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House of Commons approves relaxed rules for supervised consumption sites

A volunteer prepares a naloxone kit in the Downtown Eastside in Vancouver, British Columbia, Wednesday, December 21, 2016.

Rafal Gerszak/The Globe and Mail

The House of Commons approved changes Monday to a piece of legislation that would make it easier to open supervised drug-consumption sites, watering down a Senate amendment that would have forced staff to offer alternative therapies such as methadone before allowing someone to use such facilities.

This week's debates in Ottawa come as overdose deaths continue to break records on a regular basis, especially in hard-hit B.C., where an average of four people are dying from overdoses every day. At the opening of the Harm Reduction International Conference in Montreal on Sunday, protesters interrupted federal Health Minister Jane Philpott's keynote address, unfurling banners that read: "They talk, we die."

The minister took this message into Monday's debate, speaking of the urgent need to pass Bill C-37.

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"Community consultation includes consultation with the members of the community who in fact are seeing their friends and family members – young people – dying," Dr. Philpott said. "They need to have the opportunity for input too. These are some of the members of society that I hope members of this House will take into consideration when they're considering this bill."

Ottawa tabled Bill C-37 in December as a response to Canada's worsening opioid crisis. Among numerous amendments, the wide-ranging bill would make it easier to open supervised consumption sites, allow the Health Minister to quickly and temporarily restrict certain substances, and allow customs officers to open packages that weigh 30 grams or less.

Earlier this month, the Senate approved the bill with three amendments; that a public consultation period be changed from a maximum of 90 days to a minimum of 45 days; that the Minister of Health be able to establish citizen advisory committees for approved sites, which would provide annual updates; and that staff at supervised consumption sites be required to offer legal pharmaceutical therapies before clients use illicit drugs.

The government accepted the first amendment, removed the second amendment and changed the third amendment to say staff "may offer," rather than "shall offer," pharmaceutical options.

Supporters of the first two amendments emphasized the need to give the community a say in the matter. Conservative MP and former Surrey mayor Dianne Watts, for example, said a supervised-consumption site without community buy-in is "doomed to fail."

Opponents note that no other health service requires such consultation and that to require it for supervised-injection sites would only contribute to the stigma of substance-use disorder.

Richard Elliott, executive director of the Canadian HIV/AIDS Legal Network, said he is most concerned by the amendment that would require a mandatory offer of alternative pharmaceutical treatment before a client could use a supervised-injection site.

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"If you require every supervised-consumption service to have some alternative pharmaceutical therapy on hand, to have the medical infrastructure and personnel, to be able at any given moment to start prescribing for someone – that is not a low threshold harm-reduction service," Mr. Elliott said.

"Obviously, we are fully supportive of scaling up access to different modes of treatment … but to make it mandatory [at every supervised-consumption site] is to reintroduce an unjustifiably high barrier that will do more harm than help."

Meanwhile, the city of Vancouver, which is recording so many overdoses it recently began issuing weekly updates on fatalities, this week opened its fifth "overdose-prevention site" – essentially a bare-bones supervised-injection site operating without federal approval.

The women's-only SisterSpace, located in the Downtown Eastside, can accommodate up to 15 women at a time.

Vancouver is currently home to Canada's two federally approved and operating supervised-injection sites: Insite and the Dr. Peter Centre, an HIV/AIDS facility that offers the service to clients only.

Dr. Philpott said Monday Ottawa is currently expediting reviews of 18 sites in 10 cities.

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Insite, B.C.'s supervised injection site program, has begun piloting a program to curb the number of overdoses from drugs unsuspectingly mixed with fentanyl. Registered nurse Marjory Ditmars shows The Globe and Mail how the quick and simple test works Globe and Mail Update
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