Fear major obstacle to injection sites, experts contend

MONTREAL Fear is the only thing keeping downtown Montreal from having a supervised injection site (SIS) for drug users, health care and drug dependency experts from across Canada said Thursday.

The Supreme Court ruled unanimously in September that Vancouver's Insite centre could not be closed because it would jeopardize the health and lives of its users. In December, Montreal's public health department released a report calling for the creation of three supervised injection sites and one mobile unit.

Quebec's Health Minister Yves Bolduc has said he supports the creation of sites. In early April, researchers at the University of Toronto recommended two such sites be created in Ottawa and another three in Toronto.

Yet seven months after the Supreme Court decision, Montreal is still without an SIS, and a large part of the reason is based on the public's fear of drug addicts, experts said at Friday's forum titled Integrating Supervised Injection Services into Health Care and Community. It was part of the 21st annual Canadian Conference on HIV/AIDS Research going on this week.

"The experience in Vancouver shows us clearly the difficulties they lived in trying to open we are living the same difficulties here in Montreal," said Louis Letellier de St. Just, a founding member of the Cactus needle-exchange program in downtown Montreal that is lobbying to become an SIS. "We need to focus on the fear felt by citizens we must do it and again and again."

Montreal Mayor Gerald Tremblay has said any site must be located in an existing medical facility outside of the downtown core because residents have demanded it. But studies have shown drug users do not go to hospitals or clinics. "Drug users are not a clientele that we (as a society) like to serve or receive," Letellier de St-Just noted. Last week, the mayors and chiefs of police of Ottawa and Toronto rejected recommendations for sites in their cities.

Those barriers are the reason the Insite program was set up outside of a hospital in the heart of Vancouver's drug-riddled Downtown Eastside. Contrary to popular belief, crime rates and drug use did not increase, and the site did not attract users from all over the province, as Montreal residents fear it will, organizers said. But the rate of HIV transmission from shared needles, overdoses and public injury dropped.

"I just think it's a lack of education, of understanding on the part of the populace," said Liz Evans, founder of the Portland Hotel Society that supports people in Vancouver's Downtown Eastside. "It's not ill-intentioned. People just can't see it working." It doesn't help that many don't see drug users as human beings, she noted.

The only thing preventing Cactus from becoming an SIS is a formal approval from the Quebec Health Department, which could be hard to achieve without the support of the mayor. Given that any future SIS would likely be dependent on funding from the government, Cactus is hesitant to open without formal approval. But that idea is being debated, Letellier St. Just noted.

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Fear major obstacle to injection sites, experts contend