Injection and drug consumption paraphernalia are at SafePoint in Surrey, B.C., on June 6, 2017.BEN NELMS/The Globe and Mail
Two sites in the Vancouver region have become the first in Canada to receive federal approval to allow users to snort or swallow drugs while under supervision.
Until now, supervised drug consumption sites have been limited to injection drug users. Two sites have been operating in Vancouver for more than a decade, while others have recently received approval in the Vancouver area, Montreal and Toronto.
The two sites approved to expand services to non-injectable drugs are in Surrey, south of Vancouver. The public SafePoint supervised consumption site, located on what's known as the "Surrey Strip," opened three weeks ago. The Quibble Creek Sobering and Assessment Centre began offering supervised consumption for clients one week ago.
"We want to make sure that our services are providing as big a reach as possible," said Dr. Victoria Lee, chief medical health officer for Fraser Health. "We also wanted to ensure that others in the country have a better and more streamlined process for them to get approval for intranasal and oral substances.
The approval for oral and nasal consumption lasts for one year. Dr. Lee said health agencies opening similar sites elsewhere in the country have told her they weren't aware it was an option.
When the two sites first opened earlier this year, Dr. Lee said the health authority had asked for permission to allow oral and nasal drug consumption, but Health Canada only approved them for injectables. At the time, Dr. Lee said the health authority saw trends of people dying of drug overdoses after consuming drugs in different ways.
Staff received two weeks of classroom training followed by two additional weeks shadowing staff at Insite, Vancouver's public supervised injection site, prior to the sites opening.
Smoking, however, is still not permitted. While illicit fentanyl in smoked drugs, such as crack and crystal meth, has resulted in overdose deaths and is concerning health officials, the ventilation requirements and additional safety hazards that come with smoking rooms pose major barriers.
Dr. Mark Lysyshyn, medical health officer for Vancouver Coastal Health, has previously said that health authority would in theory like to supervise all modes of consumption, but is currently focused on injection, as it presents the biggest risk.
"Smoking would probably be the next highest risk, and we've looked into providing safe spaces for that, but the occupational health and safety, and the sort of engineering of those types of facilities, have made them prohibitively expensive," he said in an earlier interview with The Globe.
One "overdose prevention site" in Vancouver's Downtown Eastside, sanctioned by the province but not the federal government, does supervise smokers. The province opened about 20 of these unofficial supervised consumption sites in December as an emergency measure and Ottawa has quietly let them exist.
Sarah Blyth, who started and runs that site, said roughly half the users – and half the overdoses – there are smokers. People who inject drugs do so inside a trailer, while smokers smoke outside under a tent.
At least 935 people died of illicit drug overdoses in B.C. last year and the province is on pace to surpass 1,400 deaths this year. Illicit fentanyl and its various analogues have been detected in both opioid and stimulant street drugs, including cocaine, crack, heroin and methamphetamine.
Since opening on June 8, SafePoint has logged 1,079 visits by 203 people. Staff reversed 19 overdoses.
Dr. Bonnie Henry, B.C.'s deputy provincial health officer, said health officials in British Columbia want to be able to approve supervised consumption sites on their own, without the need to ask the federal government for permission.
"We would like to see them give the province an exemption to monitor and to open supervised consumption sites according to a provincial program, like we do for everything else in health care, essentially," she said. "Some of the regulations are set federally but we manage the programs."
Dr. Henry said the overdose prevention sites show B.C. can develop needed services amid a public health emergency that was declared in April, 2016.
With a report from The Canadian Press
Andrea Woo