For the first time, Canadian authorities are permitting people to consume drugs orally and nasally in drug consumption rooms, as the country’s overdose crisis escalates.

On June 27, Health Canada – the federal department that oversees public health – granted permission to two drug consumption rooms (DCRs) to allow people to use drugs orally and nasally. The facilities - SafePoint and Quibble Creek Sobering and Assessment Centre – are in Surrey, British Columbia (BC). This marks the first instance of a state approving the oral and nasal consumption - such as swallowing or snorting - of drugs in a DCR outside of Europe.

In these DCRs, people are provided with sterile equipment and individual spaces to use drugs under the supervision of medical professionals equipped with naloxone - the medication used to reverse opioid overdoses. Some Canadian DCRs also provide additional services such as counselling, or places where people may stay after consuming drugs. With the formal approval from Health Canada, people may use these facilities without facing legal consequences for possessing or trafficking of illegal substances.

The two Surrey facilities both opened in June 2017, however their application to allow nasal and oral use of drugs was not granted immediately. Thus, they began exclusively as injection sites.

“About 1,000 people have used SafePoint since it opened on June 8, and 19 of them have overdosed, requiring staff to use the overdose-reversing drug naloxone,” according to Dr. Victoria Lee who serves as the chief medical health officer for the regional healthcare authority funding these sites.

“When we look at overdose death data, 33 per cent of people have consumed substances orally and 23 per cent of them have consumed intranasally and about 35 per cent inject their substances,” Dr. Lee described. Given that their primary goal of DCRs is to save lives through the prevention of overdoses, it seems only reasonable that such services extend to include these drug consumption methods.

The exemption which allows these methods of use within the DCRs will expire in one year, after which the facilities must reapply for permission to provide services for people who use drugs orally and nasally. If the DCRs operations over the next year prove to be successful, they may serve as models for other sites around the country. There are currently 12 approved supervised injection sites nationwide that have yet to open, and 12 more applications under consideration.

This growing prevalence of DCRs in Canada is undoubtedly linked to the on-going opioid crisis. Canada is the second highest per capita consumer of opioids in the world, after the United States. This resulted in around 1,400 overdose fatalities in 2016 alone - a problem particularly concentrated in BC, which accounted for 922 of these deaths. In April 2016, the BC provincial health officer declared the overdose crisis to be a public emergency.

Right now, the need for thoughtful and efficient change is only increasing. The BC government reported 136 drug overdose deaths in 2017 by April, which represents a 97.1 per cent increase from the 69 deaths recorded in the same period of 2016.

The first DCR in North America – InSite – opened in BC in 2003. Since its opening, no one has died from an overdose in the facility, and there has been a 35 per cent decline in overdose deaths in the surrounding area. If this extraordinary success is any indication, increasing access to harm reduction services for people who use drugs orally and nasally will continue to reduce the harms of drugs.