There are mobile overdose prevention sites across Canada. Should Windsor get one?

A few days of political wrangling over the specific location of a drug consumption and treatment site in Windsor, Ont., nearly derailed a years-long plan to bring one to the region — but what if the site were mobile? 

They exist in other cities, and Windsor's downtown councillor suggests it could work here. 

Those who oversee one in Winnipeg said it's a necessary resource for people in the community — one that took a lot of advocacy following deaths from toxic drug supplies. Advocates in favour of a mobile unit say it meets people where they're at and can reach areas where it's needed the most. 

"People want it," said Levi Foy, executive director of social services organization Sunshine House. 

"A testament to it is how much we've grown just in terms of being able to connect with people in the three or four months we've been operating." 

From the outside, the site looks like a regular RV. But inside, people are supervised as they snort or inject substances. If they want to smoke, people are directed to a tent nearby.

People can also get needles, condoms, pipes and other harm reduction supplies. Drugs can be tested on site or people can take test strips with them and test on their own.

Those using the service can also be connected to other social supports. The RV stays in one location throughout the day and then travels in the last hour of its shift.

Foy said the community made it clear that they wanted something "familiar" and not "clinical," which is how they ended up with an RV. 

"For anyone doing a mobile site, really look at what your community needs and what your community is asking for," they said. 

The RV is peer run and not staffed by medical professionals. 

Sunshine House's mobile unit has been running for about three months. The organization has funding from Health Canada to run the site as a pilot over the next 18 months, according to Foy. 

Community wanted mobile and fixed consumption site 

In Windsor-Essex, people were most in favour of having both a fixed location and a mobile site, according to survey data from the Windsor-Essex County Health Unit (WECHU). 

WECHU's consultation reports noted that finding a location will be the "most contentious and challenging" — a notion proven to be true in recent weeks.

Late last month, the city's downtown councillor, Renaldo Agostino, wanted city council to revoke its support of the site, which would have stalled WECHU's applications to upper levels of government. 

Agostino said the previously approved location, at 101 Wyandotte St. E., will disrupt businesses and residents, and is too close to the border crossing. He wanted city council to explore other locations, including a mobile site. 

Between October 2018 and April 2019, WECHU consulted the community on the location of a site in an online survey that drew over 2,500 participants. 

Four in 10 community survey respondents, which totalled 38 per cent, said both a fixed site and a mobile service would be best. 

Twenty-four per cent said the site should be at a fixed location only and two per cent of people said the site should be mobile only. 

People had commented that having a mobile site could help identify areas that need the service the most. 

WECHU declined an interview. 

Health Canada said CBC News would have to reach out to individual provinces and territories to know the total number of mobile sites operating right now. 

CBC News reached out to Ontario's Ministry of Health, but didn't hear back in time for publication. 

According to the federal government's website, there are officially designated mobile supervised consumption services in both Alberta and Quebec. 

But based on CBC reporting, British Columbia also has a mobile site. 

Pros, cons to mobile site 

Outreach worker Leslie Laframboise drives around downtown Windsor providing food or warm clothing to people in need. 

She often comes across people who are using drugs and has administered the opioid rescue medication Narcan to someone experiencing an overdose. 

Laframboise told CBC News she believes the current location for the site is not ideal. She said the space should be open 24/7 and closer to the Downtown Mission, which is where she finds most people using. 

A mobile site, she said, is better, so it can move throughout the downtown. 

"When they're getting high, they're not going to walk over here to get high — they're going to get high where they are, bottom line." 

Foy said they understand this, but having a mobile unit depends on the city. He said Winnipeg does really need a permanent site in the downtown, but his organization isn't equipped to handle that. 

"This worked for us because this is what the community and the people that we work with at Sunshine House expected," they said, adding that any mobile site has to be done with "sincere intentional community consultation."

"So it can't be something that a politician is just like 'Oh I think that we should do it this way, because it's more comfortable for Joe and Cindy that live in the suburbs,' when really that's not who you're catering it to." 

They added there are a number of considerations to be made, including the available social services, addictions and treatment programming, public transit system, and employment and income programs in the province. 

For example, Foy said in Vancouver, there's a mobile unit stationed at a main transit stop. But, that might not work for all municipalities as it depends on how good their transportation system is, whether it's accessible, the cost of transit and the weather. 

They said a big challenge to operating an RV in Winnipeg is the harsh winters — but at the same time, it's better able to meet people where they are at rather than have them travel to a site in the cold. 

Yet, with a permanent site, Foy said, they could likely build stronger relationships with the community and really integrate themselves into an area. 

In an email, executive director Michael Brennan of Pozitive Pathways in Windsor said while he's not sure what the outcomes are of current mobile sites, he questions how wraparound supports that meet the provincial government's standards could be provided. 

He also said he could foresee gaps in consistency, missed opportunities for people to use due to accessibility issues and increased stigmatization from the community.