Harm reduction lessons from Europe

by Valerie Adams and Anne Christie Teeter
Somerset West CHC

What can the Netherlands and Germany teach Ottawa about supervised drug consumption rooms and the treatment of drug addicts?

That’s the question representatives from the Somerset West Community Health Centre recently tried to answer during a fact-finding trip to Europe.

Joining staff and board members from the Sandy Hill Community Health Centre, our team met with government officials and harm reduction experts, as well as frontline workers and engaged community members who live near supervised drug consumption facilities.

The team also had the chance to visit consumption rooms in Amsterdam, Rotterdam, Utrecht, and Frankfurt, providing an eye-opening and valuable opportunity to see firsthand how they work.

The International Drug Policy Consortium defines drug consumption rooms, also commonly referred to in Canada as “supervised injection sites,” as places where the hygienic consumption of pre-obtained drugs is permitted in a non-judgmental environment and under the supervision of trained staff.

The aim of such facilities is to support people who use drugs, especially those who inject in public, and to reduce some of the nuisance, violence, and property crime associated with public drug use activity.

There are 37 drug consumption rooms across the Netherlands, a country where national drug policies are designed to combat public nuisance and organized crime, and to protect public health. Drug use in the Netherlands is generally viewed as a health issue, not a personal failing, and service providers understand that recovery from addiction may not mean abstinence for all drug users. A study by the Trimbos Institute indicated that the level of community support for drug consumption rooms rose from 42% to 80% between 2003 and 2010.

Drug consumption rooms in the Netherlands also don’t often exist alone, but are instead run in conjunction with homeless shelters, community kitchens, methadone treatment programs, and other support services.

At one centre located in a residential part of Amsterdam, clients are also actively engaged in their community, patrolling the neighbourhood twice a day to collect garbage and help maintain public safety.

“You cannot operate a house like this and not give back to the community,” said Cedric Charvet, the consumption room coordinator.

Meanwhile, in Frankfurt, Germany, the first drug consumption room opened in 1994, at a time when up to 1,000 people on weekends were openly using drugs in a city park. As in Amsterdam, the motivation for opening such facilities in Germany was to provide health care to drug users, connect them with treatment and support, and offset the harmful effects of drug use on public order.

Police, politicians, and residents work hand-in-hand to address issues that arise and ensure that public safety is not compromised by a facility’s presence in a neighbourhood.
Consumption rooms in Frankfurt have literally saved lives. Nearly 150 people died of drug overdoses in 1991. By 2011, that number fell dramatically to just 26.

Ottawa does not have the kind of open drug scene formerly seen in Frankfurt or the Netherlands. But an average of three or four people die from drug overdoses every month in this city.
In addition, the rates of HIV and Hepatitis C infection among drug users are alarmingly high, and that has many health care providers and harm reduction advocates pushing for a better way to help people.

Vancouver is currently the home to Canada’s only supervised injection site, which is called Insite. But a 2011 Supreme Court ruling ,which confirmed that Insite saves lives and prevented the federal government from shutting it down, could open the door to more.

Community organizations in Montreal, Toronto and here in Ottawa have all expressed an interest in establishing supervised drug consumption facilities.

This column is a collaboration between the Centretown and Somerset West Community Heatlh Centres (CHCs). They provide a full range of health and social services to individuals and families. Through leadership and support, they foster the active participation of individuals and groups in a common effort to build healthier communities.

Centretown CHC: www.centretownchc.org or 613-233-4443
SWCHC: www.swchc.on.ca or 613-238-8210