LETHBRIDGE - What would happen if ARCHES closed tomorrow? If they didn't give out one single clean needle or pipe again?
"530 people in this community would be using in public parks up to 10 times a day; in public washrooms, in back alleys, in church parking lots. In any nook, corner or cranny they could find," says Executive Director Stacey Bourque.
ARCHES, the harm-reduction agency that's been operating in Lethbridge since 1986, has a mandate to respond to, and reduce harm associated with HIV, Hepatitis C and to help/offer a variety of services to those who are addicted to illicit drugs and alcohol. They range from counselling to housing, medical care, nutrition, indigenous cultural services, and helping addicts access detox and rehab services.
The new supervised consumption site operated by ARCHES opened its doors in late February; it has had more than 15,000 visits in three months, averages about 500 users per day, and is open 24 hours a day, seven days a week.
Initially, it was thought that the site would be used several hundred times a week.
But it is being used so much and so often, the staff there now number more than 100, with many working 12-hour shifts.
There are plans in the works to expand the site's services not only within the building, but to other areas of Lethbridge as well.
Bourque understands that many people don't agree with their harm-reduction strategies, but she also points out that without their services, while rates of Hepatitis C are increasing, they would skyrocket otherwise, along with HIV infections, and antibiotic resistant staphylococcus and streptococcus infections.
And if a worst-case scenario were to occur, if there were no services for addicts and users, she says there could be casualties that would affect users, their families and the community at large.
"The option of not doing anything is that the uses that are currently occurring inside the building are flowing back out into the community, and we start watching more and more people injecting publicly. Even more than what is occurring with the site being open now. We start stepping over dead bodies in the street from people who are dying of overdoses in our community. And so instead of needles, our children are finding dead bodies in parks."
Bourque and AHS say healthcare costs then go up as well. It costs $60,000 per person to treat Hepatitis C, while the cost of treating someone with HIV during their lifetime is about $1.2 million.
The cost of a syringe is 11 cents.
"When we add up the cost for someone to access health care services. Five percent of the population consumes 95 per cent of health care services. And most of them are vulnerable populations; chronic mental health issues, chronic substance abuse issues that we serve. So, by alleviating some of those, we're saving tax dollars and we're diverting them to a more efficient and effective way."
She says despite enforcement efforts, despite abstinence-based treatment efforts, despite trying to force people into treatment or jail, they're ineffective ways on their own of trying to address the crisis.
And Bourque too, is frustrated with the lack of follow-up services in the community.
"Nobody more than us sees the frustration in the population that we're serving, and the desperation that they have to access help. And our staff are there. Those wrap-around staff services are meant to move people along the spectrum and get them the help that they desire...when there's nowhere to move them to, we just continue to cycle back into the system over and over again. And the staff continue to crisis manage...eventually people just give up.... they stop caring or thinking it's possible for them and that their life isn't worth enough to save."
For those who believe that ARCHES is enabling drug use, Bourque has this to say:
"ARCHES doesn't believe in drug use. We do believe though, that there's a subset of the population that's going to use drugs regardless. People are going to choose to use drugs no different than people choose to speed, or swim without a life jacket or choose to eat hamburgers or smoke cigarettes. People don't always make good decisions...our job is to reduce harm in a population of people who engage in high-risk behaviour and activity. There isn't a way to stop this population... you take something away, and they will find a way to MacGyver something else up or sidestep a process."
That said, Bourque does see the crisis getting worse. Why? Because drugs are cheap. Cheaper than alcohol, cheaper than just about anything an addict can get otherwise. And cheap to make and import or distribute by organized crime.
20 or 30 years ago when someone bought marijuana or what were known as "gateway" drugs, that's generally what they got.
Now, according to AHS, street level pot and other drugs that kids, teenagers and others routinely experiment with, can be laced with fentanyl or worse; almost instantly addicting many who try them even for the very first time. Other times they just take whatever prescription pills their families have on hand, put them in a bowl and simply pick out several to see what might happen. They're called "salad bowl parties." They get high, and want or need more. Enter the illicit drug market.
It's a crisis that is hitting every race, every demographic and doesn't care whether you come from a poor family or a rich one.
There are no quick fixes Bourque says, but they are doing the best they can under the circumstances.
"Someone needs to step outside the box and start looking at new ways of addressing some of these crises. And we don't have to re-create the wheel. We can look to other countries who have implemented a lot of these programs over the years and have been operating for well over 30 years and have made significant and positive changes."
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