Brockville harm reduction workers push for safe consumption site

Workers at a Brockville, Ont., methadone clinic are pushing for a supervised consumption site, but they say strict federal and provincial rules make it nearly impossible for smaller cities to qualify for funding.

Calls for a facility where people can consume drugs under the supervision of health workers come as an especially toxic drug supply filters into the community from Toronto and other major cities, causing a sharp spike in opioid overdoses and deaths.

But while Toronto's drug supply has made it into smaller cities, the same level of provincial funding and health support has not.

"Toronto has many safe consumption sites that people can go to use. We don't have anything like that here in Brockville," said Jes Besharah, a harm reduction worker with Change Healthcare in Brockville.

"That's something we could look at doing on a smaller level to give people who are alone or just want to be safe, a safe place to use for now."

Change Healthcare administers less potent opioids like methadone to help treat users accustomed to an unregulated street supply. Besharah says it isn't enough.

Opioid deaths in Ottawa nearly doubled during the COVID-19 pandemic, and surrounding communities were similarly impacted.

The Leeds, Grenville and Lanark District Health Unit, which includes Brockville, recorded four opioid-related deaths in a ten-day period in late July. The health unit has now seen more reported overdoses in the first half of 2021 than it did all of last year.

Much of the increase comes as the emergence of more potent opioids in places like Toronto is making the drug supply across the province stronger and more toxic.

"We need [a supervised consumption site] badly," said Besharah. "Pretty much everybody who knows somebody who's using right now wants somewhere safe they can go."

That demand, said University of Ottawa professor and drug law researcher Eugene Oscapella, is present in both large and small cities.

"Small communities are having problems with drug overdoses, and small communities have needs for some sort of supervision over the use of drugs," he said.

'So much red tape'

A lengthy, two-tiered application process stands between drug users in Brockville and their goal of a safe place to use.

Supervised consumption sites in Canada require an exemption granted by Health Canada. After the Respect for Communities Act was passed under former prime minister Stephen Harper in 2015, dozens of new requirements slowed the application process.

Rob Boyd, director of the Oasis program at the Sandy Hill Community Health Centre in Ottawa, applied to get an exemption for the supervised consumption site he now oversees while those requirements were in effect.

"There were just a lot of these little tick boxes that were absolutely unnecessary," he said. "It was really an attempt to paper over or send the message out not to bother even making the application."

Boyd said conflicting federal and provincial policies further complicate the process.

"The thing about this is all along, it was the simple and obvious solution to the crisis we were seeing at the time," he said. "The fact that in order to get it done, there were so many hoops and so much red tape that we had to overcome, was completely senseless."

Crisis is 'provincewide'

The federal government scaled back the number of conditions considerably under Prime Minister Justin Trudeau, but the federal exemption is just the first step. If a group in Ontario wants to run a site with provincial funding, it must meet additional requirements under the province's Consumption and Treatment Services program.

Only one site in Canada, Saskatoon's Prairie Harm Reduction, has survived off donations alone.

Both Health Canada and the Ontario Ministry of Health did not respond to a request for comment.

"We don't qualify under federal regulations right now," said Besharah. "We don't have the space or the money or the resources to meet their qualifications."

Boyd agreed it can be "very difficult" to sustain a safe consumption site without the added stability of provincial funding.

"There are very small or remote communities that this is never going to be in their capacity to operate," he said.

"The opioid crisis is a provincewide crisis. It's something that exists everywhere and we need to think about how we can implement things like supervised or witnessed injections across the province."