In Alberta, Canada, a committee for the provincial Ministry of Health expressed opposition to the province’s legal safe consumption sites (SCS) serving people who use methamphetamine, sparking outrage among harm reductionists.
Alberta’s Supervised Consumption Services Review Committee, comprising law enforcement officials and recovery-focused professionals, released a report on March 5 that urged the provincial government to eliminate client anonymity—a key element in engaging a stigmatized community—to facilitate referrals to treatment and “empower” policing around SCS, among other things. Harm reductionists have long feared that SCS might be co-opted as a means of control, as Filter has reported.
The Committee’s criticisms also target the legitimacy of meth users’ utilization of SCS, calling for a “different strategy to respond to methamphetamine use.” Their recommendation is based on the idea that SCS are designed solely for people who use opioids, and particularly intervening in “possible transmission of blood-borne diseases through the re-use of needles” and “opioid overdoses from a toxic supply of drugs.” For them, the SCS model “does not seem to apply to amphetamine use” since “[t]here is no effective blocker for, or drug to reverse, methamphetamine overdose.”
They also allege a causal relationship between using methamphetamine and what they describe as “negative social consequences,” implying that this is another reason why meth users ought not to be served by SCS. The Committee’s review found that “[s]ubstantial increases in the use of non-opioid substance use, specifically methamphetamines, [are] leading to aggressive behaviour endangering public safety,” as a press release summarized. In the review, “psychosis with hallucinations and bizarre or aggressive behaviour that may last for long after consumption,” were specified as issues.
Psychosis, for example, is not an inevitable effect of meth use. Instead, it can be caused by people not getting enough sleep—which tends to happen when someone has been binging for days—or underlying mental health issues. People without stable housing report using the stimulant in order to stay awake through the night or to have the vigilance to protect their possessions. Some Colorado-based unhoused meth users considered these abilities to be key to “survival,” found a 2013 study. The subjects also sometimes experienced hallucinations, but they considered this to be part of surviving.
“Unless the SCS sites can effectively mitigate the negative social consequences caused by amphetamines,” wrote the Committee, “they are, as one resident noted, little more than ‘government-supported crack houses.'”
For 30 harm reduction organizations, the Committee’s approach to meth users in SCS is misguided. “Once again, this demonstrates a lack of understanding of the very purpose of harm reduction services,” they wrote in a March 23 letter to Alberta’s Premier, Health Minister and Associate Minister of Mental Health and Addictions, “which is to reduce harm related to drug use—not just opioids—and their need to adapt to the needs of the population they serve in order to ensure access.”
Beyond breaking with the principles of the harm reduction organizations, including the Canadian Association of People who Use Drugs and the Canadian HIV/AIDS Legal Network, the Committee seems to disregard the realities of people using drugs.
“Drug testing throughout the country has found methamphetamine and other stimulants contaminated with synthetic opioids, posing an overdose risk to those who intend to use just stimulants. Many individuals accessing SCS are also polysubstance users who take both stimulants and opioids,” wrote the organizations.
“We demand that the government of Alberta take measures to support SCS that have—and continue to be—essential elements of a provincial response to drug use and the overdose crisis.”
Photograph of a safe consumption site in Sydney, Australia by Nigel Brundson, as previously publshed by Filter