Overdose prevention a key local health tool

Western News File PhotoArthur Labatt Family School of Nursing professor Abe Oudshoorn said plans for a permanent supervised-injection site in London – also dubbed an overdose prevention site – is essential for the city in fostering health and preventing overdose deaths.

As the city forges ahead with plans for a permanent supervised injection site, its new temporary site is an important step in fostering health and preventing overdose deaths, according to one Western professor.

“This has been a decades-long concern for those who provide healthcare in our community around the negative and unintended consequences of substance abuse, particularly injection drug use,” said Abe Oudshoorn, who teaches in the Arthur Labatt Family School of Nursing and is a prominent voice for homeless and health-compromised Londoners.

The London program will be located at 186 King St.in London, at the Regional HIV/AIDS Connection where a busy exchange program for needles and syringes already operates.

In January, Ontario Health Minister Eric Hoskins approved the creation of several such facilities, including one in London. Two weeks ago, the Middlesex-London Health Unit announced the city’s temporary facility would open in mid-February. A process is still under way to determine a potential permanent site.

This new site – also dubbed an overdose prevention site – is essential for the city, Oudshoorn noted. A rash of overdose deaths spread across the province last summer. Just two months ago, London police issued a public warning after potentially deadly carfentanil – a synthetic opioid 10,000 times more powerful than morphine – was found in seized drugs.

Just days before the temporary site was announced, London police alerted the public to three sudden overdose deaths that had occurred in less than 48 hours.

“We have continued to see increases in overdose deaths in the London area, even after the provincial government implemented some policies to try to reduce them,” Oudshoorn noted.

The province introduced OxyNEO to address OxyContin abuse and provincial-level prescription databases to watch for over-prescription of opioids, documented as higher-than-average in southwestern Ontario.

“But ultimately, we’ve really seen no reduction in overdose deaths. It was time to do something which we’ve known we’ve needed to do for a long time. And although (a supervised injection site) is not a permanent recovery for folks, it is a way to at least keep them safe,” he said. “While we always hope for people to move to recovery, while they find their way to that path, we need to do everything we can to keep them as safe and healthy as possible.”

A supervised injection site can also prevent abscesses and heart disease related to infection from injection drug use, as well as prevent the spread of communicable disease, Oudshoorn explained. In other communities, notably in Vancouver, it has shown “incredible impact,” he added.

Vancouver’s InSite facility, the first of its kind in Canada, prevents hundreds of overdose deaths each year and offers entries towards recovery.

“As InSite and others have demonstrated, it’s not a good time to have that conversation when someone is in withdrawal and suffering from seeking their next substance. When they are calm and the immediacy of that anxiety has been addressed, then that is a good time to have a conversation about what they need, what they want and what recovery might look like for them,” Oudshoorn said.

“It’s very effective; they’ve seen folks moving into withdrawal management, residential treatment, counselling – all sorts of long-term supports – and that will be an important part of the model here,” he added.

What makes London’s site and plans for a future facility promising is the collaboration and integration of community services, support agencies and healthcare providers, he continued. The health unit, the London Homeless Coalition, the mayor’s poverty panel, research centres, healthcare and addiction service providers are working together to promote health and address overdose deaths in the community.

Oudshoorn said this collaborative approach helped lead the province to a rapid approval of the city’s proposal for a site.

“Five years ago, when there wasn’t the same political will towards this, there wasn’t the same community will, either,” Oudshoorn said.

He credits municipal and provincial leaders for recognizing something needed to be done to address overdose deaths in our communities.

“While you still hear some concerns, I think there’s much more general acceptance that overdose deaths should be prevented and we need to have more pragmatic solutions to addressing that. Part of that is just leadership saying everyone in the community matters and we need to be concerned about everyone. This is one way we can help improve health outcomes for people who have some of the poorest health outcomes in our community.”