In the midst of tomorrow’s opening of Ottawa Public Health’s (OPH’s) interim Clarence Street supervised injection site, and after taking lengthy consideration of what our guests have told us, it is clear that our work is not over.
Overdose Prevention Ottawa (OPO), will continue to serve its guests and deliver its unique model of care as OPH opens its doors. The temporary site on Clarence Street is a much needed step in the right direction. We have consulted with our guests since OPH’s announcement weeks ago and a significant number of them have expressed reluctance to access this service. We have established too much trust and respect with these members of our community to refuse them services and will remain accessible to those most at risk of death.
We look forward to continue working closely with OPH staff to address expressed issues of inaccessibility and hope that the lessons we have learnt from operating Ottawa’s only overdose prevention site, as well as our combined decades of front-line experience, are applied in their practice.
The guiding principle of any effective harm reduction strategy or service must be centred on the experience and wisdom of current and former drug users. For that reason, we expect that OPH will take up the recommendations of their 2014 Harm Reduction Needs Report, specifically the need to “meaningfully engage peers/people with drug using experience in the planning, development, delivery, and evaluation of harm reduction programs and services” (p. 19).
As a meaningfully peer-centered service, OPO’s space allows guests to: use as they normally would, split their drugs, assist each other with safer consumption, walk around while they wait for a space to open up in the tents, stay in the tents for as long as it takes for them to feel safe, have some nutritious food, be around supportive peers while they are on site, move from an inhalation space to an injection space as many of our guests do, inject multiple times in one sitting, experience human dignity and care, and learn from people with lived experienced who volunteer.
The safety and accessibility of all people who use drugs in our community, including those who are currently barred from surrounding services, is at the centre of what we do. OPO’s protocols are evidence-informed, and our standards and processes are guided by National harm-reduction best practices.
Through our work, we have learnt and demonstrated how to deliver overdose prevention services in a profoundly effective way, preventing overdoses in a multiplicity of ways. It is this unique combination of factors that foster our service to be preventative and not simply reactive. For example, harm reduction partner agencies and frontline workers who operate and work with people just two blocks away from our site report extremely high rates of overdoses combined with emergency interventions. In spite of an identical drug supply, and those very same people using at OPO during our hours of operation, we have been able to mitigate the need to intervene with emergency overdose responses. This is a direct result of creating an environment that fosters dignity and comfort where guests determine when they are safe, where the pressures to consume quickly are eliminated, combined with careful monitoring and stimulation by highly trained and experienced volunteers. Each of these elements of our service allows us to mitigate the potentiality for overdoses, or what would normally be emergency overdose interventions.
In contrast, there are several concerning policies directing OPH’s practice. For example, a “one injection per person per visit within 20 minutes” policy is of deep concern. This policy is an overdose risk, not a means of prevention. A policy refusing assisted injection is also problematic. An environment forbidding the option of inhaling drugs is also problematic. Minimal involvement of people who use drugs in service delivery is alarming and problematic.
OPO has been open and hosting guests from 6-9pm at 307 St. Patrick Street since August 25th, 2017. In that time, we have had 1,020 total visits. The need for low barrier accessible services and to the benefits of this evidence-informed model of care is evident.
OPO will remain committed to our guests, and continue to deliver uninterrupted service. If and when an accessible supervised consumption service becomes available and is accessed by those we serve, we will certainly plan to move our services to the next neighbourhood and respond to those currently grieving overdose losses and facing tragic preventable overdose deaths.
OPO would like to express deep gratitude and thanks for all the support we’ve received including daily onsite donations, supportive words from people passing by, and a group of over one hundred dedicated individuals who volunteer with us, thank you for sustaining and supporting our life-saving service.