Addictions specialist says stigma an obstacle to health care for drug users in Sudbury

Harm reduction advocates in Greater Sudbury say many people are blinded by stigma when it comes to the benefit of a potential supervised drug consumption site.

Public Health Sudbury and Districts is conducting a feasibility study on the potential of a site where people can be monitored while they inject drugs.

The ideas is that clean needles and other paraphernalia would be provided to users.

If someone overdoses, or becomes sick, trained staff would be on hand to administer naloxone or other remedies. 

Drug users could also receive information about treatment and recovery.

Pop-up drug consumption site not sanctioned

While the study is in progress and not expected to be complete until next spring, an unsanctioned pop-up drug consumption site has been operating in Sudbury, staffed by volunteers who are committed to what they see as a life-saving endeavor.

Karla Gharty is one of the organizers.

It operates for a few hours on Fridays in different locations near where drug users gather.

This week, she describes the contents of the folding table set up under a tent canopy in a littered corner of a crumbling, abandoned concrete parking structure.

"We have clean ties. We have alcohol swabs. We have matches. We have vitamin C in order to break down the drugs. And then we have also for people who use drugs other than injecting, we have clean pipes both for crack and meth. We have clean straws for snorting.."

A few people wander in and warily check out the scene.

One of the regulars is Bill. We are not naming him for his own safety.

He helps clean up the garbage around the site before sitting down.

Bill is 50 years old and originally from South Porcupine. He says he dropped out of school after having trouble learning and being bullied.

He says he's been using drugs for 20 years, injecting for 15.

Bill says he uses the site in part because it saves lives, although he's not necessarily thinking of himself, at first. 

He refers to the contaminated syringes and other detritus from drug use that is now commonly found in many areas of the city including playgrounds. He worries about kids getting infected.

"Needles and cookers, and blood and alcohol swab, and that you know for a child who doesn't know what that is," he says. " You know it could be anything with the people running around here with HIV and Hepatitis C and stuff, and that, you know, could be a matter of seconds to give."

The drug paraphernalia at the pop-up site is collected and disposed of.

As for Bill himself, he feels better using in the company of someone who can monitor his vital signs in case the drugs that he has purchased turns out to be contaminated or more potent than he bargained for.

The unsanctioned site has come up against opposition from people living near where it was operating at different times.

There is a public perception that the site attracts crime and drug trafficking and unsavoury characters.

Inspector John Valtonen is with the Greater Sudbury Police Service which is also a partner in the Community Drug Strategy.

He says police are concerned with everyone's safety, and has even checked to make sure the volunteers running the site are qualified and not in danger. 

The focus, he says, is on cracking down on the drug traffickers, not users, and police are key to educating the public about stigma.

Still, the idea that drug users should be provided care and protected from diseases and spreading disease to others is still hard for some to accept. 

A passer-by, Sylvain Villemarie, says he was a drug user once himself, although not intravenous.

"I don't think it's a great idea. Just for the plain and simple fact that it (drugs) should be eliminated from the city. A safe injection site is more enabling people to do it," he says.

Dr. David Marsh is an addictions specialist and senior investigator with the Public Health Sudbury and Districts feasibility study on the supervised consumption site. He is also a Professor at the Northern Ontario School of Medicine.

He was also the medical director for a supervised drug consumption site in Vancouver for seven years and is in favour of having one in Sudbury.

"First of all they clearly save lives. People who inject drugs don't necessarily know the purity or the content of the drugs they're injecting and they may have overdoses and not infrequently they can die of those overdoses," he says.

"But more than that supervised consumption sites engage people in relationships that can lead to referral to the health care system. They can decrease the rate of infections in the local skin or deep tissue infections in the heart or bones that are very costly for the health care system."

As for the feasibility study that is ongoing, Dr. Marsh says he sees the process as a way for the community to come around to the philosophy of harm reduction.

"Stigma is definitely a major problem for people who use drugs regularly. It prevents them from getting health care and prevents them from getting treatment."

Roxane Zuck is the CEO of Monarch Recovery Services. She points out that if a drug user dies of overdose, so too does any chance that they will recover.

 "We want to let people know that this isn't about providing individuals with drugs. It's not about making it easier for them to use. It is about keeping them alive so that they could have increased access to addiction treatment and counselling and that they could live another day to make some better choices."

The feasibility study is looking at whether people would use a supervised consumption site, funding, where it might be located and what form it would take. It is due out in the spring of 2020.