Hamilton and Vancouver are two colonial cities that have historically existed since 1800’s. What else is common between the two? The heroin and fentanyl epidemic that has consumed both Vancouver and Hamilton. Access to a safe and supervised drug injection site is a reality of those struggling with Opiate addiction in Vancouver. Where does Hamilton stand?
Fentanyl is a synthetic opioid, which belongs to the same category of painkillers as morphine and heroin. However, it has been reported that fentanyl is approximately 50 times stronger than morphine and approximately 25 times more potent than heroin. It is believed that, a microgram of fentanyl can produce similar effects that may require milligrams of heroin. Surprisingly, the heroin sold illegally on the streets may be mixed with fentanyl without the user’s knowledge. The user administers the substance in an amount which may be safe to use if the substance was heroin but unknowingly, a user can administer quantity of fentanyl which can have fatal and tragic effects such as an overdose. Therefore, the inevitable result is the number of heroin/fentanyl overdoses is increasing at an alarming rate.
In Hamilton, the number of heroin/fentanyl overdoses resulting in the fatalities and hospital visits have increased significantly in the last five years reported (2008-2013). In 2013, there were 96 deaths in Hamilton related to opioid overdose, which is the highest in province. Similarly, the number of emergency hospital visits in Hamilton related to opioid overdose is also the highest in the province. Hospitals in Hamilton and Emergency Medical Services (EMS) have noted being overwhelmed with an increase in people seeking help with heroin/fentanyl overdose. The problem does not stop there. Significant number of users are developing and spreading HIV and Hepatitis C by sharing needles/syringes and unfortunately, are not even aware of these diseases. In Vancouver, specifically Eastside Downtown, the epidemic is as bad or even worse. However Downtown Vancouver has InSite.
InSite is a supervised drug injection facility where drug users can use medical equipment such as needles/syringes to administer the substance themselves. The staff at InSite, mostly nurses, do not help in administering the substance but are available to educate the user to use the substance in a safer manner. The users bring their own substance to use. The staff is also present to avoid fatalities and medical emergencies that result out of overdosage. On average, InSite serves more than 700 users a day and till date no fatalities have occurred at InSite. Furthermore, there are also counselling and rehabilitation services available for those who may want to seek help in giving up their opioid addictions.
It is clear from the data provided earlier that there is a definitive need for such a facility in Hamilton. According to a recent survey, over 84% of respondents in Hamilton supported the notion of having a supervised drug injection facility. City council is considering conducting a study to find out where and how such a facility can be accommodated. If the study takes place, the recommendations will likely be released in 2018. That also happens to be the year when the next city council elections take place. As a result, even if the study recommends a facility, it may end up being futile as the new council may not want to implement such recommendations. By 2018, there will be many more fatalities and more new cases of HIV and Hepatitis C.
There are compelling arguments supporting safe injection clinics. The cost of running a supervised drug injection facility will be far less than the cost related to hospital visits and EMS dealing with people affected by opioid overdose. There will be far less cases of HIV and Hepatitis C due to needle sharing amongst the users. It goes without saying that use of these drugs are illegal however, treatment of addictions with the use of safe injection sites is something that all cities should consider.