Amber Fritz, manager of supervised consumption services for Réseau ACCESS Network, told Sudbury.com she is always hesitant to focus on numbers when it comes to harm reduction.
“Other people may see numbers, but we see human beings,” she said.
With the release of an infographic from the Energy Court supervised consumption site earlier this month, timed with the release of government opioid death figures from public health districts across Ontario, many have commented on what could be seen as a small number of visitors to the Supervised Consumption site, open since the end of September.
It has seen 126 visits, from 69 unique visitors, and reversed three overdoses linked to the drug-poisoning crisis. Usage per capita is on par with provincial averages and in some instances surpasses figures from other sites.
And more than that, said Fritz, those three overdoses are three people; three people who are alive today because they chose to use substances at the site.
“What could have happened if those three individuals hadn't come to the site? There's a distinct possibility that they may no longer be alive, isn't that not in and of itself worth it?”
Fritz said that while they would like the site to be busier, there are mitigating factors.
“This is a newer service: we've been open for less than three months and this has never been done, in this format, here in this community,” she said. “Those 126 visits? That's 126 times someone was safe, 126 times that someone was cared for and afforded the dignity that they deserve. That's 126 connections that were made. That's 126 times someone was loved and supported.”
She said those connections mean something to the vulnerable populations of Sudbury, and they hope to continue to build that trust.
“The vast majority of folks that have come in to use the consumption room come back. It's very rare that we see someone once and then and then never see them again,” said Fritz. “I think that that speaks volumes.”
It’s also important to be specific when referring to “deaths” from overdose. Now, more than ever, people who are dying from substances are dying because of toxic drug poisoning. It isn’t that they are taking too much, it’s that the substance they think they are taking has been cut with something else that is often more potent.
There are no substances offered at the supervised consumption site, everyone brings their own and injects their substances while under the care of health care workers and harm reduction staff. But because they must be purchased on an unregulated, illicit market, the true nature of what is being consumed is hidden.
“Overdose implies that the person took an overage of a dose, when in actuality someone can experience a drug poisoning experience and a fatal drug poisoning from less than 1/10 of a gram of downer, (such as benzodiazepines).”
On the street, drug poisoning could be fatal, especially when those who are trying to treat it are left with naloxone and CPR, which doesn’t work on benzodiazepine. But if the poisoning happens at the site, the health-care workers are on it immediately.
“We have trained professionals, we have the equipment, a drug poisoning can be addressed in the least invasive and most supportive way possible,” Fritz said.
Not only that, but because opioid poisoning presents as respiratory distress, “If you catch it soon enough, depending on the severity of the situation, of course, sometimes you can reverse that poisoning with oxygen alone. You don't even have to go the naloxone route. If you're out in the community, people do the absolute best that they can with what they have to work with. But here, we have advanced tools to be able to address that immediately.”
But that, unfortunately, only applies to those who consume substances through injection, not those who use inhalation (smoking).
“There has been a significant shift from injection to inhalation,” said Fritz. “And unfortunately, at this point in time, that is not something that we're able to support.”
Though there is a growing need, there is only one supervised inhalation site in Ontario, at Casey House in Toronto. While it is constructed, it is not yet being used, as it continues the path to government approvals.
And though the use of the site is not quite at the levels that the staff hopes, they still see it as a win.
“It's a larger community safety piece, more than just people accessing the consumption site,” said Fritz. “We're not just a place to come and consume drugs, we try to have a very fulsome and well-rounded service so that people have options when they walk through that door.”
This extends to housing referrals, case management, and health care advice or guidance from two primary care paramedics, and any referrals are given with what‘s known as a warm handoff. “The person isn’t just given a phone number because this is a non-coercive, welcoming and supportive environment,” said Fritz.
“People understand that we're coming from a place of compassion and care. We're not trying to force them to do something that they don't want, or trying to tell them how to live their lives. It's ‘I care about you. And I want to see you healthy and well’.”
Thank includes staff with lived experience.
“We have folks on our team that are deeply connected to the community, far more so than just in the capacity of providing a service; people that know folks when they walk through the door, because they knew them from another time. Having that connection to the community just increases people's level of comfort and people's level of feeling of safety.”
That connection is the heart of it all, said Fritz, regardless of the numbers.
“It's not just about supervising their consumption,” she said. “It's about that connection, it's about support, it's about knowing that they have a place to go where they're not going to be judged, just cared for.”
You can find out more about the Réseau ACCESS Network Energy Court Supervised Consumption site on their website, found here.
Jenny Lamothe is a reporter with Sudbury.com. She covers the diverse communities of Sudbury, especially the vulnerable or marginalized, including the Black, Indigenous, newcomer and Francophone communities, as well as 2SLGBTQ+ and issues of the downtown core.
