The 2011 Supreme Court of Canada ruling on Vancouver’s Insite clinic clearly established 1) that supervised consumption sites are part of health-care services that should be made accessible to people who use drugs, 2) that these sites contribute to reducing the harms associated with drug use, and 3) that denying access to these sites increases the risk of death and disease.

In addition to saving lives every day, these sites act as an essential point of contact for people to access much-needed health-care services that have been proven effective to reduce overdoses, blood-borne infections (hepatitis C and HIV), infections (i.e., skin, soft tissue, heart and blood infections) and other medical complications. They also help connect people who use drugs with social services and support to address housing and food insecurity, mental health issues, trauma and isolation.

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It has been well established that the care provided in supervised consumption sites falls within the legislated scope of practice of registered nurses. In these sites, nurses work with harm reduction and peer workers to establish a trusting relationship with clients, assess their health needs, offer care that reduces potential harms associated with injection drug use, provide harm reduction education and supplies, monitor for signs of overdose or other acute health complications, and intervene in emergency situations. They also provide primary care to clients and acting as a first point of contact with the health-care system. Primary care services include immunization, point of care HIV and hepatitis C testing, wound care, screening for sexually transmitted infections, counselling and so forth. Based on their assessment, they can also refer clients to addiction care and facilitate linkage to services, which are often difficult to access for people who use drugs (i.e. housing, income assistance, food support).

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Canada is in the midst of a public health emergency with more than 10,000 overdose deaths since 2016. Alberta is the second province most affected by this overdose crisis. In 2018 , Alberta hit a record high, with close to 800 overdose deaths including 165 in Edmonton and 289 in Calgary. As a response to this crisis, the previous NDP government accelerated the implementation of supervised consumption sites. Despite this initiative, pressing needs were still unmet prior to the elections.

On Friday, we learned that the newly elected United Conservative government is launching a review of existing supervised consumption sites and putting a hold on new locations. This has important implications for sites under development in Medicine Hat, Red Deer and Calgary, which will not receive further funding until the review is completed. It will also slow down or potentially stop the creation of new potential sites. For communities like Red Deer, this decision will result in many more overdose deaths. Red Deer has the highest number of fentanyl-related overdoses and overdose deaths, double the incidence recorded in the province.

Now is not the time to halt funding for supervised consumption sites. In fact, it is time to scale them up. As nurses, we have an ethical obligation to provide safe, compassionate, competent and ethical care based on empirical evidence. In Canada, nurses who work with people who use drugs are expected to provide care based on a harm-reduction approach. In fact, the Canadian Nurses Association, which represents 135,000 nurses across 13 jurisdictions, has adopted a clear policy on this: harm reduction is the gold standard in nursing and should be implemented across the health-care system. Halting funding to supervised consumption sites will prevent nurses from providing care they are ethically obliged to provide to people who use drugs. It will also limit their ability to respond to the overdose crisis and save lives.

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As experts in the field, we call on the United Conservative government to make policy decisions based on empirical evidence, not ideology. Supervised consumption sites work and closing them would be a death sentence for hundreds of Albertans who desperately need access to health care.

Alberta Coalition of Nurses for Harm Reduction and the board of directors of the Harm Reduction Nurses Association:

Marilou Gagnon, president;Tim Gauthier, vice-president;Leigh Chapman, candidate, secretary;Scott Harrison, treasurer;Trish Dribnenki-Pennock, regional representative west;Bryce Koch, regional representative central;Kimberly Wilbur, regional representative east.

The Harm Reduction Nurses Association is a Canadian national organization with a mission to advance harm reduction nursing through practice, education, research and advocacy.