“You think it takes a long time to get an ambulance now, or to get into an emergency now? Just wait,” said Karla Ghartey, co-founder of STOPS (Sudbury’s Temporary Overdose Prevention site), a community health nurse and Public Health PhD student.
“Wait until it is continually overwhelmed with people who are overdosing.”
In a move that some are calling a “death sentence” for people who use drugs in Ontario, a recent provincial announcement has officially not only ended Sudbury’s supervised consumption site, but also reduced access to equipment and supplies limiting the spread of communicable diseases, said Gharley.
Beyond that, beyond death and disease, wait until you try to call an ambulance, or go to the emergency room, she said.
That’s not to mention the increased health-care costs without harm reduction supplies, said Ghartey: treatment for Hepatitis C can cost the health-care system $50-$100,000, compared to the cost of a needle to avoid sharing.
“It costs $900 just to cross the threshold of the emergency room door,” said Ghartey. “Let alone diagnostics, treatment or admission.”
The provincial announcement was made Aug. 20 by Health Minister Sylvia Jones, framed as a reinvestment in recovery, rather than harm reduction.
The $378 million three-year plan is said to support the creation of the Homelessness and Addiction Recovery Treatment Hubs, which the government has said won't offer safe supply programs, supervised consumption or needle exchange programs.
The centres are billed as “connecting people to treatment, support, social and employment related services, and increasing the availability of supportive housing.”
A wonderful and much needed addition, said Ghartey. “Treatment and recovery should be part of a strategy moving forward, but it's a part of a plethora of strategies that are needed in the short, medium and long term,” she said.
In the meantime, “we need to keep people alive in order to be able to even dream of accessing these services,” said Ghartey. “Do we need them? Yes. Should you be shutting down other programs to put those into place? Absolutely not.“
Amber Fritz, former manager of harm reduction at The Spot, put it bluntly. “You can't recover if you're dead.”
Ghartey said it’s an added blow that the Sudbury site in Energy Court, had it received earlier funding, would have been unaffected by the new requirements, such as being far from schools.
So what are the new HART hubs? That’s still unclear.
Réseau ACCESS Network received a letter from the Ministry of Health on Aug. 20, which executive director Heidi Eisenhauer forwarded to Sudbury.com. The letter officially denies funding for The Spot, which was in limbo even before it was opened in Sept. 2022.
It also tells Eisenhauer to “contact your municipal Service Manager for more information about the call for proposals for Homelessness and Addiction Recovery Treatment, (HART) Hubs,”
Those calls have not yet been issued.
When Sudbury.com spoke with Mayor Paul Lefevbre about the announcement, he agreed with Ghartey’s thoughts on the hospital’s difficulty in handling “the fallout” and said he supports the hard reduction view that supervised consumption sites save lives.
He said the city will be applying for all relevant funding related to HART hubs, with a focus on the 40-unit Lorraine Street transitional housing project, but did not offer any specifics.
According to the By-Name List, the city's record of those in need of housing, there are at least 200 people living in encampments. Of the total list, 80 per cent are considered “high acuity” which means they would require serious support in order to maintain their housing stability.
Greater Sudbury’s Roadmap to End Homelessness by 2030 already has a $350 million price tag, just $28 million shy of what the whole province will receive.
Fritz suggested it’s not enough, and asked about the conditions for housing, i.e. would one need to be abstinent to access support?
“I definitely think that there should be more access to treatment, and there should be more detox beds, but it can't be at the expense of harm reduction services. Why can't it be both?” she asked.
With the long-time search for a location for the existing (but now closed) site, Fritz wants to know where the hub will go — especially in light of the protests surrounding Lorraine Street in its infancy.
“Where's it going to go? Does it have to be built?” she asked. “If there's going to be 19 across the province, how is that $378 million going to be divided between the 19 sites? Is this the startup cost? What if you need a location built?”
Not to mention Fritz feels the new plan does nothing to address the unregulated toxic supply of drugs. “There is still going to be wait times between detox and treatment, or to even get into detox, or what have you, and with the current toxicity of the supply, if people try to stop cold turkey that can kill them. So, what are people supposed to do?” she said.
It’s a point that Ghartey raised as well: “With the health-care system the way it is, you're telling me that you're going to create enough spaces for everybody who's eligible? How long are these programs going to be? If it’s 30 days, that’s only going to get you sober, that’s not going to deal with the issues that caused you to turn to drugs,” she said.
“Are we really dealing with these societal and moral issues appropriately, or are we just doing our best to push them under the rug and check off a box on our political checklist?”
Ghartey compared the removal of the service for someone with a diagnosed Substance Use Disorder to someone who has Type 2 diabetes.
“How would you feel if you were diagnosed with Type 2 diabetes largely because of lifestyle and other determinants,” she said.
She offered a scenario of losing a job with benefits that paid for medication.
“The Ontario government doesn't cover your medications, you can't get access to them and you die. Is that OK?” she asked. “Is it okay for the government to remove a life-saving intervention, whether it be a service or a medication that was once available?”
And though the health minister has previously discouraged those who have called for involuntary treatment, Jones told reporters after her announcement Aug. 20 that she was “willing to look at all the options.”
“Involuntary treatment, for one, is a violation of someone's human rights, because having a substance use disorder or having challenges with your substance use doesn't make you a criminal that needs to be locked away. As far as I'm concerned, that's what involuntary treatment is,” said Fritz. “Your autonomy and your choice is taken away, and you're forced into a program that you either don't want, don't need, or doesn't meet your needs, or won’t work.”
To compare it to the person with diabetes: if, after losing medication, you were told that the lifestyle aspects of your disease must be controlled, and you were sent, against your will, to a treatment facility.
After spending 30, 60 or even 90 days there, your diabetes would almost assuredly be under control: but would it stay that way once you were back on your own?
“People have always and will always use drugs; we're not going to eradicate substance use in our world, it's just not realistic, and it's not going to happen,” said Fritz. “We have to recognize that folks need support, and they should also have choices, and it's a matter of health care.”
Fritz feels that people who use drugs are scapegoats for all the ills of the modern world.
“It seems that substance-users, people that are unhoused, people who are struggling with their mental health, have been scapegoated, blamed for all of the societal issues that we're seeing across the country without looking at the bigger picture,” said Fritz.
“Without looking at poverty, without looking at systemic racism, without looking at capitalism, without looking at it being virtually impossible to survive because things are so expensive, even if you have a full time job, let alone trying to survive on OW or ODSP. With all of these combined, and then they're saying, nope, it's the drugs that are the problem and it's the drug users that need to be fixed.”
Ghartey said she is scared for her community.
“We're scared for the people that we care about, we're scared for our communities,” she said. “And ultimately, we don't make the rules. But let me say another thing, civil disobedience has always been part of the movement forward.”
Jenny Lamothe covers vulnerable and marginalized communities for Sudbury.com
