As soon as members of the Doctors for Safer Drug Policy and Moms Stop the Harm groups showed up at the Comox Valley Hospital on the morning of Jan.20, they were informed they could not set up their overdose prevention site on hospital property.
The yard in front of the hospital was taped off, with two security vehicles parked on the lawn. Media were told they were not approved to be filming on hospital property and were moved to the sidewalk along Lerwick Road in Courtenay. The group of protesters was made up of doctors and supporters, and they quickly were busy erecting tents to allow people who use drugs access to a safe, overdose prevention site while they visit the hospital.
"We created this organization ... in order to advocate for people who use substances, and for them to be able to use substances when they're admitted to hospital," said Dr. Eva Hemmerich, an addictions medicine doctor who practices in the Comox Valley. "We have an evidence-based way of dealing with that, and that is to have overdose prevention sites ... in hospitals.
"It's a place where people can connect to care, they can get referred to treatment, get harm reduction supplies," Hemmerich explained. "It's overseen by people who are trained in overdose response so that people will not overdose when they use their substance."
The pop-up OPS will be operational throughout the week. In addition to overdose prevention, the site will also connect patients with referrals to treatment and medical detoxification services and distribute sterile supplies to prevent the spread of blood-borne infections such as HIV and Hepatitis C.
These infections are a major danger for people who use drugs, as Heather Edward knows well. For years, she used Fentanyl. Now eight months sober, Edward said, "there were times where I wouldn't come (to the hospital) ... a lot of people get infections when they're in addictions ... people won't come for their life-altering diseases because of their addiction, and because they can't use on site. It just gets worse and worse, and then eventually they have to go to the hospital for a longer period of time, and it takes up more of our healthcare time.
"I was in my addiction for about five years," Edward added. "I was on the streets, homeless, and lost everything. I lost my family, my kids, I lost it all. And now I'm just working on getting it all back. I'm eight months sober now."
Callum Roth, another person with lived experience of addiction, said that he was "actually standing here today because of a safe injection site."
Roth was revived with Narcan at the Insite supervised consumption site in Vancouver. He said it was the only time he needed the treatment, but that he had been "kicked out many times for using in the hospital ... We get the stigma really bad in the hospitals ... and our infections get really bad. We're losing limbs and we're dying of pneumonia and infections that shouldn't be life-threatening.
"We're all terrified when we come to the hospital because of how violently ill we're going to get because of the toxic drug supply ... it sucks to say that the pharmaceutical grade care doesn't even touch the unregulated supply, and how poisonous it is. It's not even our choice anymore, we have to use or we're going to get violently ill with seizures and eventually, death. It happens so quickly too, like four to six hours and if we don't use, we're on a slippery slope."
"We don't want to use in front of people," Roth added. "We don't want to use in front of children, we don't want to use in front of nurses. But we also don't want to have to hide away, because that's when we die."
Hemmerich said that the province had indicated that each hospital in B.C. would have an overdose prevention site, but that former Minister of Health Adrian Dix had walked back that promise.
At a press conference in Vancouver on Jan. 20, Health Minister Josie Osborne said that "we are working toward minimum standards so that we can ensure that overdose prevention sites near or on hospital sites are done in a way that is safe for patients putting their care first and foremost, as well as for people and healthcare workers in facilities.”
“Overdose prevention sites are a well-known and evidence-based measure which reduces overdose. It is both life-saving and cost-saving. By patients having to leave hospital to use their substance several times per day, their care gets disrupted and requires longer admission, readmission and then with a more serious condition," says Dr. Jack Bryant, an addiction and family physician in the Valley.
"If patients knew that they could use while in hospital, they would also be more likely to present at an earlier stage which would imply a shorter stay or may not even require admission.”
“It’s understandable that hospital care staff are distressed by potential exposure to substance fumes on the wards as well as dealing with sudden overdoses. An in-hospital OPS where patients could use, would alleviate them of these added work stressors,” says Dr. Erin Gregory, an addiction and family medicine physician in Comox.
Island Health released a statement about the OPS on Monday afternoon, saying that "Operating an unapproved clinical service or demonstration on Island Health property cannot be supported. This position is not meant to dissuade advocacy but rather to ensure that all services provided on Island Health property adhere to regulatory, safety, and clinical standards. That is why our Protection Services teams worked respectfully with organizers to ensure their planned activities did not occur on Island Health property.
"Island Health is committed to ensuring all people are treated with respect and dignity, and patients who use substances receive equitable and accessible care that is free from stigma and judgment. Island Health is focused on enhancing care and connecting people to health services wherever they are at in their journey, particularly in the face of the enduring toxic drug crisis," the statement continues. "Our major hospital sites, including North Island Hospital, Comox Valley, have Addictions Medicine Consult Service (AMCS) teams embedded within them. These expert teams, including specialized physicians, work closely with patients who use substances to develop unique and tailored care plans that meet the needs of patients, protect the safety of staff and other patients, and align with provincial policies and regulations. AMCS clinicians are focused on care planning that manages withdrawal symptoms related to substance use, with the goal of supporting patient comfort and reducing the need to use substances while admitted to hospital."
