HALIFAX—Nova Scotia may not see the same level of opioid deaths as the west coast, but as Halifax’s overdose site prepares to open this year, Dr. Christy Sutherland of Vancouver says it’s vital to have systems in place before “things shift.”

Sutherland is originally from Halifax and got her medical degree at Dalhousie University before completing her family medicine residency at the University of British Columbia in 2010. She has worked for years in Vancouver’s Downtown Eastside, and is the medical director of the Portland Hotel Society non-profit, as well as education physician lead with the British Columbia Centre on Substance Use.

In the Halifax North Memorial Public Library on Wednesday evening, Sutherland gave a free keynote lecture titled “Safe injection sites and overdose prevention sites: scientific evidence and community experience,” presented by Dalhousie University’s Global Health Office and HaliFIX, the group that will be managing the overdose prevention site (OPS) a few doors down on Gottingen St.

There were 57 apparent opioid-related deaths in 2018 in Nova Scotia according to the province, while there have been 21 confirmed and 12 probable opioid toxicity deaths for this year as of Aug. 1. These numbers may be far below the 1,535 drug toxicity deaths in B.C. last year, but Sutherland said harm reduction models and services should be applied everywhere.

“The crisis hasn’t really hit here yet — but it will be coming, and so it’s wonderful to be able to prepare and have all these interventions ready to go for when things shift, and the deaths start to increase,” Sutherland said after her lecture.

Sutherland covered a variety of topics before a crowd of more than 80 people, including the best ways to treat and support people with substance use disorder (the more accurate term for what is commonly known as addiction), and how various models in Vancouver reach different groups of people: whether it be safe injection sites for women only, or ones attached to treatment centres and housing.

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Often, Sutherland said an impulse might be to ask someone why they’ve used dirty needles, or tell them they must make good choices, but it’s important to look at the world someone is living in and figure out how removing some of those risks could make it safer.

“We are called, I think, as humans to take care of each other and to think about creating safe environments.”

When it comes to an OPS or supervised consumption site, which are more permanent locations also approved by the federal government after a more extensive application process, Sutherland said they have been so well-studied “we shouldn’t research them anymore.” She compared them to insulin.

“It’s been studied enough. It works. It’s a standard of care,” said Sutherland, pointing to a slide showing more than 70 research citations.

For those who may believe drug users shouldn’t be given a comfortable place to inject, Sutherland said it’s clear that being uncomfortable doesn’t make people quit — if it did, Vancouver’s Downtown Eastside would not exist.

“In fact, (it’s) the opposite: treating them like human beings, treating them well, having safety and security and relationships is what helps people to stop using drugs if that is their goal.”

These sites promote safer injecting, connect people to primary care, don’t increase an area’s drug use, cut down on public use and stray needles, as well as reducing overdose frequency: a fact Sutherland noted might seem counterintuitive given they are areas with large numbers of people using drugs.

She said a large reason for that is that when people are inside and safe, they can do a test batch of their drug supply and there are people on hand with Naloxone, a medication that can temporarily reverse the effects of opioid drugs.

There has never been an overdose death in one of these sites since they have begun to be studied, Sutherland said, an impressive statistic considering Vancouver’s long-time Insite facility has seen more than 3.8 million injections.

After the lecture, audience members asked various questions including one about the ideal place for an OPS.

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Sutherland said they should go where people are already using drugs. Communities often worry about the “honey pot” effect, and think a site will attract drug users, but she said that’s not the case.

Sites can be small and embedded in existing services, Sutherland said, and that’s the current plan for the HaliFIX site in the basement of the Direction 180 methadone clinic, located across the street from the Mainline Needle Exchange.

During the Q&A part of the event, Rev. Rhonda Britton of the New Horizons Baptist Church said she’s “not appreciative” of the location for the Halifax OPS, which is beside the church, and asked what other services should be offered in the facility to best help people.

Sutherland said that the site two blocks from her own house has only “made the neighbourhood better” and said she believes it’s important to be able to connect clients to doctors and health professionals.

Cindy MacIsaac, executive director of Direction 180, added that the OPS will initially have two booths, clean supplies for cooking and injecting drugs and peers with first-hand experience. Nurses will also be available in the building and Mainline staff will be there to help with appointments, getting ID, housing and much more.

Matt Bonn, HaliFIX co-founder, said after the lecture that the peers will be paid for their work, which also fits with Sutherland’s comments about the importance of creating employment for drug users. Although Bonn said he’s heard concerns from North End businesses and other residents in the past about the OPS, there has been “less vocal opposition” in recent weeks.

“I think it’s just about having these conversations, having events like these,” Bonn said, adding HaliFIX will also have a community advisory committee to address any concerns from the area.

For now, the Halifax OPS will operate as an Urgent Public Health Need Site under a one-year exemption and will not receive funding from the province. However, Bonn is hopeful that such a partnership might eventually come about, opening the door to more supports and amenities.

Sutherland said Vancouver business groups, police and fire services regularly thank her and others working in these sites because they share the same goals and see how these services are actually saving police resources and time.

Public perception didn’t even take that long to change in Vancouver, Sutherland said, because “people appreciate safety.

“You community looks nicer when people are healthy and doing well,” she said.

The Halifax OPS is aiming to open before the end of summer.

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