Health unit makes the business case for permanent consumption sites

The Middlesex-London Health Unit (MLHU) has unveiled a business case for supervised consumption sites in London, Ont. as provincial funding and a federal exemption of drug prosecution laws are set to expire at the end of the month.

The business case identifies gaps in the current system and outlines their impacts. The MLHU says it presents evidence that shows how supervised consumption facilities can help reduce health care costs, improve neighbourhoods, and generate improved health outcomes, including saving lives and reducing the spread of infections like HIV.

• Ottawa's top doctor tells province supervised consumption works

TheMLHUopened a Temporary Overdose Prevention Site (TOPS) at 186 King Street on Feb12.

"We have already reversed over 34 overdoses. Those arepeople who would have easily died in a back alley or astore well, and those are just scratching the surface of the value of the service,"Dr. ChristopherMackie, Medical Officer of Health and CEO of theMLHUtoldCBCNews.

"The temporary overdose prevention site is becoming a gateway into other more life-transforming services, opening doors that definitely people would not have been ready to walk through if they hadn't had this sort of service."

Since the TOPS was opened, Dr. Mackiesays there have been150 clients connected with addiction treatments, along witha reduction in new HIV diagnoses.

"We're talking about 150 people who are among the highest-risk consumers of drugs in our community, they are people who have fallen through the cracks of the system," he said.

"They're going to this place where they build relationships, they build trust, and the staff are then able to support them to make those transitions into addiction recovery."

Seeking provincial and federal support

Both the provincial funding and the legal exemption of drug prosecution laws expire at the end of September for the TOPS at 186 King Street. The MLHUhas submitted an application for legal exemptionat the TOPS in London.

Dr. Mackie says a representative from the Health Canada Exemption Program will be visiting the TOPS on Tuesday, Sept 25.

"The Federal Government is responsible for the legal exemption process, they wouldn't be funding the site directly, so what we would be requiring from them is the legal exemption to keep operating," he said.

Last month, the Ontario PC government extendedfunding for the site, less than a week before itwas set to expire on Aug 15.

• Ontario PCs extend funding for temporary overdose prevention site in London

Dr.Mackiemet with Elliotton Aug23 to present the business case, but there was no word on what transpired from that meeting.

"The minister was very interested in what is happening in London at the temporary overdose prevention site, very interested in what we have been able toachieve over and above the base model of supervised consumption," Dr. Mackiesaid.

"The Minister was interested in what the value of supervised consumptionfacilities were and how they benefit the community."

Minister Elliott has yet to visit the TOPS in London.

Deaths and illegal opioidson the rise in London

According to the Office of the Chief Coroner ofOntario,20 deaths have beenconfirmed to be caused by opioidoverdoses in London in the first three months of 2018, along with two probable deaths. There were 31 opioid-related deaths in 2017.

"We're on pace to double the number of deaths we've ever had in our community and we're also seeingfentanylcome more and more into the community," he said.

"Over the summer we saw more fentanyl overdoses in our temporary overdose prevention site that we were reversing, so it's possible that out in the community there were a lotmore deaths over the summer. It's not going to be a good year."

Mackie says London's illicit drug market used to be dominated by diverted prescription medications, but now illegally produced fentanylhas becomea lot more prevalent.

According to the Coroner's Office, 39 per cent ofopioid-relateddeaths in London in 2017 were fromfentanyl, the leading cause of opioid-related death.

Futurepermanent supervised consumption sites

The MLHUhas applied for funding for two permanent supervised consumption sites in London, one at 446 York Street and 241 Simcoe Street.

"We're still waiting for federal approval and we're hoping that that isin place in the next few weeks,"Dr. Mackiesaid.

An application for re-zoning those locations will also be going to the city in the near future as well. Dr. Mackiehopes the permanentsiteswill be up and running within the next six months.