Sydney, Nova Scotia, will soon open its first authorized safe consumption site (SCS). The provincial health department will spend the equivalent of about $400,000 USD to open the new SCS and to support an existing site in Halifax.
SCS allow people who use state-banned drugs to do so in the presence of trained peers and staff who can reverse an overdose when needed. The term “SCS” is sometimes used interchangeably with “overdose prevention site” (OPS), and in some cases refers to the same thing; in Canada SCS are considered more comprehensive and established facilities, while OPS can refer to pop-up sites focused purely on overdose reversal.
“In terms of opioid deaths, Nova Scotia has been relatively stable over the past 10-20 years,” agency Health Protection Program Officer Sara Wuite told Filter. “We had a relatively protected drug supply in that time. I would say up until very recently you would hear that it was a ‘pill province’ … a lot of redirected pharmaceutical opioids.”
In recent years, the agency has been reporting an increase in deaths involving fentanyl and its analogues, and those involving novel benzodiazepines. “Perhaps we haven’t seen the mortality that some other places have seen,” Wuite said, “but we’re starting to see those indicators that the drug supply can become much more toxic and dangerous.”
Sydney is the largest city on Cape Breton Island, on the province’s northeast coast. The city was once a major steel producer, but the industry shrank after World War II, and with it the city’s population.
The new site will be operated by nonprofit Ally Centre of Cape Breton, which offers syringe services, naloxone training and blood-borne disease care.
“Cape Breton has for the longest time had the highest rates of overdose in Nova Scotia,” Ally Centre Executive Director Christine Porter told Filter. “We’re not a very big island, but we’ve had lots of big problems. The last two years, the toxic drug supply has been trickling into our communities … our numbers aren’t high, but if we can save one life then it’s worth the [$100,000 USD per year] the province is investing.”
The Ally Centre has still not received federal authorization, which is necessary to operate a legal SCS. But Porter expects to get this soon, and hopes the site will be open as early as mid-January 2022. It will be housed in the nonprofit’s existing facilities, but booths will need to be purchased and new staff hired.
“Everyone who works at our OPS uses substances or has lived experience. It’s essential that they have autonomy.”
In Halifax, Nova Scotia’s largest city, the existing ReFix site has been formally operated by Direction 180, in different forms, since its authorization in September 2019. Direction 180 is a nonprofit that offers both harm reduction and recovery services.
It will receive half of the total funding, about $197,000 USD total over two years. It’s the first time the provincial government has ever funded ReFix, which previously relied entirely on private funding.
ReFix Halifax is open six days a week. The new money still isn’t enough to expand operating hours, but it will help with purchasing supplies, paying staff and potentially hiring additional staff.
“Our overdose prevention site model is a non-medical model,” Direction 180 Program Manager Paula Martin told Filter. “Everyone who works at our OPS is a person who uses substances or with lived experience, so all of our staff have the expertise of substance use. They have a phenomenal rapport with people who use substances in the community. It’s essential that they have autonomy in operating our OPS.”
Ally Centre faces similar financial challenges to ReFix. Porter explained that compared to ReFix, her organization will likely have to use more of the money it receives for start-up expenses.
“That’s not a whole lot of funding,” she said. “I would like to see more money invested in the OPS because it is seven days a week, 365 days a year. You want to keep it open hours people will use the site. You want to compensate people properly for their time.”
Authorized SCS operate throughout Canada and in other countries around the world. In July, Rhode Island became the first US state to authorize a two-year SCS pilot program. In November, New York City began operating the country’s first two authorized SCS.
Photograph of a Canadian SCS by Matthew Bonn