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A third safe injection site will open in the coming days, while plans are in the works for another site to be set up in the autumn.
A third safe injection site will open in the coming days, while plans are in the works for another site to be set up in the autumn. Photograph: Courtesy of Sante Montreal
A third safe injection site will open in the coming days, while plans are in the works for another site to be set up in the autumn. Photograph: Courtesy of Sante Montreal

Montreal opens first mobile supervised injection clinic in North America

This article is more than 6 years old

First site will operate beside a two-booth mobile unit will offer a medically supervised space and sterile equipment for people who use drugs intravenously

Montreal has launched the first mobile supervised injection clinic in North America, as part of a package of services aimed at fighting back against an opioid crisis that has claimed thousands of lives across Canada.

On Monday – after years of lobbying by community organisations – the city opened its first safe injection site, alongside a two-booth mobile unit that will make its way through the downtown core. The services, which offer a medically supervised space and sterile equipment for people who use drugs intravenously, are Canada’s first such facilities outside of British Columbia.

“It’s an emotional day,” said Louis Letellier de St-Just of Cactus Montréal, the organisation responsible for one of the sites. “These people need services. They’re people that have had a hard life – most of them – and they need to be supported.”

A third safe injection site will open in the coming days, while plans are in the works for another site to be set up in the autumn. Together the services are expected to accommodate up to 300 visits per day.

Montreal, home to 1.7 million people, sees about 70 overdose deaths a year, said Letellier de St-Just. “And it’s too much. We have between 4,000 and 5,000 injecting drug users. This is a huge community and they need services.”

His organisation – which launched in 1989 as the first formal needle exchange program in North America – has spent six years pushing for a safe injection site in Montreal.

Similar battles have played out across the country, with advocates fighting to create these facilities amid an opioid crisis that has sent the number of overdose deaths rocketing across the country. At least 2,458 lives were lost in 2016, according to the Public Health Agency of Canada.

Western Canada has been the hardest hit, with the province of British Columbia pointing to the devastation being wrought by fentanyl – a drug 50 times stronger than heroin – to declare a public health emergency in April of last year.

The success of supervised injection clinics in saving lives has been demonstrated in Vancouver, where health authorities joined forces with a local non-profit in 2003 to launch Insite – the first supervised injection facility in North America – to address an epidemic of HIV and hepatitis C in the city’s Downtown Eastside neighbourhood.

By 2015, Insite had logged more than 3m visits and had safely treated nearly 5,000 overdoses – all without one death. More than two dozen studies have documented the critical role it plays in building relationships, saving lives and preventing the transmission of HIV and hepatitis C, while research has also suggested that those who visited the clinic are more likely to pursue detox programs.

Its success sparked interest across North America; some 10 Canadian cities along with groups in Seattle, San Francisco and New York City, among others, are currently exploring the creation of similar facilities.

But in Canada, a 2006 federal election ushered in the Conservatives, whose tough-on-crime approach clashed with Insite. After losing a bid at the supreme court to close the program, the Conservatives hit back with legislation – described by one health authority as “unduly onerous” – that slowed the process of opening safe injection sites.

Communities were now required to brandish multiple letters of support, compile reports detailing statistics on crime and HIV rates and carry out background checks for staff members, among other demands. The daunting requirements stalled plans by several communities and left others carrying out feasibility studies for more than a decade.

Since taking power in late 2015, the federal Liberals – fuelled by a surging number of overdose deaths across the country – have taken a different approach. Last year the party gave the green light to the country’s second supervised intravenous drug use site. Recently, they announced legislation aimed at streamlining the more than two dozen requirements needed to launch these facilities.

“It is clear that we are in the midst of a national public health crisis,” Jane Philpott, Canada’s health minister, told parliament last month. “Solid evidence shows that, when properly set up and maintained, supervised consumption sites save lives, and they do it without increasing drug use or crime in the neighbourhood.”

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