Northwestern Health Unit (NWHU) released a report that examines the need for supervised consumption services (SCS) in four local communities: Kenora, Dryden, Sioux Lookout, and Fort Frances. Recommendations highlight the need for SCS in Fort Frances. While the majority surveyed expressed agreement, potential negative effects of implementing the services are still being weighed.
SCS are a legally operated facility where people come to use their own drugs under the supervision of health care workers. A hygienic and supportive space for drug consumption is offered.
Rather than a guarantee that the services will be offered, the report informs stakeholders and local partners on recommended next steps to address the staggering increase in drug-related deaths. The report also indicated that harm reduction programs such as SCS present potential benefits to communities and that there is a need for more support in the NWHU region.
Despite the higher rates of opioid related deaths and hospitalizations in the NWHU catchment area compared to the rest of the province, there is currently only one SCS in the area, located in Thunder Bay.
“Overdose deaths more than tripled from 2019 to 2021 and the final numbers for 2022 are expected to be similar or higher than 2021.” explained Dr. Kit Young Hoon, medical officer at NWHU.
In Fort Frances, rates of ER visits related to substance-use have been higher than across Ontario for each year between 2016 to 2020, but lower than across the NWHU catchment area.
Informants noted that homelessness may be the greatest factor influencing drug use in Fort Frances.
The rates of substance use harms in Fort Frances are significant enough to indicate a greater need for harm reduction and the addition of SCS is recommended, the report said.
Led by LBCG Consulting for Impact Inc., a feasibility study was launched last spring. More than 1,850 stakeholders were consulted, including people who use drugs, health-care professionals, service providers, Indigenous partners, businesses, municipal representatives, and the public.
A majority of respondents in Fort Frances said that they would use SCS if they were available for reasons such as safer conditions, prevention of overdoses, and sterile drug use equipment.
Despite geographic challenges, most agreed that the best course of action is a centralized SCS that can be accessed by the majority.
According to members of the community in Fort Frances, potential locations for SCS include near other services (e.g., safe bed program, hospital, counseling support, RAAM clinic), downtown on the side street off of Scott Street, Nelson House, The Family Centre, NWHU site, Canadian Mental Health Association site, or Mobile services.
“We didn’t go as far as recommending specific locations, we included those ones that were suggested by some of the folks that were interviewed in the local community. But we really think that that’s part of the next phase of the work that needs to be determined because location is so important,” said John Atkinson from LBCG.
Municipal informants expressed concern about introducing SCS while there is a continued gap in local drug treatment services. In addition, they don’t see a foreseeable change in these circumstances despite mental health and addiction being a top community priority across all the communities and there has been a longstanding gap in adequate government funding to support necessary initiatives, the report said.
Police detachments spoke about how overwhelmed they have been dealing with drug-related issues. Detachments reported that there has been an increase in public safety calls, theft, and property damage as well. In addition, it was noted that people who use drugs need safe environments where they are less susceptible to victimization and human trafficking.
Harm reduction program informants spoke about the challenges with needles being left around the communities and the constant need for clean up, especially where children play.
Informants from the community noted the concern that the services currently offered are sometimes disconnected and do not coordinate well with one another. In addition, many people don’t know where to find the support they need or how to access services, the report said.
A potential benefit to businesses in communities are reduced loitering, shoplifting, and drug equipment debris left around, also reducing the number of confrontations between people regarding substance use, making the community more safe for all, the report said.
“Literature does suggest that SCS can have an impact on decreasing the amount of discarded needles or other drug gear, mainly because people are accessing SCS to use in those facilities,” said Atkinson.
Findings showed that a majority said they were in favor of SCS, however there were some that were against it. Many of those interviewed shared that there is a lot of work to be done to raise awareness of SCS amongst leaders, organizations, and the broader community.
The most common concerns regarding SCS services relate to the potential conflict that might arise between neighborhoods due to nimbyism, the worry that SCS will enable drug users to use more drugs, and an increase in crime. Many were also concerned that if locations for SCS are not “right” then there may be a potential negative impact on neighboring businesses and pushback from members of the community.
Young Hoon noted that if the SCS services are implemented, it will be important to evaluate and identify negative impacts as they appear. “they should also be monitored as you move along. This is not a sort of one and done kind of work,” she said.
LBCG Consulting highlighted the importance of further educational activities geared towards the public and partners to be able to understand concerns from local communities while fostering empathy and understanding around addictions.
Funding for SCS can come from the Ontario Ministry of Health for funding through the Consumption and Treatment Services funding program.
Securing enough funding to run 24 hour SCS has been a challenge experienced by many SCS services that currently exist, but something important to advocate for to avoid the chance of deterring potential clients, said Chauvin.
The report noted that SCS will not be a “magic bullet” to solve all drug-related concerns in Fort Frances, however, further discussions on realistic outcomes and how to lower potential risks should be held with stakeholders and the broader community.
“Research shows that supervised consumption services are indeed helpful in reducing harms, such as opioid overdose, overdose, morbidity and mortality while improving access to addiction treatment services. Research also found that the implementation of SES was not was not associated with increases or decreases in crime or public nuisance,” said Atkinson.
“Harm reduction is an approach that aims to reduce the health and social harms of substance use and addiction. It’s intended to meet people who use drugs where they are, and provide them with choices of how they will minimize harms through non judgmental and non coercive strategies in order to enhance skills and knowledge to live safer and healthier lives. While treatment services are important and often aimed to help individuals become sober, individuals coping with addiction and problematic substance use may not be in a position to remain abstinent from the substance that they use. Therefore, supervised consumption services can reduce harms to those who use drugs where treatment is not feasible,” he said.
The complete supervised consumption services needs assessment can be viewed online at NWHU’s website www.nwhu.on.ca.