Ithaca mayor on supervised-injection sites and his visit to Vancouver

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Svante Myrick, the young mayor of Ithaca, N.Y., made international headlines earlier this year when he backed a drug strategy that included the opening of a supervised-injection site. While two such facilities have existed in Vancouver for more than 13 years – and Toronto recently approved three – supervised consumption remains a controversial idea for many in North America. If approved, Ithaca's could be the first of its kind in the United States.

The Globe and Mail spoke with Mr. Myrick, who recently visited Vancouver's Downtown Eastside, where he toured the Insite supervised-injection site; the Providence Crosstown Clinic, where drug users who were part of a clinical trial receive prescription heroin; and other social-service providers.

Tell me about the drug situation in Ithaca.

It's similar to the rest of the States in that we're losing a lot of people to overdose. It's a small city – a city of about 30,000 – and we lose about one person a month to overdose. If you were to compare it to [Vancouver's] Downtown Eastside, or the Bronx, it's not the heroin capital of America, or even New York State. Ithaca's a quaint town, a college town, fairly prosperous. We have the lowest unemployment rate in New York State. But this is the face of drug use. Drug use is everywhere. We've got drug use in our classrooms, in our board rooms, and we have on-street users – the sort of folks who would really benefit from supervised injection.

You convened a drug policy committee comprising law enforcement, health officials, academics and others, which came up with a plan rooted in public health and harm-reduction principles. I heard you were surprised by some of their proposals.

Yeah, supervised injection was one of them. It came up right away. I asked them to write out on this board every resource that was available, and every resource that they had heard about and thought that Ithaca needed but wasn't currently available. Seven different people, out of 40, wrote "supervised injection" down. That was, honestly, the first time I had heard about it. I wasn't even aware of the concept. I was barely aware of harm reduction as a useful alternative to the punitive war on drugs. Over two years, I learned more and became convinced it was a good idea. When they showed me the final recommendations and supervised injection was in there, I didn't fight it. I said, "This makes sense. I will go out there and defend it."

Tell me about your visit to Vancouver's Downtown Eastside.

It was great. It's a beautiful city. Everyone was very hospitable, from the users I spoke to, to the Vancouver police officers who showed us around a little bit. Liz Evans, formerly of the Portland Hotel Society, gave us a great tour. We saw the Drug Users Resource Centre (DURC), a couple of different housing projects, a couple of [single-room occupancy] hotels. We stopped at the Providence Crosstown Clinic and Insite. I was moved by this approach, which so obviously values people who are down and out. There's nothing glamorous about living on the street, about using five times a day. The people who worked at DURC, at Crosstown, at Insite, didn't sugarcoat it, but they treated them as people, nonetheless. They had a very straightforward integrity to all the interactions that I witnessed.

Did you find anything you saw to be surprising, or unexpected?

I think how maintained the drug use and the drug sales in the Downtown Eastside are. In Ithaca, the on-street drug use and drug dealing sort of bleeds everywhere. I don't know if it's because there are so many resources in that area that the folks who use and deal just stay there, but you could cross the street [into Gastown] and be like, "What just happened? I thought we were here to explore open-air drug use." I think that struck all of us from the States.

What kind of questions did you have at Insite and Crosstown?

Many of our questions were logistical: Do you have time limits for your users? How do you sign people in? How do you screen people and make sure they're healthy enough, sober enough, to [receive prescription heroin] at Crosstown? So a lot of questions about how this would work in action, in part because we weren't looking to be convinced it's a good idea – we're pretty convinced it's a good idea – we just wanted tips on how to make sure that ours was successful when we got it up and running.

I think [heroin-assisted treatment at Crosstown] really impressed our police chief [John Barber]. He walked out of Crosstown thinking it was so orderly, so regimented, so structured. It seemed like a doctor's office.

What kind of a facility are you envisioning for Ithaca?

I think something probably less obvious than Insite, in part because we have existing clinics interested in running this, and that would be the lowest cost, simplest way, to get it started. The second part is that we're not, of course, the size of Vancouver and the scale of our problem is different. I think [one site with] even a row of one or two booths would be enough to service the population of Ithaca here.

You expressed support for the legalization of marijuana years back.

Yes, back when that seemed controversial. Now, a lot of people walk around thinking it's already legal.

Canada has federal legislation to legalize marijuana coming next spring. Did you want to just move to Canada, maybe?

[Laughs.] We'll see what happens on [U.S. election day] Nov. 8. I might be. I told them when I was up there visiting Vancouver: "I might actually have to seek asylum here."