Say YES to Barrie's SCS - No More Opioid Deaths!

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We, the undersigned, are calling on City Council to approve and expedite the Canadian Mental Health Association and Simcoe Muskoka District Health Unit’s proposed Supervised Consumption Site, in order to support the health and safety of all our residents and our community, and help save the lives affected by this growing local health crisis.

The CMHA, SMDHU, and the Gilbert Centre brought this proposal before Council in May, 2019, but were met with roadblocks and stalling tactics, which continue still.  SINCE CITY COUNCIL'S DELAY OF THIS APPLICATION, ALMOST 150 PEOPLE IN THE REGION HAVE DIED FROM OPIOID POISONING (the number of deaths from September through January has not yet been confirmed – the number is likely closer to 200). [Source: Simcoe Muskoka District Health Unit]

City Council is not entitled to vote on any other health care service the CMHA, SMDHU or any other medical organization provides.  Throughout the COVID-19 pandemic, City Hall has implored residents to respect the expertise and follow the SMDHU’s guidance – they need to respect and follow our Health Unit’s expertise and guidance on our opioid crisis as well.  POLITICIANS SHOULD NOT BE BLOCKING RESIDENTS' ACCESS TO LIFE-SAVING HEALTH-CARE SERVICES.

 

As Benjamin Perrin (UBC researcher, former special advisor to Prime Minister Stephen Harper & law clerk at the Supreme Court of Canada), author of "Overdose: Heartbreak and Hope in Canada's Opioid Crisis" stated in a November 25, 2020 interview for Grace United Church:

“You don’t have City Council votes on whether you’re going to have EKG machines in your hospital.  You don’t have City Council votes on whether or not we’re going to allow parents to vaccinate their children.  I hope you’re not going to have a City Council vote on who gets the COVID-19 vaccine or not.  Yet, we have City Council votes on whether or not there are supervised consumption sites.  And I can tell you those politicians who in 2020 vote against Supervised Consumption Sites or Overdose Prevention Sites – I have no concern in saying this, without hyperbole – have blood on their hands.  We know the research is clear.  ... IF YOU CAN'T GET BEHIND SUPPORTING A LIFE-SAVING MEDICAL INTERVENTION, YOU NEED TO QUIT YOUR JOB, BECAUSE YOU'RE KILLING PEOPLE.    [Source:  “A Conversation with Benjamin Perrin”]

 

BARRIE'S OPIOID CRISIS:

The City of Barrie is an epicentre of Canada’s opioid crisis – our 2019 rate of emergency department visits for opioid poisoning was 2.5 times the provincial rate, SPIKING TO ALMOST 8.5 TIMES THAT RATE IN OUR CITY CORE.  From 2017-19, Barrie accounted for 45% of the opioid-related deaths in Simcoe County, despite having only 28% of the population.  Preliminary data shows that there were 83 confirmed and probable opioid-related deaths in Simcoe Muskoka for the first eight months of 2020, which was 51% higher than the average of 5 deaths from January to August for the previous three years.  (The numbers for September through December await confirmation.)  [Source: Simcoe Muskoka District Health Unit]

As the numbers above show clearly, the community in our city core is especially struggling from this health crisis – which affects not just the people who use drugs and their loved ones, but also the health and welfare of first responders, business owners, and the community at large.

The Simcoe Muskoka Opioid Strategy (SMOS) needs City Hall’s assistance to implement an important part of its Harm Reduction strategy: the creation of a Supervised Consumption Site (SCS) in the Barrie neighbourhood worst hit by this health crisis, our city core.  This life-saving health service needs to be made available and accessible to our residents immediately, before we needlessly lose any more lives.

 

WHY A SUPERVISED CONSUMPTION SITE?

As written by Health Canada, “Supervised consumption sites and services SAVE LIVES AND BENEFIT COMMUNITIES.  They provide a safe, clean space for people to bring their own drugs to use, in the presence of trained staff.  This prevents accidental overdoses and reduces the spread of infectious diseases, such as HIV.  Supervised consumption sites may offer a range of evidence-based harm reduction services, such as drug checking.  The sites also provide access to important health and social services, including substance use treatment for those who are ready.”

“Canadian and international evidence show clearly that supervised consumption sites and services help to save lives, connect people to social services and serve as pathways to treatment.  When properly established, supervised consumption sites and services:

  • reduce the risk of accidental overdose, because people are not rushing or using alone
  • connect people to social services like housing, employment assistance and food banks
  • provide or connect people to healthcare and treatment [including mental health treatment]
  • reduce public drug use and discarded drug equipment
  • reduce spread of infectious diseases, such as HIV [including access to testing for HIV, hepatitis C and sexually transmitted infections]
  • reduce strain on emergency medical services, so they can focus on other emergencies
  • provides space for people to connect with staff and peers, which can help a person moderate their drug use and decide to pursue treatment”

Other benefits listed by Health Canada and the Ontario Ministry of Health include:

  • access to clean drug use equipment, and fresh water for hygienic use
  • drug checking to detect if drugs contain other more harmful substances
  • emergency medical care in case of overdose, cardiac arrest or allergic reaction
  • basic health services, such as wound care
  • education on the harms of drug use, safer consumption practices and safer sex
  • access to medications to treat opioid use disorder under the oversight of a healthcare provider
  • referrals for drug treatment, rehabilitation and other health services
  • access or referrals to social services such as housing or employment supports
  • alleviation of calls to other frontline services, such as police and paramedics
    • saving money, time and other resources
    • reducing strain on these services, allowing them to better serve their mandates, and reach their other calls more quickly
    • less secondary trauma of frontline workers from repeat calls, and their potential exposure to COVID

North America’s first supervised injection facility, Insite, opened its doors in September of 2003 with a federal exemption as a three-year scientific study.  The results of the study, evaluated by an independent research team, showed it to be successful in engaging the target group in healthcare, preventing overdose death and HIV infections while increasing uptake and retention in detox and treatment.  The research, published in peer-reviewed medical and scientific journals, also showed that the program DID NOT INCREASE PUBLIC DISORDER, CRIME OR DRUG USE.  [Source: Harm Reduction Journal]  From 2003-2019, there were over 3.6 million visits to Insite, 48,798 clinical treatment visits, and 6,400 overdose interventions, and zero deaths.  [Source: Vancouver Coastal Health]

The Simcoe Muskoka Opioid Strategy is built on 5 “Action Pillars” – Prevention, Treatment/Clinical Practice, Harm Reduction, Enforcement, and Emergency Management.  No one pillar can solve our opioid crisis on its own, they all must work together to make a difference.  An SCS is an integral part of the Harm Reduction pillar.

 

WHY IN THE CITY CORE?

The key reason is in the statistics published above – Barrie’s core has a rate almost 8.5 times higher than the provincial rate of opioid poisoning cases, and an almost 3.5 times higher rate than the city as a whole.

Health Canada requires that SCSs be set up in areas where there are high rates of public drug use, in order to provide the important health, social, and treatment services listed above.

The Ontario Ministry of Health guidelines also specify that an SCS site should be in the areas of highest need, based on mortality and morbidity data.  They also require that the site be in a location where it can provide integrated, wrap-around services, with onsite or defined pathways to addictions treatment services, mental health services, primary care services, and social services.

The two locations proposed by the CMHA & SMDHU ensure that the SCS would be accessible to the most residents in need of its services, as well as being able to provide that wrap-around service both Health Canada and the Ontario Ministry of Health outline, through its proximity to complementary organizations and services.

Beyond simply meeting the legislative requirements, having an SCS in the city core would be a key step in solving many of the issues that area has been struggling with.  It would alleviate downtown business owners’ concerns about having open drug use or purchases in front of their establishments, potential overdoses on their doorstep, having to keep large supplies of naloxone kits, or disposal of needles in parks, sidewalks, or other public spaces.  This would result in a return of foot traffic and individuals wanting to return to the downtown core to shop and dine – creating a safer space not just for those experiencing addiction, but also for the community as a whole to share space.  The people using drugs are kept safer in the presence of trained medical staff, our other community members are kept safer from discarded needles or the secondary trauma of witnessing an overdose, and our first responders are free to respond to other emergency crises more efficiently.

 

WHY MUST CITY HALL TAKE ACTION?

The Canadian HIV/AIDS Legal Network released the paper "Overdue For A Change: Scaling Up Supervised Consumption Services In Canada” in 2018.  Among their many findings and recommendations included in the report are:

  • “Implementation of SCS in Canada is contingent … on the willingness of provincial, territorial, and municipal authorities to support the services including through funding and by not imposing unnecessary regulation.  Efforts must thus be made at and by all levels of government to scale up SCS across the country.”, as well as
  • "Municipal authorities should not impede the establishment of SCS through the enactment of by-laws.”

In January of 2019, the CMHA, SMDHU and Gilbert Centre began consultations on their proposed SCS, with a report on the proposal going before City Council that May.  Their proposal met with much ideological opposition, and many delays, the result of which was the creation of a new Site Selection Advisory Committee (including residents and organizations who opposed the initial site selected), further studies and consultations.  And it appears that they are nevertheless meeting more resistance at City Hall.

City Council’s failure to take action — or to embrace evidence-based health science over personal ideology — has seen the health and safety of Barrie residents and our community decline rapidly.  This year’s death rate is 51% higher than the previous 3-year average — City Hall needs to support our local health professionals in reversing this trend, not allow it to continue to skyrocket through their inaction.

On 30 September 2011, all nine judges of Canada's highest court ruled that attempts to close the Vancouver-based SCS, Insite, contravened the country's charter of rights by threatening the lives of injection drug users.  The Supreme Court of Canada ruled in favour of Insite and underscored the rights of people with addictions to the security of their person under section 7 of the Charter of Rights and Freedoms (the right to life, liberty or security of the person) — clearing the ground for other jurisdictions in Canada to implement supervised injection and harm reduction where it is epidemiologically indicated.  This legal case validated the personhood of people with addictions while metaphorically unchaining them from the criminal justice system.  [Source: Harm Reduction Journal

*** Barrie City Council needs to uphold the Charter Rights of its citizens, and stop creating roadblocks to the health care of its citizens. ***

 

FOR MORE INFORMATION

The SMDHU keeps information about its opioid strategy and other drug-related health issues here: https://www.simcoemuskokahealth.org/Topics/Drugs, and information specific to the SCS Site Selection currently underway here: https://www.simcoemuskokahealth.org/Topics/Drugs/opioids/Supervised-consumption-sites/Site-Selection-Advisory-Committee.

The SMOS keeps an information page updated at http://preventod.ca, if you wish to delve deeper into the research.

These two organizations are essential community partners, providing vital health care to our city.  City Hall needs to allow them to function unimpeded, respect their research and expertise, and support their efforts to provide the health care our city needs and deserves, as mandated federally, provincially, and municipally.

Engage Barrie keeps an SCS-related page at http://engagebarrie-scs.carrd.co, with links to updated information and calls to action.

 

SUPERVISED CONSUMPTION SAVES LIVES – BARRIE (SCSLB)