Experts, Beltline community debate future of Calgary's supervised consumption site

Just south of Calgary's downtown core, the Beltline neighbourhood has been a magnet for new development and migration in a rapidly growing city.It's one of Calgary's most densely populated communities, with peoplepouring in to fillnew residential towers that dot the area'sskyline.

But one recent constant amid thechurn ofdevelopmenthas been Calgary'slone supervised consumption site (SCS).

Since its launch roughly seven years ago,the SCS at the Sheldon Chumir Health Centre has kept its doors open. It'sbeen lauded as a life-saving service, but also targeted with criticism fromopponents who blame itfor public drug use and increased calls to police in its vicinity.

On Tuesday, city council is set to debate whether it should call on the provincial governmentto close the site, following a public back-and-forth earlier this month between city hall and the province. The debate comes as the province has shifted itsaddiction services model to focus more on recovery-oriented care.

The debate puts the SCS back in a familiar position of scrutiny, but some Beltline residentsbelievethe political discussion around the site isoversimplifying theissue, including the needs of its clients.

"Right now, unfortunately, all we're seeing is using this issueas a political football, and when that happens the community loses," said Beltline Neighbourhoods Association founding member Peter Oliver.

Council's debate is scheduled tooccur more than three years after the province announced it would close the sitein 2021. Italso follows the worst year for opioid deaths in Calgary on record.

Alberta's substance use surveillance data shows 627 such deaths in Calgary last year, as well as the most opioid-related hospitalizations and emergency department visits in Calgary on record.

That'smirrored similar trends in many Canadian and U.S. communities that have struggled for years against a wave of drug poisoningdeaths, though both sides of the border have seen declinesso far in 2024.

Similarly, Alberta saw a decrease in opioidpoisoning deaths in the first half of 2024, leading government to express cautious optimismover the effectiveness of itsrecovery-based approach. Critics advised the figures werepreliminary.

Expanding the SCS

When Calgary's SCS opened, it was the first of its kind in Alberta. The facilities offer a place for people to use pre-obtained drugs under the supervision of a registered nurse trained in overdose response. The site wasset up as a response to the opioid crisis, and to lower public drug use and discarded needles.

It's also designed to offer harm-reduction supplies, like new needles and naloxone kits, as well as education, medical aid, andconnections torecovery, health and other social services.

In the second quarter of this year, the facility logged 10,907 visits,the highest it's recorded in a single quarter in three years.

Calgary has only ever had one SCS, but an alternative systemcan be seen in Edmonton, which has three facilitieswithin one central areato lessen the pressure on eachsite.

Since Calgary's SCSopened, additional or replacement facilities have been suggested, but none have materialized.

HIV Community Linkproposed a mobile site in 2018 to operate between two locations in east Calgary, which never launched. In 2022, the province was in talks to open two replacement sites, but these plans were also eventually dropped.

Meanwhile, as the Chumir site's usage increased in its first few years, Beltline residents reported safety concerns leading to an increased police presence in the area, as well as calls to move the site to a new location.

Former Calgary mayor Naheed Nenshisaid in 2020that he made a mistake in suggestingonly one SCS facility should open in the city. At the time, he said he was open to moving the site, but addedthat the province should also look at opening more sites across Calgary.

But finding a suitable new home for the SCS is challenging, University of Calgary nursing professor Jennifer Jackson said.

The site at the Chumirwas carefully chosen to be central, connected to a hospital, accessible by public transit, and near other resources like shelters and emergency housing, said Jackson, whose research focuses on community-based addiction and harm reduction.

Instead of closing the SCS, Jacksonsaid she favours preserving the life-saving interventionand expanding upon it.

Jackson sees supervised consumption servicesas an essential tool, and one that could be deployed in existing infrastructurearound Calgary,like pharmacies, clinics and hospitals,for more people to access it.

"It's important to move beyond the idea that addiction is those people over there who are bad. Addiction affects every walk of life, every demographic in society, and we need to start designing services that reflect that," Jackson said.

She addedthat keeping the SCS benefits all Calgarians, becausethe care it offers cankeepclients out of the emergency room, lowering hospital wait times.

Acost analysis of the Safeworksharm reduction program in Calgary from November 2017 to January 2020, co-authored by Jackson, found that each overdose successfully dealt with at an SCSproduced roughly $1,600 in cost savings.

LISTEN | The Calgary Eyeopener talks withthe Canada Research Chair in Health Systems Innovation about what closing the Sheldon Chumir's SCS could mean for its clients.

Calgary Eyeopener9:21The Sheldon Chumir supervised consumption site

We speak with the city councillor making the case to close the Sheldon Chumir Supervised Consumption site.

In the meantime, Jackson said the SCS needs stability, as it's been unable to plan long-term for years. She argued the site couldalso usemore resources to hire paramedics and social workers.

Outreach worker Cody Cook believes neighbourhoodconcerns withpublic drug use in the areacould also be alleviatedifmore SCS facilities were openedaround the city.

"We're in an opioid epidemic at the moment, and people are going to use drugs either way. We're just offering them safer ways to use the drugs," said Cook, a peer navigator with the Alberta Alliance Who Educates and Advocates Responsibly (AAWEAR).

Cook and AAWEAR's outreach work hasprovidedaid to people outside Calgary's downtown core far more often in recent years, which they say shows how more SCS facilities across Calgary would be beneficial.

One factor that's led to public drug use around the Chumir's SCS, Jackson and Cook argue, is that the site hasn't kept up with trends of how people usedrugs.

They both point outinhalation rooms would meet the needs of more clients,as smoking has become a more common way that people use drugs,yet inhalation capacity isn't currently offered in any SCS in Alberta.

Council to debate closure

While some advocates and health experts want to see SCS facilities expanded in Calgary, the current political debate is centred around whether to keep the existingsite open at all.

On Tuesday, city council will discuss a motionbrought forward by Ward 13 Coun. Dan McLean calling for council to ask the province to close Calgary's SCS, and instead implement detox facilities and other wraparound supports.

"The approaches that we've used in the past clearly aren't working," McLean said, who added he aligns with the province's movetowardprimarily focusing on treatment and recovery.

"That just makes sense that we need to find a way for recovery, not enabling and continuing the cycle of addiction."

McLean said he wants council to discuss closing the site because of safety concerns in the area.

Calgary police statistics show 5,549 community disorder calls have been made in the Beltline this year, the most in that time period since 2020. Disorder calls can reflect public perception of crime and safety, because they're based on reports of suspicion of potential crimes.

However, the Beltline's crime count, a stat based on the most serious violations that includes most violent crime offences, has steadily dropped since 2019, falling from 2,268 that year to 794 as of the end of August this year.

Alberta's Minister of Mental Health and AddictionDan Williams said in a letter to city council earlier this month that he's happy to see council vote on the SCS, andweigh in on whether the site should close and transition into recovery-oriented addiction care.

Province focuses on recovery model

Williams added that while he's unwilling to seriously consider any proposal for new SCS facilities,if council feels differently and supports additional sites, the request mustbe accompanied by a city-led proposal that includes a list of preferred locations to choose from.

The ministeralso touted the province's work to develop recovery communities,including three in the Calgary area. He saidthe province's focus on recovery hasbeen used for more detox and pre-treatment beds at the Calgary Drop-In Centre, and for overdose response teams downtown and in the East Village.

In a letter to Williams, Gondek said she agreed with the province'sassessment in 2021 that the current SCS isn't working as intended, and that she's interested in combining addictions treatment with SCS facilities.But she said the city has been waiting for years for the province to provide a plan for the site,arguing itshouldn't close withoutproper alternatives in place.

The future of SCS facilities is also being debated nationally.

Conservative Leader Pierre Poilievrehas criticized the sites,calling them "drug dens," and has discussed closing SCS facilities that are "next to schools, playgrounds, anywhere else that they endanger the public and take lives."

Earlier this year, Ontariobanned any SCS facility within 200 metres of schools and child-care centres, which will force 10 sites around the province to be shuttered, with the option to become "treatment hubs" instead.

In Alberta, Red Deer's SCS isscheduled to closeby next year, with plans insteadto introduce a mobile rapid access addiction medicine clinic and an overdose response team made up of paramedics and nurses. "Recovery coaches" will also do outreach work.

Despite the larger debate around how to best provide addiction services, addiction physician and assistant professor at the University of Alberta and University of Calgary Monty Ghosh noted that Alberta's recovery-oriented system of care doesn't exclude harm reduction and supervised consumption.

Ghosh arguedthat what's key is integrating recovery into SCS facilities, withservices like detoxoffered on-site. He compared this to Canada's first SCS, Insite in Vancouver, which is connected to Onsite, a space that offers recovery-oriented programs.Overall, Ghosh supports opening more SCS facilities, as well as providing more access to long-term treatment, detox and housing.

"The principle herethat we need to drive is on-demand support for individuals," Ghosh said. "That basically translates to we need a lot more of everything at this time to deal with the crisis."

Among community residents, Beltline Neighbourhoods Association director Peter Oliver has heard a variety of opinions on the SCS for years. Personally, he'd like to see a community-focused, evidence-based approach to find the best way to support its clients. Simply closing the site without an alternative is unlikely to help, he said.

"They could close down the Chumir SCS tomorrow, and we'd have all the same people now moving into public bathrooms, into more public parks and alleyways and doorways," Oliver said.

Roughly 130 metres away from the site is the I Love You Coffee Shop, owned by former Beltline resident Dan Murray, who's spent much of his life in the neighbourhood.

While he sees people openly using drugs near his shop, he believes this is partly due to the site's lack of inhalation capacity. He added that he sees the site as a vital, life-saving service, and that ever since the province announced plans to close the site, he's feared its absence would leave clients with nowhere go.

"I was fearful then and I'm fearful now that it's just going to lead to more people getting hurt and more people dying. And that's going to be in our neighbourhood," Murray said.

Closing a consumption site

Alberta has already seen what happens when a busy SCS facility is closed without the same level of service being offered in its place.

Carolyn Greene, an assistant professor of public safety at Wilfrid Laurier University, researched what happened to clients after the most widely used SCS in North America, which was located in downtown Lethbridge, closed in 2020.

In its place, a smaller overdose prevention site opened a 10-minute walk away, but it accommodated fewer people, offered less in the way of services, and even the short distance to travel was an obstacle. Clients coming from downtown have to walk down a narrow sidewalk on a busy bridge, where they've reported being targets of insults andgarbage thrown by drivers.

"It left people using drugs outside. They did not leave the area," Greene said. "So when we talk about closing Calgary's site, I think people need to really think about where it is they think folks are going to go."

Eliminating an SCS, Greene said, will also put more strain on the province's health-care system. It could lead to more overdoses in public spaces, more calls to paramedicsand more people needinghospital emergency rooms.

As the debate over supervised consumption sitescontinues, Greene said she hopes the conversation doesn't dehumanize its clients.

"A lot of talk is made about social disorder and things going downhill, but few people are actually talking about the individuals that are suffering," Greene said.