Safe shooting
Downtown needle exchange Cactus Montreal says it will open a safe injection site next year, with or without provincial approval
NO MORE WAITING: Jean-François Mary
Photo by RACHEL GRANOFSKY
If a Montreal needle exchange has its way, Quebec will soon become the second Canadian province to offer a safe-injection site—whether the provincial government wants it or not.
Cactus Montreal, a downtown needle exchange site, announced last week that it will offer IV drug users space to inject drugs under medical supervision at their office on Ste-Catherine E. and Sanguinet. Their goal is to reduce HIV and hepatitis C infection and prevent accidental overdose deaths.
“We see people dying (from overdoses) every month,” says Jean-François Mary, Cactus’s director of community organization and outreach.
IV injection is one of the highest-risk forms of drug use. But with immediate medical attention, most overdoses are non-fatal. Most safe injection sites (SIS) provide on-site medical profes sionals, who offer immediate life-saving measures to overdose victims. “That’s one of the main things we want to work on—people overdosing and getting infected from shooting up in public places,” says Mary.
But achieving their goal won’t be easy. Safe-injection sites have a long and complicated legal history in Canada. A landmark SIS case is currently before the Supreme Court, with a decision expected next spring. Although health care falls under provincial jurisdiction, provincial Health Minister Yves Bolduc says he’s waiting for the Supreme Court ruling before making a decision on whether he’ll allow an SIS in Quebec.
The case concerns Insite, a Vancouver SIS. Open since 2003, Insite operates under an exemption to current drug laws. Since 2008, the Conservative government has been fighting to shut it down, saying education and anti-drug policies are more effective ways to combat drug addiction.
Mary begs to differ. “We’ve had drug prohibitions for over 100 years and the actual ‘war on drugs’ has been going on since the ’70s. We see it as a complete failure. Drugs are more available now than ever.”
There are also economic costs. “Hep C is the main infectious disease we see among people who inject,” says Mary. “The cost of treating hepatitis C is $30,000 a year.” CACTUS sees an average of 1,000 new cases of hepatitis C a year.
A new report from Quebec’s National Institute of Public Health (INSPQ) sides with Cactus. Having studied worldwide SIS data, the INSPQ report concludes SIS’s are effective, and recommends Quebec’s government work with police, municipal authorities and sites wishing to establish SIS’s. “We want to put as much information before the Health Minister as possible,” says report co-author Lina Noël.
Whether or not that will be enough to get Minister Bolduc to change his mind remains to be seen. “Right now, the Minister is totally isolated” from expert opinion on the issue, says Mary. But Cactus is leaving the door open to further a dialogue.
“Maybe the Ministry of Health will move forward before the Supreme Court ruling, and that’s what we are hoping for,” says Mary. Ideally, the Ministry will provide financial assistance to help SIS’s hire medical staff.
If the Minister decides against SIS’s, other avenues exist. Vancouver has a second SIS (the Dr. Peter Centre) that operates without a legal exemption.
Regardless, Cactus is moving ahead. “We want to open in June 2011,” says Mary. “Whether people want an SIS or not, they see people injecting in the streets, they see discarded needles and they see people living below the poverty line. People need to care, because this is a society-wide phenomenon.” ■
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