Fighting for safe-consumption site

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This article was published 23/04/2018 (2738 days ago), so information in it may no longer be current.

Provincial politicians sparred last week over whether evidence showing safe consumption sites save lives and money would carry over if such sites were introduced in Manitoba.

But what was especially disconcerting about the debate, said Rick Lees, executive director of the Main Street Project, is how the government’s refutations in the wake of a new national report calling for more safe-consumption sites seemed to completely misconstrue his organization’s push for its own needs.

“I can’t tell you if they need safe consumption sites from Churchill to The Pas,” Lees said. “I’m talking about the 1,400 to 1,500 people who are homeless in the city, who live downtown in this urban area, who are using the two million needles that are given out every year for safe injection in back lanes and on buses and in bus shacks and are doing so often with dirty needles, causing other issues like hepatitis C and HIV.”

Health Minister Kelvin Goertzen and his press secretary have offered up several reasons why the government is saying no. Over the past few months, his rationale has been that there’s no evidence safe-injection sites are the most effective use of limited funding, that Winnipeg’s opioid use is more spread out than Vancouver’s and evidence indicates such sites work only in “highly concentrated areas as small as a few city blocks.”

However, a February report from Goertzen’s own department — which monitored opioid misuse and overdose in Manitoba between July 1 and Sept. 30, 2017 — shows that while naloxone use in suspected overdose cases does touch most corners of Winnipeg, it is concentrated in the centre. Downtown and Point Douglas registered the highest levels of suspected cases.

“Our government believes there is greater value to be had by investing in education and outreach, providing access to free injection supplies such as needles,” reads a statement from Goertzen’s press secretary in response to questions about the report, as well as “increasing access to opioid replacement therapy.”

It doesn’t have to be one or the other, said M.J. Milloy, a research scientist with the British Columbia Centre for Excellence in HIV/AIDS and a principal investigator for Insite, the first Canadian supervised-injection site.

“There’s very good data to suggest that when people use these sites they derive a lot of good benefits,” Milloy said. “They’re more likely to go to addiction treatment, more likely to start things like methadone — which leads to lower risk of death and less likelihood of committing crimes — and in terms of overdose, they’re far less likely to die of overdose.”

Since its 2003 opening, Insite has been evaluated in dozens of medical journals showing not only that it’s being used as intended and is reducing risks as expected, but also has saved upward of $17 million in HIV-related medical care alone.

To say such programs won’t work in places such as Winnipeg and Manitoba in the middle of a national crisis is “a bit of a hollow excuse,” Milloy said.

The city has neighbourhoods that are not unlike Vancouver’s lower east side, he said, and Manitoba could rely on mobile safe consumption sites as in some European cities. Winnipeg already offers safer drug-use supplies, such as clean needles, through its mobile Street Connections program.

“These are areas where people are suffering from high levels of addiction and marginalization and criminalization, and have a high level of service need that we’ve shown safe consumption sites help with,” Milloy said.

That’s what Main Street Project is trying to address.

“We’re talking about meth, crystal meth and IV drug use,” Lees said. “I believe that the (health) minister and the premier are talking about different things than what we’re talking about. They’re talking about opioids, particularly opioids in the bedroom.”

That being said, Lees said some of Premier Brian Pallister’s comments in question period last week “fly in the face of his government’s own discussion around investing in prevention.”

On April 17, Pallister rejected comparisons between B.C. and Manitoba.

“This isn’t the same situation,” Pallister said. “We have not had the incidents, not even remotely close, of tragedy, of tragic overdose, for example, in the streets or on the street corners of the city of Winnipeg.”

That’s because Winnipeg’s problem is relative to its size, Lees said. “Is he suggesting we wait until our city looks like the lower east side of Vancouver before we decide we have a problem?”

NDP Leader Wab Kinew said the evidence is clearly there for a safe-consumption site downtown.

“For a government to continue to refuse it shows it’s not about public health,” Kinew said. “It’s not about the evidence, they’re just refusing it because that’s what Conservatives do.”

Main Street Project has submitted an application to Health Canada to open a safe consumption site. They need community engagement, which they have been actively pursuing in conjunction with a working group that includes Street Connections, Lees said, and the provincial government to sign off.

Lees said he’d welcome a chance to speak with the health minister.

“No one’s asking for money,” Lees said, adding Main Street Project has what it needs to open. “They’re simply asking the province to say, ‘We won’t oppose this, it’s in keeping with the national evidence and we won’t oppose it.’ That’s all we’re asking for.”

jane.gerster@freepress.mb.ca