15 months and counting: behind the doors of Lethbridge’s Supervised Consumption Site

Statistics

Operating since Feb. 28, 2018, Lethbridge’s SCS is not only the busiest in Canada, but the busiest in North America according to Bourque. The site has on average, 673 visits per day, 21,000 uses per month, and 50 unique users added each month to the total of about 1,300 already using the site.

“Unfortunately, mid-sized Canadian cities – so those with populations between 50,000-99,999 are being most heavily affected by the opioid crisis and opioid poisonings in general, whether it be emergency room visits or hospitalizations,” she explains.

180 health care professionals and other staff now work at the facility. To the end of April 2019, the site has had 208,292 visits – far surpassing anything anyone ever expected. On average, there can be anywhere from five to 15 or more overdoses in a day. So far, more than 2,000 overdoses have been reversed.

Nursing Clinic for Clients inside the SCS

In the first year of operation, staff also provided more than 38,000 services over and above supervised consumption, including counselling services, crisis intervention, nurses’ services for wound care, STI treatment, and foot care. There were also more than 8,000 referrals to detox and residential treatment, opioid agonist treatment, primary care referrals to physicians, mental health professionals and specialist referrals.

“Nothing is without challenges,” explains Bourque. “We’re still trying to work through some of the issues and barriers. But I do think that things are going really well. We have a high uptake in participation in programming. Not just in supervised consumption, but in the 16 other programs that we have here as well.”

SCS Programs

What many people may not know about, says Bourque, are the number of programs offered to addicts and those living on the street.

There’s the Indigenous Recovery Coaching program for adults starting or re-starting methadone or suboxone treatment. It’s delivered for indigenous people and administered by indigenous people. It includes wrap-around services to try and help them maintain recovery.

The I’taamohkanoohsin program is one where participants reduce the amount of substances they use, while re-connecting with their cultural identity. It can include singing and drumming, sweats, smudging, cooking, day trips to sacred sites in southern Alberta and other activities.

Tipis made by clients

Others can participate in cooking classes, arts and crafts, music/rap, justice programming, meaningful daily activities- which include trips to the local humane society, aesthetic classes, bingo, movies, crocheting and art therapy.

There are also an array of medical services including a nursing clinic for STI testing and treatment, basic pregnancy care and monitoring, immunizations, foot and vein care and the Virtual Opioid Agonist Therapy program, which makes treatment available on-site through tele-health and conference calling with a physician.

And there are plenty of success stories to share as well, she says. From the those who are gradually lowering their intake of illicit drugs, to those who haven’t been to jail in more than a year, to those who are now showcasing their talents making music or original artwork.

And there are many who have come through addiction to now live an abstinent lifestyle.

“I bet you we employ, I want to say, between 30 and 40 individuals that we served at the height of their substance use that are employed full-time here in various positions. And if I lined them up, I guarantee you or anyone else that you would never be able to pick them out of the group of staff.”

Community Concerns

One of the issues that has arisen not only during meetings with city officials, business owners, on social media and among members of the public is the concern that once addicts use at the SCS, they can only stay at the site for a short period of time if it’s busy. For those who have not overdosed but are high, they must leave the facility with nowhere to go. It’s then (and at other times), that serious concerns arise not only about theft from vehicles or businesses, public intoxication, loitering, vandalism, mischief and other issues.

“We are one organization that’s trying to do our part in supporting and addressing both the safety of people who use drugs, and the community as a whole. And we keep them here as long as we can. We’re continuously trying to introduce new programming, meaningful daily activity – different things that are going to engage those people who use drugs and keep them here…. we do that as much as we can. Because of the volume of people, we do have to have time limits to keep the flow moving. The bottom line is, we don’t have many places in the city for people to go who are homeless.”

Activity Wall at the SCS

Lethbridge currently does not have a drop-in centre for those who live on the street to go to, nor is there any permanent supportive housing yet – although funding was announced in Dec. 2018 that would see a supportive housing complex built near the city’s shelter that would provide housing for 42 people who have complex issues such as substance use and an intox facility for up to 30 people.

“We have nothing here to catch these people,” she says.

Twice monthly meetings with local businesses are also ongoing to help mitigate issues, while a team of security officers patrols the area surrounding the SCS.

“If you look at crime statistics from 2013 to 2017, there was a huge jump in those five years…as we watched the drug crisis grow in our community, and homelessness grow. And we weren’t here in 2017, so that trend of increasing crime has been increasing over the last five or six years in our city at a substantial rate. I think that’s one thing to be mindful of.

“The other piece is that whether we are here or not, the issue is here. Homelessness is growing. The drug crisis is growing and then in conjunction with that, crime is going to continue to grow whether we’re here or not. The service was erected to address a problem. We didn’t erect the service and create a problem.”

There are also now partnerships between the SCS and the Downtown BRZ Clean Sweep program, the new Ambassador Watch program is also patrolling the area, and COAP – or Community Outreach Addictions Program helps to clean up encampments in the immediate area around the SCS, pick up needles and garbage and help mitigate nuisance, disturbance, and public drug use calls.

Future of the SCS

“This issue is far too large now, to just go back underneath a bridge,” cautions Bourque.

Premier Jason Kenney has said in the past that he is not a fan of supervised consumption sites, but rather more law enforcement, mental health and addictions prevention and treatment strategies. He has also indicated that future sites will face stricter approval processes including extensive community consultations and potential economic impact to local businesses.

While the SCS has a federal mandate to operate, it is heavily funded by the provincial government. So, what happens if there are fewer dollars provided in the future?

“I would hope that you know, our new government sees that although there are secondary outcomes and unintended consequences – because nothing is without consequence, we would be silly to think that this is perfect – but that despite the secondary outcomes, we can mitigate some of those… we can implement strategies in the community at very low cost, compared to what it costs every time the police come have to get called out for something or EMS gets called out because somebody is doing a funny dance in front of somebody else’s doorway.”

And at the end of the day, Bourque says the site is fulfilling its mandate.

“It’s doing exactly what we said it would do. And I know it’s not perfect. I know people don’t like that it’s here. Nobody likes it. It has to be here. The reason it’s here is because people are dying and that we have a major crisis on our hands.

“Wouldn’t it be nice five years from now to not need something like this? But the reality is it’s always going be that a subset of the population that uses drugs, no matter how much we do, how much we care…We heavily advocate, and we heavily support all of the other pillars (of harm reduction). Whether it’s enforcement, treatment or prevention.”

by Lara Fominoff

15 months and counting: behind the doors of Lethbridge’s Supervised Consumption Site

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