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Health Canada approves supervised consumption of oral and intra-nasal substances at two Surrey sites

Illicit drug users in Surrey will soon be allowed consume oral and intra-nasal substances in addition to intravenous injections at the city's two new supervised consumption sites.

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Harm reduction advocates in Surrey say federal approval allowing drug users to use orally and nasally — and not just by injection — at two supervised consumption sites is long overdue and will save lives.

Health Canada on Tuesday approved Fraser Health’s request to provide supervised consumption of oral and intra-nasal substances — the first time such an exemption has been granted in Canada — at SafePoint on 135A Street, which opened on June 8, and Quibble Creek Sobering and Assessment Centre on 94A Avenue, which began providing supervised consumption services on June 20.

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Two other supervised consumption sites that have existed in Vancouver for years, along with those that have recently been allowed to open in the city and elsewhere in Canada, still only allow drug use by injection.

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Dr. Victoria Lee, chief medical health officer for Fraser Health, said the exemption allowing people to take various drugs through different means will expire in one year before another application must be submitted.

She said while the main concern is saving lives, supervised consumption sites are also a gateway to treat opioid addiction.

“We want to make sure that our services are providing as big a reach as possible,” she said. “We also wanted to ensure that others in the country have a better and more streamlined process for them to get approval for intra-nasal and oral substances.

“We heard from colleagues from around the country that they didn’t even know that this was an option,” Lee said of the health authority’s original application requesting approval for three modes of drug consumption.

Ron Moloughney, president of the Surrey Area Network of Substance Users, said the new regulations are greatly needed.

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Surrey Area Network of Substance Users president Ronnie Moloughney welcomes Health Canada exemptions granted to Surrey’s two new safe consumption sites.
Surrey Area Network of Substance Users president Ronnie Moloughney welcomes Health Canada exemptions granted to Surrey’s two new safe consumption sites.

Moloughney said Health Canada’s approval takes into consideration that drug users are consuming “a whole gauntlet” of substances that aren’t always injected or smoked. He’s seen drug users drinking hand sanitizer and crushing and snorting painkillers.

“It’s about time this thing got wheels,” he said. “We’ve been waiting for this for a long, long time.”

At the Overdose Prevention Society in Vancouver’s Downtown Eastside, Sarah Blyth and her colleagues have been supervising people who consume substances orally or intra-nasally since last fall.

Up to 700 people visit the site per day, Blyth said. Roughly half smoke and half inject their substance, but some will snort a line of cocaine or another substance during their visit, she added.

The site has no exemption for such substances but Blyth said that because the overdose situation is so dire, allowing such substance use helps OPS volunteers make contact with that cohort of drug users and refer them to health and social services.

“They do everything – anything goes,” Blyth said. “So they come in and whatever they’d be doing on the street, we just watch and make sure that they’re OK.”

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Jordan Westfall, president of the Canadian Association of People Who Use Drugs, said his group also welcomes the change, and hopes more health regions will obtain exemptions.

“I think it’s great to expand access to this to everybody using opioids right now because obviously the drug supply is contaminated and everybody is at risk,” he said. 

Because fentanyl is turning up in meth, crack and heroin that people are smoking, CAPUD has also been advocating for ventilated inhalation rooms, which have been proven to reduce harms.

Westfall said inhalation is more common than oral or intra-nasal substance use among B.C. drug users, but he believes the new exemption is an indication that health authorities are actually heeding the advice of drug users and may someday allow for inhalation.

“I think we will get there,” he said. “VANDU’s run a room like that for years and there needs to be more.”

Provincial Health Officer Dr. Perry Kendall said the supervision of a wider range of substances will help save lives and help reverse more overdoses.

“In addition, staff at both sites will have greater opportunities to engage with people and connect them to treatment services when they are willing to access them,” Kendall said.

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The SafePoint supervised consumption site on 135A Street in Surrey opened June 8.
The SafePoint supervised consumption site on 135A Street in Surrey opened June 8. Photo by Surrey Now /Vancouver

Since its opening, SafePoint has seen 1,079 visits by 203 people who have accessed supervised consumption services, with an average of 5.3 visits per person. Fraser Health says during that time, 19 overdoses have been reversed, with zero deaths. 

“Since opening on June 8, we have had more than one thousand visits. This latest exemption from Health Canada means we will be more inclusive and provide care to more people,” said Lee.

The approval means drug users are exempt from laws involving possession and trafficking of controlled substances even if they consume their own substances by means other than shooting up.

Many of the street drugs are contaminated with the potentially deadly painkiller fentanyl, which has been implicated in thousands of overdose deaths across Canada.

“These substances are not being made in pristine labs, they’re being made in clandestine labs, more like bathtubs, in somebody’s house,” Lee said.

Fraser Health’s application to Health Canada did not request an exemption for smoking crack because that would have created an occupational hazard for workers, Lee said.

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Dr. Bonnie Henry, B.C.’s deputy provincial health officer, said users of supervised consumption sites primarily inject drugs such as heroin.

She said provincial officials are in discussions with Health Canada to allow B.C., where over 900 people fatally overdosed last year, to approve its own supervised consumption sites.

“We would like to see them give the province an exemption to monitor and to open supervised consumption sites according to a provincial program, like we do for everything else in health care, essentially. Some of the regulations are set federally but we manage the programs.”

Henry noted B.C. has already opened nearly two dozen overdose prevention sites in an effort to curb deaths, showing it can develop needed services amid a public health emergency that was declared in April 2016.

The sites were opened through a ministerial order and are run by community peers including the Vancouver Area Network of Drug Users, though the facilities don’t connect people to other services or treatment.

“It’s us trying to protect people while we’re dealing with this very toxic drug supply right now, where people were using alone and dying,” Henry said.

— With files from Scott Brown and The Canadian Press

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