“Hamilton has been known for some time to be the “epicenter for the opioid crisis in Southern Ontario”, says Ken Durkacz .

In October 2016, the City surveyed Hamiltonians to find out if there was public support for harm reduction sites (HRS, aka “safe/supervised injection sites” or “overdose prevention sites”). Over 84% of residents were supportive of HRS, so the City embarked in early 2017 on a detailed needs assessment and feasibility study. The recommendations included:

  1. “Hamilton should implement one integrated supervised injection site located in the area flanked by Queen Street (west), Barton Street (north), Ferguson Ave (east) and Main Street (south);
  2. “Additional integrated sites should be considered based on implementation of the first site, monitoring for need, and the interest and willingness of service providers and users to have additional locations.
    Potential areas to monitor include the East End and Mountain”; and
  3. “Geographic areas outside of Hamilton’s downtown core could be serviced with a mobile supervised injection site.”

The study and recommendations were approved by Council in December 2017. By February 2018, the AIDS Network was ready to move forward with Hamilton’s first permanent HRS at its downtown location of 140 King Street East, at Catharine Street South. It proposed at the same location “a smaller temporary overdose prevention site as a stopgap that would allow supervised injection until the permanent location was approved and operating.”

Then trouble struck. The landlords for the AIDS Network and Wesley Urban Ministries both refused to host the site. The proposal for a mobile SIS trailer had already run into zoning, bylaw, and permit issues, and its feasibility thus became questionable, though people continue to die of opioid overdoses in frightening numbers.

Happily, the Urban Core Community Health Centre agreed to host the site and received ministry approval. Staff have been trained at this time of writing and stand ready to begin June 5, 2018.

That said, this Harm Reduction Site is only the beginning, and a temporary one, since the Urban Core is projected to be in a new home within the next couple of years. So a permanent site is needed for the area. Since it doesn’t look like the mobile site will be feasible, an HRS will need to be established in other parts of the city.

It was interesting to see how as part of their McMaster Leadership Training, Brenda Duke, Autumn Getty, and Renee Bisson chose Harm Reduction Sites as their mock community engagement project. They prepared community engagement brochures, a slideshow, and other information, applying it to the Gibson neighbourhood as an example and providing the necessary background for understanding the benefits of HRS for all areas in Hamilton. If such materials were used in a context of open dialogue in advance of other sites being established in Hamilton, there could be more community support and “buy-in” for HRS.

The city is currently discussing with hospitals the possibility of one of them hosting a HRS.  However, there are good reasons why most HRS are not located in hospitals, the most critical one being accessibility. “Many health care facilities and institutions are seen by many in the drug-using community as inaccessible—partially because of location, but also because of the stigma associated with drug use, addiction and mental health conditions.” In other words, they will be reluctant to go to an HRS in a hospital.

I know some of you reading this may be concerned that harm reduction sites only encourage drug use. However, there is a large consensus in health care as well as solid from leaders of harm reduction sites in Canada like Vancouver – for many reasons, harm reduction is vital.

The City and its Council have an obligation to represent the 84% who support this vital initiative. Let us all work together, Hamilton, to better care for these Hamiltonians in need.

(This article was updated from one that I wrote earlier, published in Raise The Hammer May 7 2018)