Political will needed to open supervised injection sites in Manitoba, expert says

​One of the country's leading experts says Manitoba needs the political will to bring in safe injection sites.

Dr. M.J. Milloy criticizes lack of recommendation in province's new mental health, addictions report

An injection kit is shown at a supervised injection facility in Vancouver. Dr. M.J. Milloy says the question in Manitoba is not whether such sites are needed, but whether there is political will to establish them. (Jonathan Hayward/Canadian Press)

One of the country's leading experts says Manitoba needs to find the political will to bring in safe injection sites.

Dr. M.J. Milloy says multiple studies have shown safe consumption sites prevent overdoses, stop the spread of HIV and hepatitis C, and increase public safety by reducing the number of needles on the street.

The infectious disease epidemiologist with the B.C. Centre for Excellence in HIV/AIDS and a principal investigator into a five-year evaluation of Vancouver's first safe injection site, said it's no longer a scientific question whether sites should be established.

"The question in my mind is not whether Winnipeg needs this facility but whether or not there will be the political will or courage," Milloy told The Canadian Press on Tuesday in an interview from Mexico City.

A copy of a report commissioned by the Manitoba government on addiction services and provided to the media Monday morning included a recommendation to open a safe injection site in Winnipeg. By the afternoon, the recommendation was deleted in a copy posted by the government online.

Dr. Brian Rush, who wrote the report, said the recommendation was removed in the final draft because he didn't have enough evidence and data to back it up.

No interference: health minister

Health Minister Kelvin Goertzen has said the government didn't interfere with the report. "There simply doesn't exist the data and evidence in Manitoba" to back up the need for an injection site, he said Wednesday.

Goertzen acknowledged there was communication between health department officials and the report's authors, but insisted no one told Rush to take the supervised injection site recommendation out.

"Not to my knowledge, but also [not] to Dr. Rush's knowledge. So he's indicated that no official asked him to change anything," he said.

I don't think the argument that we are not Vancouver, we don't need this, is necessarily founded on good science.- Dr. M.J. Milloy

Premier Brian Pallister has also said he doesn't support the idea of a supervised injection site.

Pallister told the legislature last month Manitoba isn't facing the same drug overdose situation as British Columbia and other jurisdictions.

"We have not had the incidences, not even remotely close, of tragedy, of tragic overdose, for example, in the streets or on the street corners of the city of Winnipeg," he told the house in response to a question from Opposition NDP Leader Wab Kinew.

"In fact, fully 70 per cent plus of the incidents are happening in homes of users or of users' friends."

Pallister said at the time he was waiting for Rush's report and would follow its recommendations.

Milloy said Pallister's argument is a common one but "there are areas in Winnipeg which have the sorts of concentrations of urban poverty and drug use which ... would be well-served by supervised injection facilities."

"I don't think the argument that we are not Vancouver, we don't need this, is necessarily founded on good science," he said.

Kinew said Wednesday experts agree safe consumption sites work and the government has taken it off the table "simply because of the premier's own personal beliefs."

Ontario, Quebec, British Columbia and Alberta have all opened multiple safe injection sites.

Consultant didn't know about site proposal

Winnipeg's Main Street Project, which offers clean needles and harm reduction supplies, has seen demand for needles jump to 1.5 million from 500,000 in the last year.

The downtown shelter is applying for federal approval to open a safe consumption site, which involves reaching out to the province. Executive director Rick Lees said he knows "they have a different view."

"These are people that are homeless in many cases, or unable to find a safe place to use," Lees said. "They are also burdening our health-care system ... so it makes sense for this particular population to have a safe consumption site."

If we could solve the addiction and mental health issues, then you wouldn't need safe injection sites because they wouldn't be injecting, but that's not going to happen.- Paul Melnuk, Aurora Recovery Centre

Rush said he was unaware of a proposal for a safe injection site by Main Street Project, which was publicly working on plans at the same time as Rush was conducting his research.

Goertzen said he doesn't know why Rush wouldn't have the information he needed on safe injection sites.

"I don't know, or wouldn't know, why Main Street Project or anyone else involved in those consultations would have felt constricted in terms of what they could have said to him."

Paul Melnuk, founder of Aurora Recovery Centre in Gimli, said he agrees with the report's recommendation that mental health and addictions services be brought together into one integrated system.

"The broad recommendations — one of accessibility and the other integrated service from beginning to the end and beyond — is exactly what we do. So I think the recommendations are very much on point."

On the issue of a supervised injection site, Melnuk said while they don't stop people from using drugs, they are effective at preventing the spread of infections from dirty needles.

"I wish it didn't need to exist. If we could solve the addiction and mental health issues, then you wouldn't need safe injection sites because they wouldn't be injecting, but that's not going to happen."

With files from Cameron MacLean

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