People who use drugs, health care and community service providers gathered in Vancouver February 16-17, 2017 for a national meeting on scaling up supervised consumption services (SCS). Sharing Knowledge, Saving Lives was co-hosted by the Canadian Drug Policy Coalition, Canadian Association of People Who Use Drugs and The Canadian HIV/AIDS Legal Network. The goals were:
- to provide a forum for information exchange on SCS best practices;
- develop advocacy priorities and strategies; and
- create a national network of service providers and advocates.
There were opportunities for attendees to visit Vancouver area SCS, and this was a great opportunity for those from places where SCS are still a dream.
Several topics echoed over the days. Decriminalization is a top-level goal, but obviously not the easiest to reach. The inclusion of people who use drugs in conversations about service and policy needs was emphasized throughout. The influence of stigma was central. There were also discussions about community engagement in building support for SCS, and balancing peer-based and medicalized services.
“There are thousands and thousands of conversations being had on this problem and maybe three of them include people who use drugs,” said Canadian Drug Policy Coalition’s Donald MacPherson. Nothing About Us Without Us principles must be upheld: the people most affected by policy and practice need to have a say about both. “Low barrier” services are just a concept if the barriers aren’t truly understood. Advocates have done fantastic work on this over the years, much of it without funding to fuel their efforts.
The criminalization of drugs and stigma of problematic substance use shape the inaction of health care and social services to people who use drugs (PWUD). Federal exemptions for safe injection sites and governmental support for safe consumption sites are helpful but not a solution. Canada needs to build a culture where people can access non-judgmental care and support for problematic drug use and for the underlying trauma that frequently accompanies it. Services should be based on health and social needs, not legal limits, Dr. Mark Tyndall said.
Richard Elliott of the Canadian HIV/AIDS Legal Network reviewed the strict demands for setting up a safe injection site that are set out in Bill C-2, which was introduced under the Harper government after the Supreme Court ruling allowing Insite to remain open. He also walked attendees through Bill C-37, the more accommodating replacement for Bill C-2 which is not yet approved. Its approval may or may not change how applications are processed in practice, and Richard urged everyone who is in the exemption application process to say in touch to be aware of how each others’ applications are being handled.
What is the best service approach in safe consumption sites: peer-based care, medical care, or a combination of both? This question was explored throughout the meeting. Medicalized care under the supervision of nurses can help connect PWUD to other health care and social services they might want, but legally sanctioned SCS are few and far between. Peer-based care is easier to set up; CPR and overdose reversal training is achievable to get things going. This was an interesting conversation that will be ongoing, I suspect.
The meeting was inspiring and encouraging overall, despite shared grief over overdoses and deaths that should have been preventable. The passion of the people doing this work is clear. BC services are different than any other province, and sharing experiences and best lessons so far helped many leave the conference with hope.
Interested in more? Check out these resources:
- Canadian Drug Policy Coalition: http://drugpolicy.ca/
- Canadian Association of People Who Use Drugs http://capud.ca/
- The Canadian HIV/AIDs Legal Network: http://www.aidslaw.ca/
- Centre for Addictions Research of BC http://www.uvic.ca/research/centres/carbc/
Questions? Feedback? Get in touch!
Janet Madsen, Special Projects Contractor, [email protected]