Welcome to Ground Zero: fighting the opioid crisis

The trailer sits nestled against the side of the old brick building next to the Shepherds of Good Hope on 256 King Edward Ave. It will soon become the safe haven that many injection drug users will turn to once the winter rolls around.

The site will be the first government sanctioned and supervised injection site in Ottawa.

The trailer will remain open 24-7 in hopes to fight the opioid crisis that has been gripping the country for years. 

To fight the increase in opioid related overdoses, many organizations have taken it upon themselves to offer services to injection drug users seeking help.

Ottawa Inner City Health (OICH) is the group that will be running the supervised injection site on King Edward Avenue.

Anne-Marie Hopkins, supervisor of Peer Outreach Services at OICH, has been working with the organization for eight years now, and she supervises the peer workers on staff at the injection site.

“They’re incredible with working with our clients, and they’re so connected to the community,” Hopkins said. “They’re so invested in this community.” 

The supervised site will be staffed by one nurse and one peer worker. Peer workers are people who have lived experience with mental health, homelessness, addiction, or a combination of the three.

The OPO safe injection site

Overdose Prevention Ottawa (OPO), a volunteer run group,  operated a pop-up injection site in Raphael Brunet Park from late August to November.

The group provided clean needles, as well as safe injection services regulated by registered nurses, and on-site volunteers in case of an overdose.

The pop-up site saw 3,445 visitors over the last 74 days of its operation, according to the group’s website.

As of Nov. 7, OPO decided to close the pop-up site the same day the supervised injection site opened at Shepherds of Good Hope.

The difference between an official site and a pop-up site, Hopkins said, lies in  the paperwork.

Despite the work that OPO did for the community, it was not a legal injection site and lacked the funding to stay open.

For an injection site to be  considered legal, the organizers must apply with Health Canada and receive a federal exemption. This exemption allows organizers to be around illegal substances.

Injection sites are also held to specific health and safety standards outlined in procedures and protocols made by Health Canada.

“They’re not legally bound by all those things,” Hopkins said. “But they’re doing a really good job.”

Despite closing the site, the group said they are not done fighting the ongoing crisis.

Infographic by Mariam Abdel-Akher

“Overdose Prevention Ottawa provided the first public safe space in our city for people to use drugs, primarily through injection and inhalation,” a public statement from the group’s website read. “Every day, our guests tell us that they and their friends are alive because of our services.”

In other Ontario cities, local and provincial governments are offering support to help OPOs stay open.

The Charlatan attempted to contact OPO for this story, but was told the organization didn’t have time for an interview.

“I think that it’s really unfortunate for [OPO],” said Hopkins. “We’re in an opiate crisis, we’re on the front line of this major war, and I completely understand that they [OPO] feel like it was a slap in the face to not receive that support,” Hopkins said.

OPO has committed to remain active and provide services and healthcare to those who are most at risk.

Despite this commitment to the community, OPO is unhappy about the closure of the pop-up site.

“Particularly reprehensible are the actions of Mayor Jim Watson, Councillor Mathieu Fleury, and Minister of Health Dr. Eric Hoskins,” a statement from their blog reads. “Who profess to take action to address the overdose emergency in one breath and then deny services to people who use drugs in another.”

A pop-up injection site located in Toronto was recently given equipment to remain open throughout the winter, provided by the provincial government on request by Toronto Mayor John Tory.

When the same services were requested by the pop-up site in Ottawa, it was denied by Watson. 

As the drug crisis has developed, more organizations have formed to show their support to those on the frontlines.

Organizations to end opioid overdoses

Campaign for Safer Consumption Sites (CSCS) is a group of community members who advocate for the implementation of safe injection sites. 

According to their website, the goal of CSCS is to provide knowledge and awareness to the greater community, reduce the risk and spread of HIV and other diseases, and rid community streets of waste from drug use.

Louise Lafond, a member of CSCS and volunteer with OPO, said that along with injected drugs, inhaling drugs is also a growing problem in Ottawa.

The increased contamination of many street drugs with carfentanil gives this method of drug use additional dangers.

If the drugs that are being inhaled are contaminated then the smoke in the air can be a danger to anyone surrounding the user as well.

This creates a greater need for a safe inhalation site as well as proper ventilation to keep not only the user safe, but also the supervisor, who is at risk of inhaling any airborne drugs as well.

“It is possible to engineer,” Lafond said. “But it is difficult. And expensive.”

“Killer” drugs

The Canadian Encyclopedia traces the roots of the opioid epidemic back to March 2015, when the Blood Tribe reserve in Alberta first declared a state of emergency after multiple fentanyl overdoses.

Since 2015, the tide of opioid related overdoses has continued to rise.

In Ontario alone, approximately 6,300 people have died from opioid related overdoses since 2000.

“This is the ground zero of the opioid crisis,” Dr. Jeffrey Turnbull, chief of staff at the Ottawa Hospital, said.

He said the hospital is currently seeing about three to four overdoses a day.

According to Turnbull, the drug scene has gotten more complex than it used to be.

“What we are seeing is fentanyl now finding its way into the drug scene,” Turnbull said. “And with that we are seeing just a rapid spike up in terms of the overdoses.”

Opioids are rapidly becoming more and more dangerous.

Fentanyl and related drugs like carfentanil, are increasingly being cut with other drugs such as heroin, cocaine, and various methamphetamines. This has led to a tidal wave of accidental overdoses by those who are not aware of what is in the drugs they are using.

Infographic by Mariam Abdel-Akher

The problem with carfentanil in particular, is its incredibly high potency—it’s been said by the European Monitoring Centre for Drugs and Drug Addiction to be 10,000 times more potent than morphine, making it incredibly dangerous. Police have said that as little as 20 micrograms can kill a person.

This potency often guarantees an overdose among those who don’t even know their drugs have been cut with deadly opioids.

“My brother-in-law had a friend who went to a party, and he took ecstasy which had carfentanil in it and he died,” said Jay Villeneuve, a second-year sociology student at Carleton University.

Villeneuve is a recovering drug addict himself. Admitted to Harvest House at 19, he now works alongside the drug and alcohol rehabilitation centre as a counsellor for others hoping to fight addiction. He has been working for the organization for four years as a peer counsellor.

“What I do is I council guys based on my experience,” he said. “Cause there’s foundational principles that are used to recover from the disease of addiction. I help apply those and I’m just an ear for the guys to listen to.”

As the drug crisis has developed, more organizations have formed to show their support to those on the frontlines.

Ottawa Public Health is also a member of the Ontario Harm Reduction Distribution Program and offers free harm reduction supplies to those who need it. 

These supplies include sterile, single-use equipment, and instructions on how to minimize the risk and spread of infection and disease.

While many organizations are fighting for more support for harm reduction initiatives, others seem to be worried about the potential negative effects of these sites on the surrounding community.

“We hear about more crime, more garbage, more needles,” Lafond explained.

According to her, contrary to common belief, results from Vancouver’s safe injection sites show a decrease in crime, garbage, and needles.

“Waste was less, drug dealers did not hang about, people were invested in the site, crime didn’t go up,” Lafond said. “I wouldn’t mind having a safe injection site next to my house.”

Even though the group has closed their safe injection sight, OPO is still fighting against the opioid crisis through advocacy.

“Through our dedicated service and our  advocacy, we have forced harm reduction service providers to respond, and have helped pave a path towards a more  equitable healthcare system,” OPO said in a statement.  “One that treats drug users with the diginity and respect they deserve.”

Feature graphic by Manoj Thayalan