It is very challenging to respond to the government decision on removal of funding for the remaining 7 supervised consumption sites in Ontario. Responding effectively requires an awareness that the emotion contained in your response will be scrutinized far more severely than the facts about what this decision will mean for the lives and deaths of people who use drugs.
Time and time again we have to dispel the myth that harm reduction, safer consumption, safer supply, different forms of recovery, and addiction and treatment services are in conflict with one another. These services are complementary to one another, and an important component of a good healthcare system. Many people have advocated for a healthcare system where these services all exist in abundance, with easy access for individuals whenever they decide they are ready for change. This is an ideal we should strive for. Scientifically, we know that we cannot force a person into treatment for substance use, and expect a lasting result. To do so would remove their autonomy, creating more trauma, and likely contribute to their ongoing substance use.
Healing the traumatized brain takes time, intention, empathy and support. Trauma changes the brain. Substance use with a toxic drug supply also changes the brain. In order to improve brain health after trauma and substance use, we must first attend to a person's basic needs. Food security, affordable permanent housing, harm reduction, safe consumption, and a wide array of flexible treatment options keep people alive. Individuals who are not fighting for survival, and feel safe and stable, have better capacity to think about overall wellbeing and the future. People must be able to choose goals around their substance use that they know they can succeed with, rather than being forced into forms of treatment they know are not personally attainable, setting them up for failure. On average, people will need 7 attempts to achieve some success in altering or ending their substance use. We must support people at all stages of their substance use, in every attempt at change, and in recovery.
Overdose deaths in the province of Ontario increased by more than 75% between 2018 and 2022. Supervised consumption site closures mean death rates will continue to rise. These deaths are preventable. If we deliver healthcare to improve health, wellbeing and quality of life, we will use all the programs, tools and resources available to save lives. Cutting services in a healthcare crisis is a decision grounded in stigma rather than science.