Edmonton needle-exchange sees rise in use, renewing calls for safe-injection site

The city’s only needle-exchange program is handing out thousands of more sterile needles every month, raising concerns about public health problems and renewing calls for a safe-injection site.

Streetworks needle-exchange program has seen a 22-per-cent increase in the number of needles handed out

Richard Chenery prepares heroin he bought on the street to be injected at the Insite safe injection clinic in Vancouver, B.C. (Darryl Dyck/Canadian Press)

The city's only needle-exchange program is handing out thousands of more sterile needles every month, raising concerns about public health problems and renewing calls for a safe-injection site.

The Streetworks needle-exchange program has seen a 22-per-cent increase in the number of needles handed out over the past 12 months.

Over the course of a year, that would translate into an increase from 1.35 million to 1.75 million needles annually.

Program manager Marliss Taylor said Streetworks is not sure what's behind the marked increase.

"It might be good news," she said. "It might mean that we are actually reaching more of the people that we need to be meeting. However, it may be an indicator that things are not going well, and that more people are injecting. I think we need to pay attention and watch the trends very carefully."

Street Works program director Marliss Taylor is not sure what’s behind the marked increase. (CBC)

There has been no radical shift in the types of injection drugs being used on city streets - crystal meth, cocaine, heroin and fentanyl are still among the most common, Taylor said.

"What we do know is that the numbers are just increasing radically around unintentional drug overdose," she said. "We know that fentanyl has been part of that picture, and a big part of it. But there are other drugs that people are overdosing on as well. That includes heroin."

There were 272 fentanyl overdose deaths in Alberta last year, up from 120 the year before.
The alarming increases — both in the number of deaths and the number of needles — have renewed calls to establish a safe-injection site in Edmonton.

Elaine Hyshka, an assistant professor at the University of Alberta School of Public Health, works with a group trying to create a medically supervised injection site in the city.

"I think what appears to be an increase in injection drug use in the city is concerning," Hyshka said. "Also, with the increase in overdose deaths we've seen related to fentanyl, I think now is an excellent opportunity to be having these discussions.

An injection kit is shown at a supervised injection facility in Vancouver. (Jonathan Hayward/Canadian Press)

"Frankly, though, I think these services are overdue."

Hyshka said evidence from Vancouver proves that safe-injection sites can protect addicts and communities.

In a unanimous decision in 2011, the Supreme Court of Canada ruled that a safe-injection clinic in Vancouver could remain open. The court ruled that not allowing the clinic to operate under an exemption from drug laws would be a violation of the Charter of Rights and Freedoms.

In 2014, Hyshka conducted a study with 320 drug users in Edmonton - almost all were injecting. The vast majority reported injecting in public. The study also found high rates of needle sharing, and almost one-quarter of users reported they had overdosed at least once in the previous six months.

"To me, those statistics really clearly indicate that there's a need for additional services to try to reduce some of those risks," Hyshka said.

Evidence shows that safe injection sites do not lead to increases in substance abuse or crime, she said.

"What they do do is save lives."

Plans for a such a site in Edmonton would not mean building a new facility. The new service would instead be added to those that already exist, Hyshka said. 

Elaine Hyshka, a researcher in the School of Public Health at the Universty of Alberta, found 26 per cent of Edmonton drug users surveyed in 2014 shared needles with other users. (CBC )

For example, an existing agency could create special rooms where addicts could bring their own drugs, so they could have access to sterile needles and inject under the supervision of a nurse. When finished, the addicts could move to another room for observation, to make sure they haven't overdosed.

That's where they could be connected with health-care workers or counsellors, Hyshka said.

Her group is now working to finalize a model. When finished, the group will apply to the federal government for an exemption similar to the one now in place for the Vancouver site.

That could happen by late this year or early next year, she said.

Taylor said adding a safe injection site in Edmonton would not lead to an increase in drug use.

"What we know is that people will not start using substances because there are safe injection services," she said. "Who we would be capturing are people who have no options, who may be out in back alleys or in bathrooms, behind people's garages, who are using."

Such a site, Hyshka said, would simply shift some of the injection drug use that is already occurring on city streets.

"Take it out of the back alleys, take it out of the parks, take it out of the public restrooms, and put it into a medical environment," she said. "Where people who are typically quite dependant on drugs, and very sick, can get access to potentially live-saving resources."


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