Lethbridge braces for closure of Canada's busiest supervised consumption site

Arvin White Cow is taking a break at one of the picnic tables in Galt park in downtown Lethbridge.

The area is busy with young families enjoying a nearby spray park, there are some people lying on the grass basking in the late summer sun. There are people sleeping under trees and some small groups are hunkered down with what looks like all of their belongings packed in shopping carts, baby strollers and overstuffed bags. There are also a number of people who appear to be intoxicated by either drugs or alcohol. 

White Cow is recovering from a recent fall at a downtown construction site that left him with a broken foot. He says it's been a difficult summer for him and others who are addicted to drugs and alcohol.

He's worried about the impending closure of the city's only brick-and-mortar supervised drug consumption site, run by the non-profit group ARCHES.

The site, the busiest in Canada, has been controversial since it opened in early 2018.

Downtown business owners are applauding the government's decision to stop funding the facility, while public health experts and researchers predict more people will die if they can't access a safe, medically supervised site to consume their drugs.

White Cow says he is an alcoholic and that he has never set foot in ARCHES, but he knows a lot of people who have and he fears for their safety once the site closes for good today.  

"You have people out here who are dying, literally, they're dying," he said. 

White Cow says he knows of four people who have died of drug overdoses in the past month and he predicts the situation will become even more dire because the mobile consumption site that will replace ARCHES will not be able to meet the demand from people who need a supervised place to inject drugs, the majority of which include opioids such as fentanyl and heroin, but also crystal methamphetamine, a non-opioid stimulant. 

ARCHES, which had 13 injections booths and two inhalation rooms, saw an average of about 500 visits per day. The new mobile truck will have two booths and an area to monitor people for signs of an overdose.

"Not everyone is going to go to that shelter and make it to that little trailer," said White Cow, referring to Alberta Health Services' new mobile service. Last week it was parked outside Alpha House, the city's only homeless shelter. 

The provincial government pulled funding for ARCHES after a financial audit found evidence of mismanagement and misuse of government funding.  No one from ARCHES responded to multiple interview requests for this story.

The closure of the supervised injection site is being celebrated and criticized, exposing yet again the deep divisions that were created in Lethbridge when the site opened 2½ years ago.

'A real risk that we'll see more people die'

Public health experts who specialize in at-risk groups say the closure of the site doesn't mean that people will stop using drugs, instead the behaviour will continue in an unsafe and potentially deadly way. 

"There's a real risk that we'll see more people die," said Elaine Hyshka, an assistant professor at the School of Public Health at the University of Alberta.

"That just really opens up the increased risk of them getting into trouble, potentially having an overdose and there not being anybody there to provide emergency medical care," she said.

Hyshka says along with a safe and supervised place to use drugs, people will lose access to a number of services that were provided by ARCHES, including treatments and medications for opioid addictions, counselling and peer support. The organization also ran a community needle pick-up service. 

"We need more support, not less support in Lethbridge," Hyshka said.

The province said the south health zone, which includes Lethbridge, had the highest per capita number of accidental drug poisoning deaths related to fentanyl during the first three months of 2020. The rate was 14.1 per 100,000 people. The rate in Calgary was 11.4.  

Between January and March of this year, 142 people died from an apparent accidental opioid overdose in Alberta.

Researchers and academics, including Hyshka, are calling on the province to release updated opioid statistics which could provide insight into how the COVID-19 pandemic has impacted the overdose crisis.

B.C. and Ontario have reported a spike in overdose deaths during the pandemic, one of the factors is believed to be an increase in toxicity of street drugs. Hyshka says it's very likely the same trend is happening across Alberta, including Lethbridge.

"We're getting reports from across the country and epidemiology from across the country that show that deaths and EMS calls, ambulance calls for overdoses are up everywhere," she said.

• B.C. marks 3rd straight month with more than 170 overdose deaths

Hyshka is calling on the government to release updated overdose data to get a better idea of what's happening. The most recent data released publicly in Alberta covered the first three months of 2020. B.C. just released statistics to the end of July.

"We really are operating in a total information vacuum."

She credits the government for releasing a lot of data that covers ambulance calls, impacted neighbourhoods in Calgary and Edmonton, but the information needs to be released in a more timely manner.

A spokesperson for the associate minister of mental health and addiction expects the second quarter report sometime in September.

'Unintended consequences'

Em Pijl is an associate professor at the University of Lethbridge's Faculty of Health Sciences. She led a study exploring the perceptions and observations by business owners and managers of social disorder in downtown Lethbridge after ARCHES opened the facility in 2018.

"While the public in general understands the merits of harm reduction services, there remains the question of unintended consequences of these services," read the report which was completed for Lethbridge city council in January. 

The findings revealed a 100-metre zone around the consumption site had the sharpest increase in some antisocial behaviours and the sharpest increase in discarded needles. Increases in antisocial behaviours were also observed in the southwest downtown zone. Pijl notes that not all antisocial behaviours were associated with the supervised consumption site.

Pijl said the findings differ from previous studies which did not find any negative neighbourhood impacts caused by supervised consumption sites, but she cautions those studies involved consumption sites in much larger urban centres and suggested the smaller, "Lethbridge context" must be considered. 

She says ARCHES enjoyed many successes, including reversing overdoses and connecting people with health and social support services, but there were drawbacks. 

"When there is social disorder new to an area, some people aren't going to like that," she said.

"The question as a community is 'are we okay with those drawbacks?' And I think that's where our city continually seems to be a sticking point."

Pijl doesn't think the mobile service will be able to meet the demand or the same level of service and she echoes the same dark prediction made by others.

"I think we're going to see overdose deaths go up and I think we're going to see a lot of people using in public. I don't think that's what Lethbridge wants," she said.

Downtown business on edge

The long-serving executive director of the downtown Lethbridge business revitalization zone fears there could be more open, public drug use and a real or perceived impact on public safety once ARCHES closes.

Ted Stilson said a number of encampments have sprung up in Galt Gardens park where he says 10 to 12 people are now living. He says the COVID-19 pandemic forced the cancellation of a number of community events in the park and thus created an opportunity for some people to move in. 

Stilson said it depends on how many people can be helped through the mobile consumption vehicle.

His hope is that the city can get back to where it was before it became home to the country's most used drug consumption site.

Stilson believes the consumption site attracted a number of people addicted to drugs — and dealers — to Lethbridge and many downtown business owners continue to deal with the fallout.

"I don't think we ever wanted the supervised consumption site," he said. 

Stilson says in hindsight he wishes the community would have fought harder to oppose it because the Lethbridge wasn't able to provide other services for people with addictions, including treatment and supportive housing.

He says the site has been devastating for many downtown business owners who've been dealing with panhandling, loitering, shoplifting, needle use and the proliferation of drug paraphernalia. 

Bracing for fallout

One of the organizations that helps vulnerable people in the community is the Diversion Outreach Team, which is run by the Canadian Mental Health Association. DOT, as it's known, is preparing for the transition to a mobile consumption site but the impact is already being noticed. There have been more calls about needle debris and people loitering at school sites.

There's a call for social agencies in Lethbridge to work together to help people who will be impacted by the demise of ARCHES.

"I think for the individuals going through it, it's going to be scary, it's going to be nerve-wracking," said David Gabert.

"Our community really needs to have a good sense of empathy towards them and towards each other as we all go through this." he said.

Bryan Labby is an enterprise reporter with CBC Calgary. If you have a good story idea or tip, you can reach him at [email protected] or on Twitter at @CBCBryan.