After years of pleading, debating and waiting, the Quebec Ministry of Health officially released the funds to open three supervised injection sites (SIS), as well as one mobile unit in Montreal. Two such sites are already in function in Vancouver, but it will be a first for Quebec.
Quebec will release $12 million over three years to three community centres in Montreal: Spectre de rue, CACTUS and Dopamine. One part of the money will help the centres prepare the locations and fulfill all the requirements to be granted an exemption from the law on drugs by the federal government.
The other part will be used for the launching and running of the sites’ operations. One mobile unit will also be providing services in a few boroughs. No official date is set for the opening of the facilities, but Le Devoir mentioned that it could be as soon as March 2017.
The project is far from new. In fact, six years have already passed since the Director of Public Health started pushing for the opening of SIS in Montreal. In June 2015, Mayor Coderre had announced his plan to go forward with the facilities, with or without Ottawa’s approval.
At the time, the provincial government decided to lend a hand. According to Lucie Charlebois, Quebec’s Minister of Health and Healthy Living, “we are now at the final step” of the process.
She told Radio-Canada that the work on installations and the hiring of medical staff was already on track. “That means we’re advancing quickly.” She commented that she discussed the matter with her federal counterpart, Jane Philpott: “she is very receptive towards it, but we have to fit certain criteria, that is clear.” Charlebois stated that she believes that getting the federal approval will be a formality.
Sandhia Vadlamudy, the director of CACTUS, told FTB by phone that this formality requires a lot of paperwork, but no problematic modifications.
Last year, CACTUS distributed 610 000 clean syringes in an effort to prevent transmission of infection, which is around 65% of distributed materials on the island, including those distributed in CLSCs and drugstores. With their supervised injection site finally going forward, they will be able to “add one more tool to prevent infections and overdoses.”
Some have argued that the government would do better to focus on treating drug addiction or even on cracking down on drug crime instead of improving the conditions of drug use. Vadlamudy doesn’t think that promoting abstinence and prohibition is sufficient.
“This approach is more based on pragmatism; which is to say drugs exist and people take them.”
She argued that SIS are beneficial for more than just drug users, highlighting that, within four years of operation, SIS start saving money for the healthcare system by preventing overdoses and health deterioration in users.
It will also help reduce the number of intoxicated people and of used needles left on the streets “and thus improve the quality of life of everyone in the community.”
Slowly breaking the taboo
According to the Director of Public Health, there are 4000 regular users of injectable drugs in Montreal. People who use injectable drugs are 59 times more like to be infected with HIV. An average of 70 people die of drug overdoses every year in Montreal.
In the eyes of many, SIS remain a marginal, controversial option for desperate cases, when they are not a silly progressive scheme. But their growing popularity around the world and the expanding stack of evidence in their favour are now hard to ignore.
The first North American facility, Insite, opened in Vancouver 13 years ago. In 2008, federal health minister Tony Clement called it “a failure of public policy, indeed of ethical judgment.” Just last spring, Toronto’s Police Association expressed firm opposition to the idea of opening SIS in their city.
“Insite is not a model we want to see replicated,” association president Mike McCormack said, fearing that SIS would attract crime and loitering and thinks that government money would be better spent on treatment options.
Insite handles 600 injections daily. Not one person has died of an overdose within its walls. According to the B.C. Centre for Excellence in HIV/AIDS, there was a 35% decrease in overdose deaths in the area of forty blocks around the site. BC’s HIV and Hepatitis C infection rate went from the highest of the country to one of the lowest. More than thirty peer-reviewed papers were published about Insite’s beneficial impact.
Supervised rooms for drug consumption started popping up as a response to AIDS epidemics and the spike in overdoses in the eighties and nineties. There are now about 90 of them around the world.
The European Monitoring Centre for Drugs and Drug Addiction recently published a study in which they found overall that those sites increased safe and hygienic drug use and reduced risky behaviours. They also found that, contrary to Toronto’s Police Association’s concerns, there was no evidence that those sites increased drug related crime and violence in their vicinity.
*Featured image by Todd Huffman, WikiMedia Commons