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Despite their sombre colours and floral bouquets, the mourners marching toward Calgary’s Olympic Plaza on June 10 were anything but subdued. Then again, with a megaphone blasting cadence calls down Stephen Avenue, maybe propriety was beside the point.
According to Jessica McEachern, the one brandishing the bullhorn, the event invitations that went out a few days before should have dictated the terms and the tone. “Dress in black, come for the memorial … and help us fight like hell for the living,” she said.
When the Government of Alberta decided to close Safeworks, Calgary’s sole supervised consumption site (SCS), McEachern, an advocate for drug users’ rights, decided to mark the loss and make arrangements with a handful of grassroots organizers in the city.
“It was a funeral for the death of the SCS,” she explained, “and for the thousands of drug users who have died.”
In 2020, Alberta had more than 1,100 opioid overdose deaths. It was the province’s deadliest year thus far in the epidemic, which saw 623 opioid-related deaths the year before. In the first four months of 2021, there have already been 488 overdose deaths—an average of four per day—which means this year is shaping up to be even more lethal than the last.
Hanging the closure on crime and disruption in the area surrounding the site, the United Conservative Party (UCP) has committed to keeping the Calgary service open until similar services have been relocated to two new sites.
It was a funeral for the death of the SCS, and for the thousands of drug users who have died.
But to harm reduction advocates who’ve already seen Alberta’s government shut down supervised consumption sites in Edmonton and Lethbridge, the demise of Safeworks is another nail in the coffin for services that are badly needed in Alberta, especially now.
In August 2019, Alberta’s government ordered a review of the province’s supervised consumption sites that culminated in a report focused on their “socio-economic” effects. Citing needle debris surrounding the sites, as well as social disorder and a “near absence of referrals to treatment and recovery,” Jason Luan, Alberta’s associate minister of mental health and addictions, said the review found a “system of chaos.” The government would focus immediately on funding a “recovery-oriented continuum of care,” he added.
And yet, “chaos” is the same word Claire O’Gorman uses to describe the uncertainty surrounding the Safeworks closure, which, for many users, threatens a fragile trust in a program that keeps drug users alive.
A Calgary nurse with 10 years of harm reduction experience, O’Gorman says that the provision of supervised consumption services hinges on relationships that service providers develop with clients who’ve often been spurned by health-care and social services given the stigma attached to illicit drug use.
When that relationship is lost, there’s potential for people to drop off or fall through the cracks.
“We’re asking people to come inside somewhere safe and hygienic and warm—with medical supervision—to do something that’s otherwise illegal on the other side of the door,” she said.
Relocating service, O’Gorman adds, not only undermines the hard won confidence of clients who’ve grown comfortable with the site, it also risks raising the bar for access to medical and social services housed in the very same building. In Calgary's Beltline community, the Sheldon M. Chumir Health Centre offers everything from clinics for dental work and sexually transmitted infections, to a program to help unhoused and at-risk clients obtain provincial identification and health-care cards.
“When that relationship is lost, there’s potential for people to drop off or fall through the cracks,” O’Gorman said.
A former program manager for Safeworks, she describes harm reduction as an opportunity for clients to get non-judgemental care as they work toward their own individual goals, be it abstinence-based recovery, reconnecting with family, or finding stability and a place to live.
Sometimes the goal is simply staying alive long enough to make a change.
At Olympic Plaza, the demonstration has evolved into a funeral in earnest. Beneath crosses staked into grassy strips on the steps, protesters-turned-mourners chalk the names and initials of lost relatives and friends onto the concrete ground below.
“RIP Lily,” one read. “I miss my sister,” said another.
The spectre of Safeworks (or at least its future) a few blocks away looms large over the scene. In a eulogy of sorts, McEachern tells the crowd about her own connection to the site, and the role it’s played in her life.
After many failed attempts at abstinence-based treatment programs, she says she first stepped into a supervised consumption site in east Vancouver in 2007. An injection heroin and methamphetamine user at the time, McEachern says she was relieved to have finally found a place that was willing to help her without demanding that she change her habits first. That lived experience, she adds, led her to a peer support worker position with Safeworks and some of the most meaningful work she’s ever done.
If they die, you’re gonna bring them back to life. That’s literally it. There’s nothing out there like this.
“It liberated me,” McEachern explained in a phone interview. “It was a $26-an-hour job where, for the first time in my life, they encouraged me to talk about things on my cover letter such as crime, homelessness, survival sex work experience. These are things I would usually hide.”
Having seen the value of supervised consumption sites from both sides of the booth, McEachern boils down the nature of harm reduction services like Safeworks to a basic and sacred understanding between clients and providers. “If they die, you’re gonna bring them back to life,” she said. “That’s literally it. There’s nothing out there like this.”
According to an Alberta Health Services report, Safeworks responded to 2,583 overdoses between October 30, 2017 and March 30, 2021. To date there have been no overdose deaths at the site.
With the impending closure of Safeworks, and the relocation of supervised consumption services in Calgary, there are some concerns that the Beltline, which some experts say has been hit particularly hard by the opioid epidemic, could see a spike in potentially deadly overdoses.
In December 2020, a few months after the supervised consumption site in Lethbridge—one of the busiest in North America—transitioned to a mobile trailer, Alberta Premier Jason Kenney acknowledged that the city was seeing fewer opioid-related deaths. Last summer, the province pulled funding from ARCHES, the non-profit that ran the site, after an audit found financial irregularities and missing money ($1.6 million that has since been accounted for).
But not all communities are affected equally by opioid use. Esther Tailfeathers, senior medical director of Alberta Health Service’s Provincial Indigenous Wellness Core, said earlier this month that 91 Blood Tribe members have died in the aftermath of the closure of ARCHES’ Lethbridge site in August 2020. Recent data from the province found that the rate of deadly overdoses was six times higher for First Nations people than the general population in 2019, and seven times higher in the first six months of 2020.
Alberta realities to confront on #NationalIndigenousPeoplesDay:— Hakique Virani 🟠 (@hakique) June 21, 2021
- First Nations were 7.3X (!!!) more likely to die of opioid OD than non-FN in the first 6 months of 2020
- such shocking data were released to the public without comment last Friday afternoonhttps://t.co/mmlKnASfap pic.twitter.com/Yue2AhgEk8
While the COVID-19 pandemic likely plays a part in the province's climbing death toll, provincial data shows that Lethbridge had eight more opioid overdose deaths in the first four months of 2021 than the first four months of 2020. And Lethbridge isn't the only community affected.
Elaine Hyshka, a researcher and assistant professor with the University of Alberta’s School of Public Health, would like to have at least a year’s worth of data to study the effects of SCS closures in Lethbridge and Edmonton. Nevertheless, she says, some of the more recent headlines closer to home have been disheartening.
In Edmonton on June 2, for example, a team from Boyle Street Community Services—which had an SCS until it was relocated to a winter shelter at the Edmonton Convention Centre last fall—responded to 10 overdoses around the building before noon.
We seem to think it’s appropriate to introduce chaos into the system at a time when so many people are relying on these services to save their lives.
In a statement to CBC, the Alberta government said it’s engaged with Boyle Street Community Services about “potentially” opening similar services in an under-serviced part of the city. Meanwhile, acting in line with its recovery-oriented strategy, the province just earmarked $2.1 million dollars for the George Spady Society, across the street from Boyle Street, to fund 35 detox beds.
While she doesn’t disagree with expanding treatment options for those struggling with addiction, Hyshka doesn’t see the sense in closing a service with a proven track record of saving lives, especially given the current rate of overdose deaths.
“Those options are great for many people, but at the end of the day, we have to recognize that for opioid use, which is driving the vast majority of mortality in the province, residential treatment is not really an effective approach for that,” she said. “We are really seeing a trend toward closing the most effective services we have for preventing death.”
Rather than losing and relocating supervised consumption sites, Hyshka suggests that Edmonton, and the rest of Alberta for that matter, would be better served with additional sites and a greater capacity.
“We seem to think it’s appropriate to introduce chaos into the system at a time when so many people are relying on these services to save their lives,” she said. “I would worry in Calgary that we’ll see the same thing, where we will have a population that are currently accessing Chumir—that have trusting relationships with the providers that work at Chumir—but are not willing or able to go to a different agency to access those services.”
Part of that chaos flows from the fact that the public has no sense of when Safeworks will close, or where to expect replacement services.
The lack of details has prompted a Calgary man with a “direct interest” in the matter to demand Alberta Health Minister Tyler Shandro delay the closure until the government makes a "binding" commitment to a seamless transition of service that includes consultation with service users. Edmonton civil rights lawyer Avnish Nanda, who recently represented 11 Alberta patients in a court battle to prevent the province from closing an injectable opioid treatment program, sent the letter to Shandro on his client’s behalf, and has given the government until July 19 to respond.
Yesterday, I issued a formal legal demand on behalf of a client who is impacted by the Alberta government’s decision to close Safeworks, Calgary’s only safe consumption site, which serves thousands of Albertans each year.— Avnish Nanda (@avnishnanda) June 17, 2021
Read it in full here: https://t.co/ysC3sP0s03 pic.twitter.com/OwSppSHr4M
For her part, McEachern’s doubts the province will follow through with the replacement sites. As founder of the Calgary Harm Reduction Alliance, she plans to pour her energy into advocacy work and trying to reduce harm in the Beltline in her own small way.
“I just want people to know that there’s hope, because people do care... We’re going to do everything we can to fight against this,” she said.
On June 26, groups including Moms Stop the Harm, Friends of Medicare, and others are organizing a day of action in Central Memorial Park, across the street from the Safeworks site. McEachern says she’ll be there. In the meantime, she’s working on other ways to support drug users in Calgary.
On the morning of July 17, just before noon, she was out on 17 Avenue S.W. trying to make a difference.
“I go out all the time looking for people,” she said from her phone, “giving mutual aid, building community, and looking for people in alleys to try to save from overdose.”
Hamdi Issawi is The Sprawl's Edmonton editor. Follow him on Twitter @hamdiissawi.