Commentary | Community health in community hands

In December, the Quebec Health Ministry released a proposal to create three supervised injection sites in Montreal. One of these sites was to be located in the Ville-Marie borough and operated by Cactus, a local not-for-profit organization that assists people who use intravenous drugs. Last week, however, Montreal Mayor Gerald Tremblay stated that he will not allow Cactus to operate this facility. Tremblay claimed that these facilities should be run through hospitals or health clinics instead of community organizations. The Daily finds the Mayor’s decision highly disconcerting.

While a health facility may seem like a natural location for a safe injection site, a site of this nature would be unlikely to achieve the same participation rate as a community based facility would, as the latter would likely be more accessible for individuals facing drug addictions. According to Cactus, 93 per cent of those who use intravenous drugs do not use the health-care system.  In addition, some people who use intravenous drugs could feel uncomfortable entering a health facility because Quebec’s health insurance system would document the individual’s visit.

Cactus’ facility was partially based on the model of Insite, the highly effective supervised injection facility in Vancouver. Since 2003, Insite has operated in Vancouver’s downtown lower east side providing clean injection supplies and medical supervision to individuals with drug addictions. The facility creates a supervised space for addicted individuals to inject pre-obtained substances. In 2010, Insite averaged over 500 injections per day with 221 overdose interventions and over 5,000 referrals to drug rehabilitation programs. Insite has seen no drug related fatalities in nine years of operation. According  to Anna Marie D’Angelo, Insite’s senior media relations officer, the facility would likely not have achieved these results without allowing visitors to be pseudonymous.

While Insite is partly operated by the Vancouver Coastal Health Organization, individuals’ visits are not documented by health insurance providers. This is the same plan Cactus’ facility would use. Given Insite’s success in Vancouver, Tremblay would be foolish to prevent the creation of a similar facility in Ville-Marie.


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