Harm reduction workers encouraged by new mental health and addiction plan

People who support and treat those who are addicted to drugs are "very, very" encouraged by the province's new five-year plan to improve mental health care and addiction treatment.

Debby Warren of Ensemble Greater Moncton says they are ready to act quickly to open an overdose prevention site as soon as funding becomes available.

"We need to make sure people are safe," said Warren.

"They don't want to die, trust me."

Overdose prevention sites are among 12 "key priority initiatives" announced Tuesday by Health Minister Dorothy Shephard. 

The provincial government is aiming to implement them this year, Shephard said.

It would cost $100,000 to $300,000 a year to run an overdose prevention site, said Warren, depending on the hours of operation.

It wouldn't be as elaborate as a "supervised consumption" or "safe-injection" site, said Warren. They have more medical staff, mental health counsellors, case workers and resources.

An overdose prevention site would be a "very basic" space, she said. 

People who use substances would be able to go there with their own drugs. And the drugs could be tested for the presence of fentanyl, a synthetic opioid 50 to 100 times stronger than heroin or morphine, that can be deadly even in small doses.

"Front-line" workers would supervise the location and administer Naloxone if needed to counter an overdose.

People who are addicted to drugs are "a very vulnerable population," said Warren.

"You have people running down the street in their bare feet screaming for Naloxone because someone's dying. We had a couple of incidents in the past month of that happening."

A committee has been working to set up an overdose prevention site in Moncton for about two years now.

Warren co-chairs the committee with regional medical officer of health Dr. Yves Léger.

They have found a location and a room has been renovated, said Warren. Another partner helped pay for that work.

They've interviewed drug users and gathered data to demonstrate the need.

She cited a scholarly article published in 2019 that estimated there were about 5,000 intravenous drug users in New Brunswick in 2016, representing the second highest rate in the country behind British Columbia.

Warren also submitted figures that indicate the number of individuals using the needle exchange service in southeastern New Brunswick has increased from 835 to 923 in the past two years.

"I know residents are uncomfortable to see them using on the street. This way they come to us. We work with them, help them to be in a better space and hopefully connect them to services."

The committee stopped meeting, said Warren, because progress was stalled by a lack of funding.

"Now that the minister has said it will be this year, we're ready to make it happen."

Shephard highlighted Tuesday that the overdose prevention sites would be a safe place to dispose needles, ensure people aren't injecting drugs laced with toxic substances and "meet individuals where they're at" to offer "services that could be helpful in a recovery process."

A Fredericton doctor who specializes in addiction treatment is also welcoming the new plan.

"It's extremely exciting to hear all of the innovative and very timely interventions that Minister Shepherd is proposing," said Dr. Sara Davidson of the Riverstone Recovery Centre. 

"It's certainly things that many of us in health care, especially in mental health and addiction medicine, have been really, really longing for and needing ... So it's extremely encouraging."

Besides the overdose prevention sites, Davidson feels increased walk-in access for mental health counselling and supportive housing for addiction and mental health patients will also make a big difference.

"It's a very holistic view that's being taken," said Davidson, "which I really appreciate."

Davidson said she is very interested in the "drivers" behind substance use disorder.

"It's extremely important to reduce harms associated with I.V. drug use or other inhalation forms. And that's where an overdose prevention site comes in. But if all the energy were going there and it wasn't looking upstream to see, you know, if people were properly housed, if they had the kind of counselling, support, other things in the background that are maybe perpetuating substance use disorder, then we would only be looking at it from such a narrow angle."

Like overdose prevention sites, Davidson's clinic also operates with a philosophy of "harm reduction."

"We're not going to necessarily make people stop just because we want them to, you know. There's some causes behind it."

The Riverstone centre is a national test site that began offering injectable opioid agonist treatment or iOAT therapy last fall. Twenty-seven people are now receiving prescribed injectables.

It's a five-year pilot project meant to help develop a "safe opiate supply." 

Davidson said the treatment targets the 15 per cent of people with substance use disorder that don't seem to benefit from replacement therapies, such as methadone.

Her clinic also helps connect people with Social Development to get income assistance and medical coverage and connect them with Housing First workers.

"We do all of that at the same time because we can't let any part not be addressed or something is going to fall through. People do need the housing to get stable. It's not just a medicine given. An overdose prevention site is important. But it's only one part."