Ethos Ho, BSc Pharm Student
Responding to the Opioid Crisis – Safe Injection Sites
Safe injection sites are evidence-based health services with the goal to reduce harm and deaths related to opioid use, which has become a rising problem with fentanyl use. Safe injection sites are also commonly called “safe consumption services” because these sites aren’t limited to individuals who inject drugs, but also available to those who take them in different ways such as smoking or snorting.
So, what purpose does it serve? As the name suggests, it offers a safe and hygienic place for individuals to use drugs under the supervision of trained medical staff, and also:1
- Connect users to health and social services
- Provide sterile equipments and encourage safer drug use to reduce harm
- Administer naloxone in the event of an opioid overdose
This very idea behind safe consumption sites is the basis for harm reduction principles. By offering a safe environment that is supervised by medical professionals, not only is it offering appropriate health and social services to these individuals, but it’s also reducing the strain on the healthcare system.
Furthermore, there is evidence to support the benefits of medically supervised consumption sites, in both medical and social aspect:2
- Reduce risk and healthcare costs such as overdose, HIV, hepatitis C and bacteria infections of the skin, bloodstream, heart valves, and joints
- Reduce deaths from opioid overdose.
- Increase the number of individuals that seek treatment.
- Increase community safety, such as by reducing public injecting and decrease publicly discard injecting equipment.
- Decrease neighborhood crime, such as theft and vehicle break-ins.
Although the evidence and research suggest that establishment of a safe consumption site is a viable response to the relentless opioid epidemic, there has been strong opposition in local communities about the unforeseen impact that these sites are having. Lethbridge, a city in southern Alberta, has been facing many social challenges after its implementation of a safe consumption site. Today’s article will explore the challenges that this community is facing since the site’s recent approval on February 27, 2018.
The Opioid Crisis in the South Zone
In the first half of 2017, about 60 percent of fentanyl-related overdose deaths in Alberta Health Service’s south zone occurred in Lethbridge.3 As a result, there was a recent establishment of a safe consumption site, which was run by the AIDS Outreach Community Harm Reduction Education & Support Society (ARCHES). It was also North America’s first facility that allowed all four forms of consumption – snorting, injecting, smoking, or taking pills.3 However, among the noise of this new facility and its goal of reducing harm was ongoing controversy regarding the impact that it was having on local businesses and the safety of the community.
Safe Place for Drug Users, Bad for the Community?
From my personal experiences with exploring the city, talking with city residents, and reading the local news, it was obvious that there were unforeseen consequences of the implementation of the safety injection site. Perhaps one of the most notable was the negative impact it was having on surrounding business near the site.4,5 The facility is open 24 hours a day, seven days week, 365 days a year, and employs over 100 people. The constant flow of traffic and explosive demand by hundreds of drug users in the community have created a negative environment for surrounding businesses. A local business owner reported that clients from the facility have been “loitering and harassing the public, discouraging and even scaring customers.”4 Many managers and owners felt the same way about the negative impact and the financial, personal and emotional toll that it was having on them and their employers.5 Some businesses felt that the city and ARCHES didn’t consult with them about the potential impact it would have on them. Increased theft, needles, and debris have also been reported, leading people to avoid the area due to safety concerns.5 Staff members have also been afraid to go to work due to fear for their safety.5
Although the intentions of a safe consumption site were good, and quality evidence backs the harm-reduction services they provide, the anticipation of the user traffic and location of the facility could have been better managed. Additionally, consideration of the local community and the impact it would have on them should have been incorporated in the plan when building such a facility. The benefits of a safe consumption site has been established by research, and would greatly help any community that is looking for a solution in preventing harms and deaths related to opioid drug use, while at the same time offering drug users support and resources for receiving treatment. In fact, cities such as Edmonton and Calgary have safe consumption sites that have been approved in 2017, with more likely waiting for approval due to increased demands for these services.
The Bottom Line
Safe injection sites are evidence-based health services with evidence for reducing harm and deaths related to opioid use. It provides a safe environment for individuals to inject, snort, smoke, or take pills under the supervision of a trained healthcare professional while also offering support in social services and treatment. On February 27, 2018, a safe consumption site was approved for the city of Lethbridge and was North America’s first facility that offers all four forms of consumption. Ever since the facility was built, there have been increasing concerns regarding the impact that it was having on surrounding local business and safety. Reports of increased theft, negative experiences with clients from the facility, needles and debris, as well as personal safety have become primary concerns in the surrounding area. Although the safe consumption site was intended to reduce harm in those using drugs, it caused indirect harm to the local community. These social issues need to be better addressed when planning and building such facilities, and collaboration with local communities should not be overlooked.
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- Supervised consumption services. (2018). Retrieved from https://www.alberta.ca/supervised-consumption-services.aspx
- GET INFO SCS – ARCHES Lethbridge. (2018). Retrieved from https://www.lethbridgearches.com/get-info-scs/
- Edwardson, L. (2018). Lethbridge safe drug consumption site will be a North American 1st, official says | CBC News. Retrieved from https://www.cbc.ca/news/canada/calgary/lethbridge-safe-drug-consumption-site-will-be-a-north-american-1st-official-says-1.4502598
- Knight, D. (2018). Lethbridge business owner says supervised consumption site hurting his revenues, blames clients for litter, loitering. Retrieved from https://globalnews.ca/news/4331351/lethbridge-supervised-consumption-site-business-litter/
- Fominoff, L. (2018). Businesses near Supervised Consumption Site say they’re suffering. Retrieved from https://lethbridgenewsnow.com/article/611939/businesses-near-safe-consumption-site-say-theyre-suffering