New 'safer supply' clinic is harming Hintonburg, councillor says

An Ottawa city councillor says a Hintonburg clinic that prescribes opioids to fentanyl users is harming the community and exacerbating the drug crisis.

Northwood Recovery opened an Ottawa location on Wellington Street W. at Merton Street in September. Since then, according to Kitchissippi Coun. Jeff Leiper, an "open-air drug market" has popped up near the clinic.

"It's not a comfortable corner to pass by," said Leiper. "There are a lot of kids that are passing by. Parents are very concerned about the open drug use that's happening."

He said dealers have swooped in and violence has followed. Residents have reported multiple robberies including one involving a firearm, Leiper said.

"We have confirmation that dealers and others are robbing the patients of their drugs," he said. "Those incidents of violence are very concerning to me and they're very concerning to the community."

Northwood Recovery's website doesn't say anything about safer supply, also known as "prescribed alternatives," a harm reduction model that aims to help users replace toxic drugs like fentanyl by prescribing drugs like hydromorphone instead.

But three patients outside the clinic confirmed to CBC that it offers safer supply for fentanyl users.

They said a doctor sees them, in at least some cases by teleconference, and prescribes Dilaudid, the trade name for hydromorphone. One of the men was holding a bubble pipe, commonly used for smoking fentanyl.

Clinic resembles 'pill mill,' says expert

Leiper said he supports safer supply in principle, but he wants to see policy changes at the clinic to prevent drug diversion, which he blames for fuelling the drug trade around the clinic.

"What we see is a lot of patients who are receiving their prescriptions at Northwood, they're filling those at the Victoria Pharmacy next door, and then they're going around the corner and there's what appears to be a lot of drug deals going on," he said.

When CBC visited the clinic, a reporter witnessed money changing hands right in front of the door, followed by a fist bump.

Leiper said part of the issue stems from restrictions that prevent safer supply from offering the stronger drugs that users are seeking.

"Instead, they're receiving drugs that aren't satisfying their cravings and so they are selling those into a market," he said.

Rob Boyd, CEO of Ottawa Inner City Health, said the evidence shows safer supply is effective in reducing fentanyl use and overdoses. It can also improve mental wellness and reduce criminal behaviour. 

But he questioned the way Northwood Recovery is operating. 

"From what I understand in terms of their program, they do not have any staff on site here, except maybe a receptionist," he said. "They don't have the wraparound services that safer supply programs like ours have, and that a lot of the care is being done virtually."

He said Ottawa Inner City Health, one of the partners in an existing safer supply program, offered to meet with Northwood to share best practices.

"They actually never got back to us. We didn't hear back from them after several attempts of trying to reach out," he said. "We want to support people to be successful, particularly around this issue which is so potentially lethal and so problematic. So it's a bit concerning that they didn't reach out."

Boyd said Northwood appears to be missing so many essential elements of safer supply, from face-to-face contact to wraparound supports, that he doesn't think it deserves to be called a "safer supply" service.

"I think that it's very similar to the old pill mills that we were talking about back in the early 2000s," he said.

'There's probably no quick fix'

Northwood Recovery told CBC in an email response that it is treating an epidemic "that is worsening by the minute." It pointed to the tainted drug supply and said "people are dying consistently."

But it did not respond to specific questions about whether it is operating a safer supply program or prescribing hydromorphone, or what it is doing to prevent diversion.

Cheryl Parrott of the Hintonburg Community Association said neighbours have been finding empty vials of hydromorphone from a Northwood physician. She said the neighbourhood has noticed a "huge change" since the clinic opened.

"There was open injecting on Wellington Street, which we hadn't seen before," she said.

She pointed to the same violent robberies as Leiper and said the trend "really increases the anxiety within the community."

"People walking down the street have been harassed or threatened," she said. "Neighbours who have asked them to get off of their property have been threatened."

Parrott said the community association has been asking for a meeting with Northwood for months, but it still hasn't happened. She said the clinic needs to put protocols in place to prevent diversion.

That's also what Leiper is calling for.

"There are some best practices, he said. "Like for example where patients are regularly selling those drugs or trading those drugs ... to ask them to leave the program, to no longer prescribe them with those drugs that are just going to be diverted anyway."

He said supervision could also be part of the answer, especially if stronger, longer-lasting injectable drugs were used instead of vials filled with dozens of pills.

Boyd said longer-acting injectibles could indeed be a valuable tool, but the Ontario Drug Benefit formulary doesn't cover the medications required.

Leiper said the city has no real leverage to push for policy changes. Unlike a supervised consumption site, which requires authorization from the provincial government and a federal exemption from the Controlled Drugs and Substances Act, safer supply clinics are regulated in much the same way as any other medical practice.

"The prescriptions are happening under the rules that guide doctors in prescribing drugs," Leiper said. "It's no more regulated than the heart medication that I take every day."

"I'm cautioning the community that there's probably no quick fix," he added. "There's no permission to operate that can be withdrawn."