Safe injection sites could be coming to Nova Scotia

Federal health minister Jane Philpott's announcement that she wants her department to make it easier for supervised injection sites to be set up in communities is being greeted with enthusiasm from a leading health promotion researcher in Nova Scotia.

Jacqueline Gahagan is the interim director of the School of Health and Human Performance at Dalhousie University and for about the last 15 years, she's sat on the ministerial council on the federal initiative to address HIV and AIDS in Canada.

Gahagan said a safe injection site is needed to reduce the spread of blood borne infections such as Hepatitis C and HIV, and slow the death toll from opioid overdoses.

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Injection sites are supervised places where people are given clean needles and other paraphernalia to shoot up drugs. If someone overdoses on opioids, a nurse is on hand to inject naloxone to reverse the effect.

There are only two such facilities in North America, and they're both in Vancouver. 

From 26 to 5

Under the Respect for Communities Act, 26 criteria are to be met before the federal government can consider an application to open a new supervised site. Philipott said the criteria will be replaced by five benchmarks.

"This is a step in the right direction," said Gahagan. She points to a 2011 study that found the fatal overdose rate after the opening of the supervised injection facility in Vancouver decreased by 35 per cent. 

Gahagan said the move toward drug consumption sites is "long overdue," and a marked departure from the previous Conservative government's stance "where harm reduction was not something people could talk about let alone get funded in a sustainable way."

Funding challenge

Coming up with the money to pay for harm reduction sites will be a challenge, Gahagan said, if Ottawa doesn't set aside money, and provincial health budgets are constrained by other programs.

"The downside will obviously be what is this going to cost, and what are we going to get rid of to absorb the cost of this," she said. "I think that's going to be a very contentious issue in many regions of Canada."

According to the website for Insite, Vancouver's first supervised facility, it operated on a budget of $2.9 million in 2015-2016. There were more than 263,000 visits last year which works out to about $11 per visit.

But Gahagan doesn't think the decision whether to open more facilities should come down to dollars and cents, but rather a commitment to curbing illegal drug use and addiction. 

"If we choose not to do something about it, I think the cost to society, as trite as that sounds, is going to be exponential," she said.

As of November, there were 49 opioid related deaths in Nova Scotia — that's one Nova Scotian dying every six days.

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Nova Scotia health minister on board

The federal health minister's direction is being welcomed by her Nova Scotia counterpart, Leo Glavine. In a statement, he said he's pleased Ottawa is moving on this "very important issue that will simplify and streamline the process for safe consumption sites."

Glavine said the province's opioid action plan is looking into "how safe consumption sites fit into what we're currently doing with needle exchange programs and expanding access to naloxone."

Recommendations from the harm reduction and other working groups are expected early in the new year.

When asked whether the province is seeking to share the cost of an injection site with Ottawa or whether the province would foot the bill on its own, Glavine said "it would be premature to discuss funding or options in advance of that report."‎

Health and social benefits

Gahagan said there are additional benefits to a supervised facility such as decreases in criminal activity, admissions to hospital emergency rooms, and "anti-social behaviour."

A supervised injection site also has the support of street-level harm reduction groups, including Mainline Needle Exchange and Direction 180, the methadone clinic in Halifax. 

With that community backing, Gahagan said she hopes applications for a facility will be "activated and mobilized" in Nova Scotia.

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