Demand for supervised injection sites steady as funding decisions loom

It’s another busy Thursday at Ottawa Inner City Health’s supervised injection site on the edge of the ByWard Market.

Clean needles, alcohol wipes and other supplies hang in stainless steel tins inside the cramped trailer, tucked behind the Shepherds of Good Hope shelter on Murray Street. 

Most of the 13 booths are occupied.

The nurses here are on constant guard, looking for any sign of a client slipping into overdose.

A year-and-a-half ago, these people were injecting themselves at home or on the street. 

Staff at the site are always close by in case someone experiences an overdose. (Ryan Tumilty/CBC)

As toxic and often deadly fentanyl began popping up in the city’s illicit drug supply, however, fatal overdoses surged.

Despite strong opposition, four supervised injection sites, including this one, opened their doors in Ottawa.

Later this month, the provincial government will decide whether the facilities will continue to get funding.

Without that money, some may not survive, and advocates fear the same is true of their clients.

By the numbers

The Clarence Street site, operated by Ottawa Public Health, opened in September 2017, and was soon followed by the Ottawa Inner City Health trailer that November.

Last April, the Sandy Hill Community Health Centre opened its site and the Somerset West Health Centre site opened in July.

By the end of 2018, there had been 72,015 visits to the four sites.

Over the same period, naloxone, the antidote that can reverse the effects of an overdose, was administered 566 times at the four sites, and oxygen was used 599 times.

Paramedics were called to the sites on 62 occasions.

Citywide, there were 446 emergency room visits for opioid overdoses in 2018.

From January to June 2018 — the most recent numbers available — the city saw 28 opioid overdose fatalities. In all of 2017, there were 64 deaths, up from 40 in 2016.

Surprising demand

The Ottawa Inner City Health trailer is by far the busiest supervised injection site, with nearly 50,000 visits since it opened.

We were basically slammed the minute we opened. I mean there, were people trying to break in to use before we were even open.– Wendy Muckle, Ottawa Inner City Health

The 24-hour site was supposed to be temporary.

According to Wendy Muckle, executive director of Ottawa Inner City Health, the plan was to remain open only until the Sandy Hill facility was up and running.

That’s not how it worked out.

“We were basically slammed the minute we opened. I mean, there were people trying to break in to use [drugs] before we were even open,” Muckle said.

Meanwhile, recent testing shows the illicit drug supply continues to be tainted with fentanyl.

“The problem is as bad as it ever was,” Muckle said.

“If anything, the drug supply is more toxic than it was two years ago.”

Staying close to home

The Clarence Street site, which costs Ottawa Public Health $996,000 to operate annually, immediately began drawing about 200 clients per week when it opened, and didn’t see the demand drop when the Ottawa Inner City Health trailer opened just one block away.

According to Muckle, that’s because drug users won’t travel far for the safety of a supervised site.

“We did a survey to ask people where they had slept the night before and most people, almost everybody, had slept within a couple of hundred metres of the supervised injection facility. It’s a very local kind of a response.”

Andrew Hendriks, director of health protection for Ottawa Public Health, said the research clearly demonstrates a need for multiple sites.

“We had heard in the different research studies before that clients are [only] willing to walk about seven to 10 minutes to access supervised consumption services,” he said.

Recognizing the need isn’t going away, Muckle said there are now plans for a permanent supervised site inside the Shepherds of Good Hope, but that will cost about $2 million to construct.

Clean drug supplies hang in stainless steel containers at the Ottawa Inner City Health trailer. (Ryan Tumilty/CBC)

Funding questions

Provincial funding for Ottawa Inner City Health, which budgets $2.9 million annually to run the trailer, runs out at the end of the month. 

“We’re nowhere close to what we need in terms of demand, and there’s a lot of communities that don’t have facilities who really desperately need them,” Muckle said.

Hayley Chazan, press secretary to health minister Christine Elliott, said the Progressive Conservative government is taking the crisis seriously.

The government insists on calling them “consumption and treatment services,” and is making treatment options other than supervised injection a condition for continuing funding.

“It will also feature an enhanced and necessary focus on connecting people who use drugs to primary care, treatment and rehabilitation, and other health and social services,” Chazan said in an email.

Chazan said the government is currently reviewing funding applications, but did not say when funding decision will be made.

Both Muckle and Hendriks said they’ve been meeting regularly with provincial officials, and believe their organizations can fulfil the new requirements.

“We’re hopeful at this point in time that the ministry will continue to fund,” Hendriks said.

“I haven’t seen any signs at this point in time that they won’t be providing ongoing funding for us. We know that it’s a service that is making a difference in our community.”