Ontario is planning to close 10 of its 17 harm reduction sites, saying they’re too close to schools or daycares. It’s ignoring evidence about lives saved.
“People are not going to die,” Ontario Health Minister Sylvia Jones said last week as she announced the end of supervised drug consumption and treatment services (CTS) at most sites in Ontario that now provide them, including the Somerset West Community Health Centre.
But of course, they will.
Last year alone, Somerset West’s CTS staff successfully reversed 487 overdoses. That’s 487 lives saved. Does Jones seriously believe that shuttering the service won’t result in at least some deaths in future?
The province’s official reason for ending CTS at Somerset West and many other sites is that they are located within 200 metres of schools or daycares. It says banning the sites in such locations will help protect children and communities.
In the case of Somerset West, it’s the Nanny Goat Hill Nursery School, located in the Dalhousie Community Centre, that is too close. The school, which has a maximum capacity of 10 toddlers and 16 preschoolers, is, ironically, run by the Somerset West Community Health Centre.
But if proximity to its own nursery school is the true reason Somerset West must shut down its supervised drug program, why does the province’s proposed legislation preclude municipalities or organizations from simply setting up new supervised consumption sites farther away from schools, or from participating in federal safer supply initiatives? Wouldn’t these be logical steps?
Clearly, the province has decided that harm reduction, one of the four pillars of Health Canada’s Canadian Drug and Substances Strategy — the other three being prevention, treatment and enforcement — is simply one pillar too many.
Harm reduction involves strategies to minimize the negative consequences of substance use, without necessarily requiring abstinence, which is a tough goal to meet for many addicts. Some strategies include supervised consumption sites, needle exchanges and access to naloxone to reverse overdoses, as well as providing non-judgmental support, education about safer practices and connecting people to health and social services. Somerset West, for example, does all this. Ideally, harm reduction and the supports around it not only save lives, they support people managing and perhaps overcoming the use of drugs.
In place of the harm reduction centres it is closing, the province has announced it will invest $378 million in 19 new Homelessness and Addiction Recovery Treatment (HART) hubs, which will not offer safer supply, supervised consumption or needle exchange programs. Instead, the hubs will connect “people with complex needs to comprehensive treatment and preventative services that could include: primary care; mental health services; addiction care and support; shelter and transition beds; supportive housing; and other supplies and services, including naloxone, onsite showers and food.”
When asked whether Somerset West could continue its harm reduction operations if it wasn’t within 200 metres of the nursery school, Alexandra Adamo, a spokesperson for Minister Jones, somewhat fuzzily replied in an email that “if the Somerset West site moved, they would not be able to reapply for their provincial license.” Adamo didn’t say why not, and the daycare declined comment.
Chief among the safety concerns over supervised consumption sites near schools, according to the province, is crime. The health ministry says crime near Somerset West is 250 per cent higher than in the rest of the city. Asked for the data supporting that assertion, as well as any evidence that the crime rate is higher because of Somerset West’s supervised consumption operations, Adamo simply replied “The crime data speaks for itself.” If so, why didn’t she provide it?
The assertion that the data speaks for itself is ridiculous. The neighbourhood is lower-income, with the highest proportion in the city of residents in rooming houses. For many, the pandemic, inflation and higher housing costs have exponentially increased their desperation.
“I have been hearing extensively about challenges in all of Centretown and all of Somerset Ward, with public drug use, visible signs of addiction and homelessness,” says Coun. Ariel Troster. “If people are upset about public drug use, removing the one indoor safe place where people are able to use drugs is not a solution. Because the only alternative then is to use outside.”
Additionally, says Suzanne Obiorah, Somerset West Community Health Centre’s executive director, the very reason the centre was selected in 2017 to offer CTS was because the community already had the second-highest rate of overdose deaths and the second-highest rate of blood-borne infections in the city. In other words, the supervised injection site didn’t create the problem.
Still, we need to ask: Are parents of schoolchildren upset about the site’s proximity to schools, or even the existence of harm reduction programs?
Neither Ottawa-Carleton District School Board trustee Justine Bell, in whose Somerset/Kitchissippi Zone 10 the health centre is located, nor school board chair Lynn Scott — Cambridge Avenue Public School is close by — responded to my queries.
I did speak with a handful of parents in the affected neighbourhood.
“It’s a double-edged sword,” said one resident who only identified himself as Tyler, a father of a 10- and a 14-year-old. He’s glad that the consumption site is there, “because it does help.”
At the same time, he worries about the congregation of drug users. “The kids ask what’s going on; that’s good because it opens up a conversation, but trying to explain to your children that there are addicts, and some are aggressive about asking for things. I’ve been in the neighbourhood for about 20 years, and it’s getting more congregated here. I think these sites just put a Band-Aid on the problem.”
Oleksandr Korodchenko, who has lived in the neighbourhood with his partner and their one-and-a-half-year-old and five-year old for about six months, says they’re tired of finding needles in playgrounds. “Of course we understand that such people need some help, some support, but if it were possible to have the centre farther from schools, that would be great.”
Alex Flores and his three-year-old daughter have only been in the neighbourhood for about a month, but he’s already seen enough. “A lot of people are walking around and blatantly smoking their pipes. I don’t think it’s healthy for the community and I don’t want my daughter to see people taking drugs on the street.
“I’m ambivalent about harm reduction,” he added. “I’m not sure how much it helps people, and I think it can foster this behaviour. It’s difficult to strike a balance between not fostering this behaviour and also provide services that are good for people.”
Zora Jergovic, a mother of two girls, 22 and nine, isn’t ambivalent at all. “Why would they stop it if it’s helping the community in need? I see people walking around here like zombies, but if they close it down, it’s just going to get worse. There’ll be police and ambulances down here all the time, and it’ll cause chaos in the hospitals. These people need the help.”
So the situation on the street is dire, but it’s not going to improve by eliminating harm reduction programs.
Such services save lives in other ways, too. Last year, Somerset West’s CTS program made more than 7,000 referrals of people in need to primary health care, addictions counselling and treatment, housing and mental health services and other supports.
I asked the ministry what health care and drug policy experts it consulted before deciding to do away with these harm reduction sites. Adamo did not respond, but clearly Ottawa Public Health was not among them.
“Supervised consumption and treatment sites (CTS), and other places that provide single-use gear and retrieve needles to decrease spread of hepatitis and HIV, are places where people are engaged with compassionate approaches that can lead to better health outcomes, including decreased substance use,” Benjamin Liking, manager of OPH’s Community Health and Wellness Branch, said in an email.
“Ottawa Public Health (OPH) is committed to ensuring that people who rely on supervised consumption and treatment services continue to receive the support they need, while considering the needs of people living near various service delivery sites. Approaches to service provision must consider and address any harms to the surrounding communities, residents and businesses. Our priority remains the health and well-being of all Ottawa residents.”
OPH officials declined to comment when asked if they supported the 200-metre restriction on where supervised injection sites are located.
Rob Boyd, who was program director at the Sandy Hill Community Health Centre and is now CEO of Ottawa Inner City Health, both of which offer supervised consumption, says the 200-metre restriction is “somewhat arbitrary.”
“There are policy alternatives that the government could implement instead.”
One of those is the Block Leaders Program that Inner City Health started this year in the ByWard Market. It employs drug users and shelter residents to work with drug users to help restore the norms and social responsibility that were decimated by fentanyl, the pandemic and the death toll wrought by the increased toxicity of the drug supply. For instance, they encourage people not to use drugs or sleep in the doorways of businesses and residents, near schools or in front of children, and not to leave drug paraphernalia lying about.
“At its heart, it’s really simple,” says Boyd, “just in terms of engaging people and talking to them about the things that are creating a sense of unsafety in their lives, and getting them to identify what the solutions would be, not only to their own safety needs, but also the safety needs of neighbours.”
Troster has been working with the Somerset West centre and has proposed to the mayor’s office that it use some of the provincial funding earmarked for downtown revitalization to implement a program similar to Block Leaders.
That would be a excellent way to help deal with the problem of blatant on-street drug use, which might then ease some of neighbours’ concerns.
In the meantime, the province should reverse its poorly informed decision to shut down some harm reduction programs, and instead include them in the HART hubs. It should also add supervised inhalation — since more drugs are being consumed that way; it’s no longer just about needles — which it currently prohibits as part of the CTS programs.
If it doesn’t, more people will certainly die.
KICKER
