Latest news with #harmReduction
Yahoo
2 days ago
- Health
- Yahoo
Opinion: Closing Alberta harm-reduction hubs is going backwards
In 2018, a middle-aged man arrived on my patient panel. I will call him Jon. Jon was being treated in our clinic for hepatitis C but did not yet have his own family physician. When I met with him for our first visit, he told me the story of how he had contracted, years prior while incarcerated, this chronic viral infection of the liver. Supplies for tattoos and drug use were contraband at the time, so he and other inmates had shared needles and syringes. By the mid-1990s, studies were advancing our understanding of harm reduction. Based on growing scientific evidence, Canada began to implement programs that were known then as needle exchanges and have since evolved into low-barrier, wraparound services. Many today think of harm reduction as being about drug use only — supervised consumption sites for example. But harm reduction is nothing new. It was historically integral to the HIV/AIDS movement of the late 1980s and early '90s, when communities of men who have sex with men and people who use drugs (PWUD) demanded access to care that helped them reduce their risk of disease transmission. It worked. Today's modern care includes a whole spectrum of public health interventions that sharply decrease the risk of sexually transmitted and blood-borne infections (STBBI). These include things as simple as access to condoms or new syringes. The gold standard is to provide these on demand. Anything less, like having to exchange your used syringe for a new one, increases infections. In Alberta, harm-reduction services are often co-located with primary health care, including pregnancy and wound care as well as treatment for substance use and other mental health disorders. These centres are resource hubs for people who find themselves in the most painful of life's trying moments. Red Deer's Turning Point Society, founded in 1988 in response to the HIV/AIDS epidemic, is the only resource of this kind in all of central Alberta. This week, it was announced that all provincial funding for Turning Point will be discontinued on Nov. 1. What will closures like this mean for Albertans? Without access to wraparound services that include best harm-reduction practices, blood-borne and sexually transmitted infections including hepatitis, HIV, gonorrhea, chlamydia and syphilis will rise. Hospital use and costs will also increase due to more skin, organ and bone infections, more ICU stays, and even amputations. The cost of infections like these is a high price to pay compared to a harm-reduction kit that costs around a dollar. There is a common conception that the neighbourhoods around resource hubs such as Turning Point are more likely to have many discarded needles and syringes or that they are 'honeypots' for drug dealers. Studies have shown these not to occur. In fact, the hubs' cleanup and outreach crews often ensure that the area is more tidy and safer than they would be otherwise. My patient Jon came a long way since I first met him in 2018. He was eventually cured of his hepatitis C. He continued to use injection drugs and was careful to never share equipment — he knew the risks. He relied on our centre — one of Calgary's resource hubs — not only for his drug use supplies but also for getting tested regularly for STBBIs, screened for chronic diseases as he aged, and mental health supports. We have all, in fact, come a long way since the days before harm reduction. Watching, from Calgary, the defunding of central Alberta's resource hub, I fear for other similar centres — places like Alpha House in Calgary and George Spady in Edmonton. What is to become of the places that have always, as the evidence guides, provided low-barrier, wraparound care? That are doing what studies show is safest, healthiest, and most cost-effective. They have not only their clients' and patients' best interests in mind, but also the public's. By shuttering low-barrier and harm-reduction services, we are going backwards, not forwards. As citizens, we must object to the UCP's misguided and regressive restructuring and fight for places like Turning Point, Alpha House, and George Spady. History and science have shown that these are the places doing the work that helps us all. Dr. Bonnie Larson is a clinical assistant professor of family medicine at the University of Calgary. Letters welcome We invite you to write letters to the editor. A maximum of 150 words is preferred. Letters must carry a first and last name, or two initials and a last name, and include an address and daytime telephone number. All letters are subject to editing. We don't publish letters addressed to others or sent to other publications. 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Yahoo
15-06-2025
- Health
- Yahoo
Despite 'massive shift' towards smoking over injection, Ontario has only 1 supervised drug inhalation space
Advocates and researchers say Ontario is far behind when it comes to protecting the growing number of drug users in the province who are choosing to inhale opioids rather than inject them. "We know what we need to help support people who smoke their drugs — and we've been really, really behind the curve on it," said Gillian Kolla, an assistant professor of medicine at Memorial University, who studies drug use across Canada. Data shared with CBC Toronto last week from the Ontario Office of the Chief Coroner shows that in 2024, just four per cent of deadly opioid overdoses are thought to have been caused by injection alone — down from 20 per cent in 2018. That's the opposite trajectory of the statistics for inhalation alone, which are thought to be responsible for 40 per cent of last year's fatal overdoses — up from 18 per cent in 2018. Though Kolla cautioned that the coroner's data has some uncertainty baked in, since about half of overdose fatalities are listed as having no evidence at all as to what consumption method was used, she said the growing move toward inhalation has been a clear trend in Canada for years. Opioid toxicity deaths in Ontario where inhalation was the only mode of usenearly doubled between 2017 and 2021, according to a study carried out by Kolla and academic colleagues. "We have multiple sources of data that are telling us about this," she told CBC Toronto. "We can see it when we talk to harm reduction programs which distribute equipment to people who use drugs," Kolla said. "And when we talk to people who use drugs about how their use is changing, they are also talking about how they have been moving more towards smoking." The growing need for safer ways to inhale drugs has long been obvious to Joanne Simons, Casey House CEO. Her specialty Toronto hospital, which serves people who have HIV or are at risk of it, runs the province's only supervised inhalation booth, installed in 2021. "It's a very simple setup," Simons said of the small room. "There isn't anything super technical about it other than a very powerful fan that is venting any of the smoke outside of the building." She said the hospital decided to open the booth in the first place because clientele were requesting it, and that since then, about 80 per cent of the people who arrive to use supervised consumption services at Casey House are choosing to inhale over inject. "We're thinking about doing a second one because the need is so great," said Simons, describing the move toward smoking as a "massive shift." Ontario's 2019 consumption and treatment services plan, which approved 15 supervised consumption sites in the province, did not include funding for inhalation booths. At a price tag that Simons estimates around $50,000, that means only supervised consumption services that can solicit private funding and donations — like Casey House — can foot the bill to build one. "Since we've installed it, we have had consistent interest from [other health centres] across the country, in terms of what it does," said Simons. "I think the barrier to entry actually is the funds." The government "does not and will never support the use of illicit drugs in public spaces," said a spokesperson for Ontario Health Minister Sylvia Jones in a statement. "Our focus is on connecting people struggling with addictions challenges to treatment and recovery, not giving them the tools to use toxic, illegal drugs," Ema Popovic said via email. A couple of kilometres south of Casey House, at the MAP Centre for Urban Health Solutions in St. Michael's Hospital in downtown Toronto, Dr. Ahmed Bayoumi has been examining the health implications of the shift towards inhalation. The researchers and advocates that spoke to CBC Toronto for this story all said that part of what's been driving changing habits is the belief among people who use drugs that it's safer. So, is it? When it comes to the risks posed by needles specifically, Bayoumi says inhalation would "clearly be safer" since it dodges the possibility of infection via dirty equipment. The risk of overdose may also be lower, he said. "There is some evidence that … the rate at which the drugs accumulate in the blood is slower with smoking than it is with injecting, which allows people to control the amount of drug that they're taking in more precisely," said Bayoumi. Calls to fund safe inhalation sites have been ongoing since Liberal Kathleen Wynne was premier in the mid 2010s, said Zoë Dodd, co-organizer of the Toronto Overdose Prevention Society. Dodd said her organization set up a supervised inhalation tent in Moss Park in 2017, where they operated unsanctioned for a year. Eventually, they moved indoors and had to give up the tent. "We saw thousands of people through that service. And we reversed many, many overdoses within that tent itself," she said, adding that now, she and other harm reduction workers have to run outside when they're alerted to an inhalation overdose. This spring, Doug Ford's government closed nine supervised drug consumption sites and transitioned them into HART Hubs, their new concept for treating addiction and homelessness. The province invested over $500 million to build 28 HART Hubs across the province, according to the health minister's spokesperson. "HART Hubs will reflect regional priorities, providing community-based, life-saving services including mental health and addiction care, primary care, social and employment services," Popovic said. Data from the coroner shows more than 2,200 Ontarians died from opioids in 2024 – a slight dip from the last few years – and more than triple the deaths from a decade ago.
CBC
15-06-2025
- Health
- CBC
Despite 'massive shift' towards smoking over injection, Ontario has only 1 supervised drug inhalation space
Advocates and researchers say Ontario is far behind when it comes to protecting the growing number of drug users in the province who are choosing to inhale opioids rather than inject them. "We know what we need to help support people who smoke their drugs — and we've been really, really behind the curve on it," said Gillian Kolla, an assistant professor of medicine at Memorial University, who studies drug use across Canada. Data shared with CBC Toronto last week from the Ontario Office of the Chief Coroner shows that in 2024, just four per cent of deadly opioid overdoses are thought to have been caused by injection alone — down from 20 per cent in 2018. That's the opposite trajectory of the statistics for inhalation alone, which are thought to be responsible for 40 per cent of last year's fatal overdoses — up from 18 per cent in 2018. Though Kolla cautioned that the coroner's data has some uncertainty baked in, since about half of overdose fatalities are listed as having no evidence at all as to what consumption method was used, she said the growing move toward inhalation has been a clear trend in Canada for years. Opioid toxicity deaths in Ontario where inhalation was the only mode of use nearly doubled between 2017 and 2021, according to a study carried out by Kolla and academic colleagues. "We have multiple sources of data that are telling us about this," she told CBC Toronto. "We can see it when we talk to harm reduction programs which distribute equipment to people who use drugs," Kolla said. "And when we talk to people who use drugs about how their use is changing, they are also talking about how they have been moving more towards smoking." Ontario's only supervised inhalation booth The growing need for safer ways to inhale drugs has long been obvious to Joanne Simons, Casey House CEO. Her specialty Toronto hospital, which serves people who have HIV or are at risk of it, runs the province's only supervised inhalation booth, installed in 2021. "It's a very simple setup," Simons said of the small room. "There isn't anything super technical about it other than a very powerful fan that is venting any of the smoke outside of the building." She said the hospital decided to open the booth in the first place because clientele were requesting it, and that since then, about 80 per cent of the people who arrive to use supervised consumption services at Casey House are choosing to inhale over inject. "We're thinking about doing a second one because the need is so great," said Simons, describing the move toward smoking as a "massive shift." Ontario's 2019 consumption and treatment services plan, which approved 15 supervised consumption sites in the province, did not include funding for inhalation booths. At a price tag that Simons estimates around $50,000, that means only supervised consumption services that can solicit private funding and donations — like Casey House — can foot the bill to build one. "Since we've installed it, we have had consistent interest from [other health centres] across the country, in terms of what it does," said Simons. "I think the barrier to entry actually is the funds." The government "does not and will never support the use of illicit drugs in public spaces," said a spokesperson for Ontario Health Minister Sylvia Jones in a statement. "Our focus is on connecting people struggling with addictions challenges to treatment and recovery, not giving them the tools to use toxic, illegal drugs," Ema Popovic said via email. The safety question A couple of kilometres south of Casey House, at the MAP Centre for Urban Health Solutions in St. Michael's Hospital in downtown Toronto, Dr. Ahmed Bayoumi has been examining the health implications of the shift towards inhalation. The researchers and advocates that spoke to CBC Toronto for this story all said that part of what's been driving changing habits is the belief among people who use drugs that it's safer. So, is it? When it comes to the risks posed by needles specifically, Bayoumi says inhalation would "clearly be safer" since it dodges the possibility of infection via dirty equipment. The risk of overdose may also be lower, he said. "There is some evidence that … the rate at which the drugs accumulate in the blood is slower with smoking than it is with injecting, which allows people to control the amount of drug that they're taking in more precisely," said Bayoumi. Shifting provincial policy Calls to fund safe inhalation sites have been ongoing since Liberal Kathleen Wynne was premier in the mid 2010s, said Zo ë Dodd, co-organizer of the Toronto Overdose Prevention Society. Dodd said her organization set up a supervised inhalation tent in Moss Park in 2017, where they operated unsanctioned for a year. Eventually, they moved indoors and had to give up the tent. "We saw thousands of people through that service. And we reversed many, many overdoses within that tent itself," she said, adding that now, she and other harm reduction workers have to run outside when they're alerted to an inhalation overdose. This spring, Doug Ford's government closed nine supervised drug consumption sites and transitioned them into HART Hubs, their new concept for treating addiction and homelessness. The province invested over $500 million to build 28 HART Hubs across the province, according to the health minister's spokesperson. "HART Hubs will reflect regional priorities, providing community-based, life-saving services including mental health and addiction care, primary care, social and employment services," Popovic said.
CTV News
13-06-2025
- Health
- CTV News
Changes coming to Waterloo Region's approach to drug strategy
Changes are coming to how the Region of Waterloo handles its approach to illicit drugs. The Waterloo Region Integrated Drug Strategy (WRIDS) has focused on substance abuse harm reduction for more than a decade, but now their funding stream from the region is drying up. 'Public health has funded, for many years, resources to the WRIDS in the form of funding to support an administrative role that would support the steering committee and the actions of the working groups,' said Rhonda Nicholls, director of strategy, performance and partnerships for Region of Waterloo Public Health. Now, that funding will no longer be available at the end of this year. 'After that, public health staff and other system partners will continue all the impactful work that has really started to take shape over the last number of years,' Nicholls said. She explained the funding that supported WRIDS will instead be directed to other community organizations also focused on tackling substance abuse issues. In light of the funding decision, a steering committee has decided to sunset WRIDS. 'This was not an easy decision, but given much of the work within the Four Pillars of our drug strategy is happening at various tables and initiatives, the Steering Committee felt that everyone's resources were best utilized in supporting this existing work,' a release from WRIDS explained on May 26. WRIDS lists its four pillars as prevention, treatment, harm reduction and enforcement. 'We know that the drug poisoning crisis continues to claim lives across our community, and we need to continue to work collaboratively to coordinate programs and strategies, share and advocate for resources, and put an end to this crisis,' the release said. A call for support Advocates say more work is needed at a provincial level to really get a grip on the ongoing issues. 'We have a public health policy, but the public health policy really isn't working,' said Brice Balmer, former chair of the Waterloo Region Crime Prevention Task Force, which developed WRIDS. 'It comes out of the province now instead of out of the region. It's really not working at the systemic [level] that needs to go on with everybody working together.' Balmer said it will take effort on all fronts to effectively address the pervasive problems. 'The work of the [Waterloo Region] Integrated Drug Strategy has actually minimized over the last six, seven, eight years. Even after we got the whole strategy together, everybody worked on it. But then it turned out to be maybe six or seven people that were working on the strategy, rather than bringing a whole group of people together to really look at how addiction impacted many agencies.' He said the best way forward, is to work together.
National Post
09-06-2025
- Health
- National Post
Derek Finkle: Pro-drug injection site activists were dangerously wrong on closures
'A lot more people are going to die.' Article content This was the dire prediction oft-repeated back in March by a busload of lawyers who supported a legal challenge filed by an injection site in Toronto that claimed recent Ontario legislation forcing the closure of sites within 200 metres of schools and daycare facilities violates the Charter rights of drug users. Article content The two expert witnesses for that site, in the Kensington neighbourhood of Toronto, are employed by the MAP Centre for Urban Health Solutions, a hospital-run research centre. MAP had played a key role in the establishment of the city's first injection sites in 2017. Dr. Ahmed Bayoumi and Dr. Dan Werb both submitted evidence that overdose deaths in Toronto would increase sharply if half of the city's ten injection sites closed at the end of March because of the legislation. Article content Fred Fischer, a lawyer representing Toronto's Board of Health, one of the intervenor groups in the case, also told Justice John Callaghan of the Ontario Superior Court that reducing harm reduction services in Toronto during the ongoing opioid crisis would have severe consequences — more people will overdose and die. Article content Article content A lawyer for another intervenor, a harm reduction coalition, put an even finer point on it. He said that one of the Toronto injection sites not affected by the legislation was anticipating such an immediate and overwhelming increase in overdose deaths in April, after the closures, that the site was in the process of hiring grief counsellors for its staff. Article content More than two months have passed since then, and now that we're in June, you might be wondering: How many more people ended up dying because of the closure of these sites? Article content According to data that's compiled by Toronto Paramedic Services and Toronto Public Health, the answer, so far, is none. In fact, the number of overdoses in Toronto for the month of April, the first month after the sites had closed, dropped notably. Article content Article content Toronto had 13 fatal overdose calls in April, one less than in March, when the now-closed injection sites were still open. Thirteen is less than half the number of fatal overdoses across the city in April of last year, and significantly below the monthly average for all of 2024 (19). Article content Article content Thirteen fatal overdoses are far lower than the average monthly number during the period of Covid-19 emergency between April 2020 and May 2023 (25). The last time 13 was the norm for monthly fatal overdoses was prior to the pandemic. Article content The number of calls for non-fatal overdoses in April was 161. This may sound like a lot but it's the lowest monthly total so far this year in Toronto. And 161 non-fatal overdoses are 55 per cent less than the 359 that occurred in April of 2024. Article content Remarkably, in the third week of April, there were zero fatal overdose calls, something that hasn't happened in Toronto in months.
