Future of supervised consumption sites in Alberta remains murky

While the Alberta government pushes forward with its recovery-oriented strategy to address the drug poisoning crisis, its plans for existing and future supervised drug-use sites remain unclear.

Premier Danielle Smith and her chief of staff, Marshall Smith, have in recent days spoken about increased funding for harm reduction measures in Tuesday’s provincial budget. An expected $275-million is to be allocated to the Ministry of Mental Health and Addiction, but specifics have not yet been revealed.

Mr. Smith spoke specifically to supervised consumption services, or SCS, during a recovery conference, stating that the government is not averse to them “despite what you will read in the pages.”

But the government’s track record shows the opposite, according to some harm-reduction advocates, drug-policy experts and addictions physicians. Elaine Hyshka, associate professor in the University of Alberta’s School of Public Health, said irrespective of the government’s claims, there has been “huge animosity” toward this harm-reduction service.

Dr. Hyshka said the sector has been engulfed in “chaos” since the provincial government changed in 2019 with unpredictable funding and disingenuous studies on the effectiveness of SCS.

“That’s really unfortunate because they are one of the only tools we have right now in Alberta that we know are very effective of preventing deaths,” she said.

The office of Nicholas Milliken, Minister of Mental Health and Addiction, did not respond to request for comment.

An average of four people are dying daily in Alberta – far above prepandemic levels. Between January and November last year, more than 1,400 people fatally overdosed, based on the latest data from the province.

When the UCP took power, they commissioned a report that looked into the socioeconomic impact of SCS. It did not consider the merits of these services to reduce drug-related harms and deaths, but focused on the impact to neighbouring businesses and residents. It detailed a “system of chaos” and, in part, set the tone for Alberta’s response to the overdose epidemic.

Government officials have repeatedly claimed that there are the same number of SCS sites operating in Alberta since the UCP were elected in 2019. However, there are now three sites in Edmonton from four and there remains one site each in Calgary, Red Deer, Lethbridge and Grande Prairie.

But the biggest change has been to capacity with government-led closures and transitions at certain sites. Four years ago, there were 37 injection consumption booths in drug-use sites across Alberta, in addition to two inhalation rooms in Lethbridge. There are now 24 booths, and the safer smoking spaces have been eliminated.

Lethbridge was hardest hit after the UCP forced the closure of the ARCHES SCS site in August, 2020, that had 13 booths and North America’s first drug inhalation area with eight stalls, open 24/7. It was replaced with a mobile site, run by Alberta Health Services, that serves a maximum three people at once and operates 20 hours daily.

Similarly, in Red Deer earlier this month, a homeless-serving agency operating a four-booth consumption site was told it will be closing and replaced by an AHS-run mobile version with an undetermined number of booths.

Mr. Milliken has said the transition is taking place due to “changing needs” in the community.

But Dr. Hyshka said the changes are undermining the effectiveness of drug-use sites by severing connections between service providers and clients, and making them more inaccessible.

“You can’t overemphasize the fact that people who are at risk of drug poisoning are also at risk of being criminalized or arrested, so they’re very much a hidden population and it takes a long time to establish trust with people who use drugs and to engage them in care,” she said.

“Expecting that all of a sudden you can just replace those relationships with new staff and a new service – it doesn’t work like that, especially because there’s been very little rationale provided for changing over operators.”

Under the former NDP government, additional sites were proposed for Calgary and Medicine Hat, neither of which moved forward. The latter has one of the highest rates of drug poisoning in Alberta (68.5 per 100,000 people), behind Grande Prairie (77.7) and Lethbridge (94.7), show government data.

In Edmonton, the Boyle Street Community Services site – a five-booth, 12-hour per day operation – closed in December, 2020, as part of Alberta’s plan to decentralize SCS from the Chinatown community. EMS responses to drug poisonings have since surged in the capital city.

After the closure, the George Spady SCS, across the street, added two new booths to bring the total to four and began 24/7 operations.

Boyle Street is now trying to open a new overdose prevention site in southeast Edmonton, but they must first conduct exhaustive community consultation and implement a “good neighbour agreement” under provincial regulations, introduced by the UCP. A community group opposed to the proposal has been formed, and heated debates have boiled over during public meetings.

Similar opposition fractured government plans in Calgary to open two smaller drug-use sites in place of the existing Safeworks consumption site run by AHS. After consultation sessions turned ugly for a homeless-serving organization, it walked away from housing a drug-use site and another agency put plans on pause.

Earlier this month, Mr. Milliken told reporters that the government is “always looking for potential partners” but provided no clear plans. He said the focus needs to be “on what the government is continuing to do, which has seen successes” pointing to their treatment-focused strategy.