City moving too slow on safer injection sites while people die, expert says

A leading authority on safer injection sites in Canada says Hamilton is moving far too slowly on the implementation of a proven system thatsaves lives.

Senator Larry Campbell says local politicians are dragging their heels on the issue as overdose deaths climb, considering Hamilton is only now debating whether or not to simply study supervised injection sites let alone debating whether or not to actually create one.

At this rate, Hamilton is still years away from a safer injection site if the city gets one at all and that's just not good enough when people aredying at record levels, Campbell told CBC News.

Do you want to keep people alive or let them die?If you're that moral, surely that has to be at the top of your list.-Senator Larry Campbell

The city, for its part, says it is bound by federal regulations, and meeting thoserequirements takes time. But should it take a year to do a study?

"I really think we need to be moving faster on this rather than slower," Campbellsaid. "Politicians are elected to do the right thing for people, and saving a life has to be the right thing."

"Doing nothing or pushing it off for two years what does that accomplish?"

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Campbell is every inch an expert on the subject and his experiences have made him a proponent for the sites. He was a part of the RCMP's drug squad in the 70s, and became the chief coroner for British Columbia in 1996. He ran for mayor of Vancouver and won in 2002, with harm reduction strategies for addictions as a central pillar of his platform.

He also oversaw the establishment of North America's first legal safe injection site called InSite in Vancouver and he has ties to Hamilton. Campbell was born in Brantford, and worked as a steelworker in the city back in the 60s. He still has family here, and visits his mother in Hamilton every couple of months, calling the city "a special place for him."

Overdose death rates nearly double

Record numbers of people are dying from overdoses in that special place. In 2005, 18 people died of opioid overdose in Hamilton. That number peaked at 34 in 2011, and continues to stay high at 31 in 2014.

By contrast, 18 people died in traffic fatalities in Hamilton that year.

The city has noted the powerful prescription painkiller fentanyl as a particular concern and that comes as police and community groups warn of an oncoming crisis involving so-called "bootleg" versions of the drug.

With that danger looming, the board of health approved plans last month to begin exploring the viability of local safe injection sites for intravenous drug users. But while there was support from many councilors, official approval is contingent on a debate for the 2017 budget, as costs were a sticking point.

It would cost $250,000 in next year's budget for the supervised injection site study. If approved, it would cost about $1 million to $1.5 million to set up a safe injection site, though the city says annual costs are more difficult to predict at this stage.

Campbell questioned why a year-long local study is necessary, given the wealth of information that's already available. "There's lots of evidence out there," he said. "It's been studied."

The 'morality argument'

A city report given to councillors outlines 27 different citations from previous studies on the effectiveness of safer injection sites.

Among the information were these statistics:

• Safer injection sites reduce overdose deaths, reduce transmission of blood borne infections, improve access to medical and addictions care, and do not increase crime in surrounding areas.
• That there was a 35 per cent reduction in overdoses within 500 metres of InSite, and a 9.3 per cent drop in the rest of Vancouver.
• During the operating hours of an injection site in Australia, the number of ambulance calls within a 1.5 kilometre radius of the site dropped by 68 per cent.
• That there was no increase in the rates of drug trafficking, assaults or robberies after InSite opened in Vancouver, and there was a decrease in the number of thefts and car burglaries.

Ancaster Coun. Lloyd Ferguson was less than enthused with the idea of safer injection sites when was discussed at board of health last month. Yet even he doesn't see the merits of spending $250,000 to study something for a year that has already been researchedextensively.

"Why are we going to do it again? [It's] just doing what somebody has already done for us."

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Associate medical officer of Health Dr. Jessica Hopkins told CBC News that the issue isn't studying how effective the sites are, but rather gathering information to meetthe needs of finding an exemption under the controlled drugs and substances act.

That information would include where the site would be, alongside statistics on things like infectious disease and crime rates in the city.

"We need to look at the local data," she said. "It is quite significant in terms of the requirements under the current legislation."

However, that data would only become necessary if the city decides it wants a safer injection site yet the city still seems poised to seek it out at the outset, rather than after that decision is made.

Ferguson, who chairs the city's police board, also talked about how the issue could be a quandary for police, seeing as drugs like heroin are illegal, and "here we are as a city, encouraging it."

"It's an illegal product, so how is that morally correct?" he said. "We shouldn't be endorsing and supporting it."

Campbell says he doesn't buy the "morality argument."

"Do you want to keep people alive or let them die?" he said.

"If you're that moral, surely that has to be at the top of your list."

adam.carter@cbc.ca