Supervised injection sites remove some risk for opioid drug users

They're safe spaces for shooting up drugs and there's a movement to bring these controversial facilities to Massachusetts.

They've been in Canada for years. The first safe injection sites opened in Vancouver back in 2003. Since then, their success has been the foundation for new sites to open in other provinces, most recently in Montreal, Quebec.

Boston 25 News reporter Stephanie Coueignoux and photojournalist Jason Solowski were the first TV news crew allowed to film inside a site in Montreal.

Tucked in an alley off the busy Rue de St. Catherine, the sign for Cactus Montreal is the only visible indication of what happens here.

"These are other kinds of needles, depending on what the person will inject, it is easier to do it with a larger needle or smaller one," said Sandhia Vadlamudy, Executive Director of Cactus Montreal.

Inside a room with a sign that reads "salle d'injection", there are ten cubicles where people sit down and shoot drugs like heroin and cocaine -- legally.

Vadlamudy holds a plastic bin used to carry drug paraphernalia that is provided for anyone to use. In this room there are syringes, vials of water for mixing with drugs, a cup to mix the drugs and water in, and lots of sanitary wipes.

It's one of three supervised injection sites that opened in Montreal this past June. The city even has a mobile injection unit that will meet users to provide clean syringes and other supplies.

It's a radical idea that took a decade for lawmakers to approve.

"This is out of the box. We're nuts in the sense of the law. We're not supposed to do that," said Manon Massé, a politician who represents Sainte-Marie/Sainte-Jacques for the National Assembly of Quebec.

One of the supervised injection sites opened a few hundred yards from an elementary school. Massé said it caused a lot of controversy in the neighborhood.

"At the beginning, people were afraid, at the beginning they didn't want it so close to them," she said.

But opinions changed as the number of addicts shooting up in public grew.

"When you find outside syringes, it's not good for you or for your children," Massé said.

One main goals for these programs is public safety. To keep people off streets so they don't use drugs and then overdose without anyone around.

Massé said now that the opioid epidemic isn't as visible, families have told her they feel safer.  She said that since the injection sites have opened, hospitals and first responders have seen less overdose patients, although there is no current data available on this.

During the two days Boston 25 News was in Montreal not a single syringe was visible near any of these sites.

"I certainly never made a conscious decision to use a syringe. It was part of that lifestyle, I lived on the streets and it just happened," said Farin Shore.

Shore was an addict for 35 years. He's now a peer worker at Cactus Montreal, providing support to current drug addicts.

There are strict rules inside Cactus Montreal.  Before drug users are allowed inside they write down the drug they've brought so the staff is ready in case of an overdose. They can only inject themselves and they can't share their drugs.

Only ten drug users are allowed inside at one time. Two nurses, one psycho-social worker and a peer worker are always present.

Once a person has their basket with their drug paraphernalia, they can sit down at a cubicle where a mirror is placed in front of them.

"If a person is overdosing, we will be able to notice a change in their face and be able to give proper care to that person," said Vadlamudy

She said the site has a powerful ventilation system so no one inhales drug fumes. Some users stay for 10 minutes, others for two hours.

"They're responsible for cleaning their booth. They put the used needle into the bin and then take a wipe, clean up, and put everything in those big bins there," Vadlamudy said.

They also have naloxone kits, the generic brand of Narcan, in case of an overdose.

Vadlamudy said this site has about 80 visits every day. Since it opened in June there hasn't been a single fatal overdose.

Critics say this program enables drug use- instead of encouraging people to seek treatment.

"Does it enable? Yes, in the sense that we give them a safe place that is sanitary that has sterile equipment to use," said Shore. "More importantly, what we're doing in a bigger sense than that is reducing the risks people are taking."

Peer workers also help connect addicts to outreach programs like housing and treatment options, encouraging them to face their addiction head on.

"The fact they can come in here without being judged, without having a stigma attached to them, means they can bring their addictions out of the closet and deal with it," said Shore.

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