MONTREAL — A researcher from the National Institute of Scientific Research will attempt over the coming months to document the impact of the implementation of supervised consumption sites in their environment, with the aim of collecting conclusive data that could lead to a more harmonious and more relevant deployment of future sites.
This pilot project will pay particular attention to the impact of these sites on groups in vulnerable situations, such as women, single-parent families, children and newcomers, said the project manager, Professor Carolyn Côté- Lussier.
“The idea is to take into account the mode of operation of supervised consumption sites, but also their location to produce conclusive data on the impacts for local communities,” she summarized.
It was 20 years ago last year that the first supervised consumption site opened in Canada. If the scientific literature solidly documents the benefits of such sites in reducing deaths by overdose, the risks of transmission of diseases through blood or even the harms associated with drug consumption, much less is known about the impact that ‘have these sites in the environments where they are established.
Canada, like other countries, is currently facing an opioid crisis that continues to grow, recalled Professor Côté-Lussier. For example, Toronto Public Health recently reported 523 deaths from opioid toxicity last year in the Ontario capital, a slight increase from the previous year but a decrease from the previous year. peak of 591 reached in 2021.
It therefore stands to reason, said the researcher, that the pressure on health services to reduce harm among the user population will also increase. We can therefore anticipate that more and more supervised consumption sites will open in densely populated urban areas, she predicted.
“When we talk about changing the supply of services intended for vulnerable populations in dense urban centers, it is obvious that we must think about what the potential benefits will be for nearby communities,” said Professor Côté- Lussier.
While there has been a lot of research on the importance of what is called “social acceptability” of such sites before their implementation, there is much less data regarding the impact of these services on the communities that welcome them, lamented the researcher.
Health Canada’s recommendations regarding the establishment of these sites ― and which mention, for example, establishment where there are overdoses and where these sites will be most useful ― are also very vague and subject to interpretation.
“The public debate around these sites is often very simplistic,” said Ms. Côté-Lussier. We criticize these sites, we don’t want them in our backyard, and it’s a dialogue that is perhaps not effective in responding to the real fears of people who live nearby.”
The heated debates of recent days, concerning the establishment of the Maison Benoît-Labre next to the Victor-Rousselot school in the Saint-Henri district, illustrate to what extent cohabitation between these sites and the community can be thorny.
These sites, recalled Professor Côté-Lussier, are often located in disadvantaged areas that do not have the political or economic capital necessary to mobilize and have a voice in the planning of services in their community. The literature then demonstrates that, in certain cases, the risk assumed by these communities is associated with a benefit for the community as a whole.
“But it is still these communities that have to live with the burden if the service does not work well,” she stressed. The idea (of the research project) is therefore to document in order to respond to the phenomenon of what we could call ‘not in my backyard’, but which we can also see as an interest in participating in the planning of services in neighborhoods and in urban environments.”
The neighbors of these sites have “no ill will,” she added, and they recognize that they are necessary, but like any public service, we must ensure that they function well.
Implementation arrangements
The scientific community is currently interested in the methods of establishing these sites, said Ms. Côté-Lussier. Should they be implemented in health centers? Or should we rather favor mobile sites?
“Literature evolves very quickly,” she said. To answer these questions, we need conclusive data.”
This data can be obtained by talking to site users and stakeholders, but it is also important to include local communities, the researcher said. Residents’ reluctance to host these sites often stems from their feeling of having been excluded from the conversation, according to her.
The evidence will make it possible to better respond to the “legitimate” fears of citizens, but it will also better inform decision-makers when the time comes to equip these sites so that they best meet the needs of users and the local community.
Professor Côté-Lussier cites as an example a supervised consumption site which opened near an elementary school in the Saint-Henri district of Montreal. If certain authorities then declared that the problem of consumption in public spaces was already present in the neighborhood, the perception and experience of the neighbors of the site were very different.
“The location is not insignificant,” she recalled. If we’re talking about crime, for example, we’re talking about a radius of around one hundred meters. It’s a very small geographic location.”
In other words, if we set up a supervised consumption site even one kilometer from where the overdoses are concentrated, there is a risk of clashes. The site must instead be located where overdoses are found, but also where the population has expressed concerns in this regard, said Ms. Côté-Lussier.
Reassuring location
In Toronto, for example, evidence led to the opening of fixed supervised consumption sites specifically in apartment buildings where there was a reported problem with consumption.
“It has to be reassuring for the local community,” said Professor Côté-Lussier. The population must say, ‘We know that this problem exists, and here we are given a potential solution which will be beneficial for the users and for the local community’.”
Conversely, if the site is deployed in another way, this could cause a feeling of incomprehension among the local population who will wonder “why” we are implementing this in their community, she added.
The same will apply if we explain to the local population that the establishment of the site aims to respond to a problem in the neighborhood, but that the residents of the neighborhood consider that the situation is not a problem for them.
“With the project that we wish to carry out, I hope to respond a little to this issue, precisely by surveying people who live nearby and in other locations, to understand a little about the perceptions of people in the needs in their neighborhood, especially post-implantation,” said Ms. Côté-Lussier.
Once the site is deployed, do people who live nearby notice more social cohesion in their neighborhood? Are they more likely to walk or use public spaces? These are clues that can reveal whether or not the site meets the needs of the community, the researcher said.
Ms. Côté-Lussier and her colleagues will therefore set out to meet people who live within a 200 meter radius around a supervised consumption site, but also within a 500 meter radius to be able to nuance the impacts on people who live nearby. nearby and on those who live further away.
Comparison sites will also be chosen to ensure that any impacts that could potentially be observed are not attributable to another social phenomenon, she specified.
Residents will be invited to answer public health questions, questions about life in their neighborhood and obviously questions about the consumption site.
“It is important to understand what impacts they perceive on their health, on their well-being and on neighborhood life, and what are the optimal solutions, according to them, to meet these needs,” concluded Ms. Côté-Lussier .
