Ottawa city's first permanent Supervised Injection Site opens at Sandy Hill Community Health Centre
The room is spotless, the tabletops gleaming of polished stainless steel that matches the sleek, stylish desk lamp. At each of the five booths, a round cosmetics mirror is affixed to an adjustable arm.
“We wanted these mirrors here in case people wanted to do some neck injections,” says Rob Boyd, director of harm reduction at the Sandy Hill Community Health Centre, site of Ottawa’s first permanent supervised injection site.
“We don’t encourage people to do that — it’s a very dangerous place to inject. You slip up and you could be paralyzed. But we’re not going to turn people away from here because of it. If it’s going to happen, it’s better that it happens here.”
Seven years after it began lobbying for a supervised injections site in Ottawa, the Sandy Hill Community Health Centre accepted its first clients on Monday, hours after getting the official go-ahead from Health Canada. The site was to have opened last October, but delays in getting final approval and provincial funding for renovations pushed the opening back six months.
“I don’t feel like celebrating — that’s the wrong mood — because we are seeing an escalation in overdoses and escalation in overdose deaths,” Boyd said. “Relieved is the word. We just need to get in there and do our part.”
When it is up and running at full speed, the site will be open from 8 a.m. to 8 p.m., 365 days a year.
Though it was first site in Ottawa to get conditional approval from the federal government to open back in 2017, the delay makes the clinic the third official safe injection site. Ottawa Public Health operates an interim site on Clarence Street, and Inner City Health runs one in a trailer near the Shepherds of Good Hope on Murray Street. (A rogue, “pop-up” injection site ran for more than two months under a tent in Raphael Brunet Park in Lowertown before closing in November.)
The Clarence and Murray Street sites will remain open and a fourth site at the Somerset Street West Community Health Centre is awaiting its final approval to open from Health Canada.
Visitors to the Sandy Hill clinic at 221 Nelson St. are greeted by an intake worker and must complete a form — anonymously — that goes over their history of drug use. They are then asked to wait until one of the five booths in the injection room is available. Boyd hopes no one will ever have to wait more than 15 minutes for their chance to inject.
“The biggest risk we face is the waiting time. We don’t want people leaving just because they’ve been waiting too long.”
Once in the injection room, a nurse will do an assessment of the person’s general health and level of sobriety and offer advice, if needed. The goal is to complete the injection within 15 minutes and clients are asked to wait a further 15 minutes afterward to be sure there is no risk of overdose. There is naloxone on hand as well as oxygen and a defibrillator and a nurse to oversee the clients. Clients will be given clean needles to inject with but will supply their own drugs.
“We’re expecting that when we have overdoses, they will happen very fast, right in the booth,” Boyd said. “This is due to the high toxicity of the drugs that are out there right now.”
The clinic is prepared to deal with multiple overdoses at the same time, he said, knowing that some users will be injecting from the same batch of drugs. Staff are all trained to deal with overdoses and have a protocol that includes calling 911 for paramedics if necessary.
The advantage of the Sandy Hill site has is that it offers an integrated service all under one roof, with counsellors, case managers, a methadone program and health care, Boyd said.
“It connects people to services. The nurse might notice some people have an abscess and say, ‘Hey, we have a clinic right across the hall. Why don’t you drop in there?’”
The supervised injection sites help reduce the amount of public drug consumption in places like public washrooms, parks or alleys, Boyd said. They also have been shown to reduce risky behaviours that can lead to HIV or hepatitis infections and also keep drug users from discarding their needles and syringes in public places, since all sharps are disposed on site.
The ultimate goal, though, is to save lives, Boyd said.
“The reality is that people who inject drugs don’t want to be doing this in public spaces,” he said. “We’ve seen a spike in overdoses that we think is connected to the illicit fentanyl that’s now in the drug market. We need this as an intervention that can save people’s lives.”