

Multiple approaches necessary

For Annie Aubertin, head of Spectre de Rue, the money comes as a great relief, but she says it will only allow the organization to resume its regular operations. She hopes one day Montreal can have a supervised injection site that runs 24/7, which would require much more funding. 

"When people come here and use our safe injection site, they don't want to die. They want to be in control of what they're consuming, have support and accompaniment and sometimes we can go further with them," she said. 

"These are humans we're seeing, real people, not 'problems.' These people need to be considered as full human beings with full lives, which we tend to forget."

Aubertin said that the money is greatly needed, but so are better housing policies, health care and drug decriminalization.

Josefina Blanco, the executive committee member responsible for dealing with homelessness and social inclusion, said she wants to push for more social housing, support for community organizations, mental health services and prevention efforts. 

"We will make sure everyone who can be part of the solution has a seat at the table," she said.

But, Carmant said Quebec is not looking into drug decriminalization.

On Wednesday, Montreal Mayor Valérie Plante's office expressed its dismay about three ongoing crises: housing, overdoses and mental health.

"While the housing crisis is accelerating, homelessness issues have never been so complex, given the skyrocketing mental health problems and the arrival of highly impure drugs on our streets," said Plante.

This is "unprecedented," according to the city, which speaks of a problem that's "scope is taking on unbearable proportions."

Langevin also criticized Plante, saying she should have formulated "clear demands: how much money is needed to be able to offer 24/7 resources, how many additional street workers and nurses do we need in the field, how much do front-line organizations need financially to improve their services?"

Lower quality drugs in circulation

As in many North American cities, Montreal is experiencing a deterioration in the quality of drugs in circulation.

Addiction specialists note the virtual disappearance of heroin, replaced by fentanyl analogues, which people have to use more frequently. It's also more common for people to inject crystal methamphetamine, which Naloxone is not effective against.

"The stronger the drugs, the more harmful the effect can be on the person, so rapid intervention becomes paramount. Every second counts — not minutes, seconds," said Smith.

He says that someone who has overdosed will lose consciousness, then go into respiratory arrest, followed by cardiac arrest if no overdose reversal drugs are administered.

Urgences-Santé is not alone in using Naloxone to save people from overdose. Montreal police officers administered Naloxone 147 times last year, compared with 115 the previous year.

In Metro stations, Société de transport de Montréal (STM) officers also administered Naloxone 15 times between January and March.

According to Montreal Public Health, an average of 14 people die every month from drug overdoses in the city.