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Closing Safe Consumption Sites: Progress or a Dangerous Mistake · Recovering Out Loud

• 0:00
  So there seems to be a lot of debate whether supervised
• 0:05
  consumption sites are beneficial or we should take them out.
• 0:10
  This has sparked recently within Toronto, the city in which I
• 0:14
  live, where they just announced, the government announced that
• 0:17
  they were closing down supervised consumption sites.
• 0:19
  So harm reduction, safe consumptions, not where they
• 0:22
  provide drugs, but where they provide safe tools to use your
• 0:29
  own drugs so that you don't need to go in the back alley of a
• 0:33
  school to shoot up heroin or use your other drugs.
• 0:37
  It's just one area where people can go to safely use their
• 0:41
  drugs. Clean needles, lots of good
• 0:44
  benefits. However, people see the
• 0:46
  headlines and think, oh, we're closing down those stupid drug
• 0:50
  sites where all those dirty homeless people hang out.
• 0:53
  And I'm pretty passionate about this because I think harm
• 0:56
  reduction saves lives. And I know a lot of people in my
• 0:58
  industry agree with that sediment.
• 1:01
  I want to spread some awareness on why this is bad.
• 1:05
  And the government has, yes, pumped in money for recovery.
• 1:10
  The problem though, is, and I'm going to get into it in this
• 1:12
  episode, is not everybody wants to stop using drugs today.
• 1:16
  That might not be the case down the road, however, and it is my
• 1:20
  opinion that if you keep someone alive long enough, which is what
• 1:24
  the supervised consumption sites are doing, these needle
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  exchanges, these, these sites that were shutting down, you
• 1:30
  keep people alive. They reduce overdose deaths to a
• 1:33
  point where they can hit their bottom.
• 1:35
  That is the goal in my opinion. How do I get somebody to get
• 1:39
  help with treatment and addiction?
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  Well, the only way I know how is to let their consequences happen
• 1:46
  to them so that they can come to a place where they want to stop.
• 1:50
  And let's be honest, not everybody will want to stop.
• 1:52
  Some people will want to go on the rest of their lives using
• 1:56
  and they're OK with it wasn't my story, wasn't my situation, my
• 2:01
  scenario. I hated it every second of it.
• 2:04
  And I wanted to stop and I did stop and I got help to do so.
• 2:07
  And without rehab I wouldn't have been able to do it.
• 2:09
  So I'm going to go over what these new heart hubs look like
• 2:13
  in Toronto. And essentially it's not just
• 2:17
  Toronto, but this will apply to around the world because I think
• 2:20
  a lot of governments are starting to push towards the
• 2:22
  abstinence based model, which is great for somebody that wants to
• 2:26
  stop. But if you don't want to stop
• 2:27
  yet, which it was, I was in that boat for a long time, I didn't
• 2:31
  want to stop. If we're forcing people to stop
• 2:33
  against their will, I think it causes more overdose.
• 2:36
  And I think the data and literature reflects that as
• 2:39
  well. People are only ready when
• 2:42
  they're ready and we can't force them into abstinence based
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  recovery because it's a big step for a lot of people.
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  They can't fathom abstinence and quitting altogether.
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  So Toronto announced a new strategy, it's called the Heart
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  Hub Hart, and its purpose is to connect people who use drugs
• 3:02
  with treatment, housing, healthcare.
• 3:05
  And there's a big debate around it because, like I said, the
• 3:09
  services like supervised consumption and safer supply are
• 3:11
  not included. So the purpose of this episode
• 3:13
  is to talk about the opioid crisis in devastating cities,
• 3:16
  Toronto, the new model that we're trying and we're going to
• 3:21
  cover what the hard hub is, what services it provides, what it
• 3:25
  doesn't include, the potential benefits, the criticisms and
• 3:28
  concerns. And I want to hear your opinion
• 3:31
  on closing down safe consumption sites and harm reduction.
• 3:34
  I want to hear what you have to say about it.
• 3:36
  So comment down below and let me know how you feel.
• 3:39
  So as you know, Toronto, as like many cities in North America,
• 3:44
  still faces opioid, opioid overdose deaths, homelessness,
• 3:48
  fentanyl contamination, lack of detox beds and lack of
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  supportive housing. We're calling it the drug
• 3:54
  toxicity crisis, which is exactly what it is.
• 3:57
  It's not a drug crisis, it's a drug toxicity crisis.
• 4:00
  Our drugs are toxic. People are overdosing
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  accidentally. The key problems people are
• 4:05
  facing are no access to treatment, untreated mental
• 4:09
  illness. So there's usually a lot going
• 4:11
  on below the surface of addiction.
• 4:13
  No stable housing, limited primary healthcare, and many
• 4:16
  people bounce between shelters, hospitals, jails and the
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  streets. So the hard hub is meant to
• 4:22
  create a centralized pathway to care.
• 4:24
  Oh, here's what it stands for. I was looking for this hard hub
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  stands for hard, stands for homelessness, addiction recovery
• 4:29
  and treatment hub. So the Ontario government plans
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  28 hubs across Ontario and they're pumping in $550 million
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  into investment, into treatment, into this initiative.
• 4:41
  Has this happened yet? Not sure.
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  I don't think so. I think they're still rolling it
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  out. But as with anything in the
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  government, slow and steady, I guess wins the race as their
• 4:50
  motto. I don't know, so the idea is to
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  create a one stop access point for everyone struggling with
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  homelessness. People use drugs and people with
• 4:59
  mental health disorders. So instead of navigating
• 5:02
  multiple systems, people can access addiction treatment,
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  medical care, housing, referrals, and mental health
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  support all in one place. Beautiful isn't it?
• 5:10
  How is the government going to screw this up?
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  I'm sure they'll find a way. So here's the services they
• 5:16
  offer. Opioid agonist treatment, OAT,
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  So medications like methadone, Suboxone and slow release
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  morphine. I have a whole episode on OA TS
• 5:26
  and when I sat down with Kate Johnson, I sat down with Kate
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  Johnson. Jeez, I couldn't remember her
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  name for a second there from CATC.
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  And we break down what opioid agonist treatment looks like.
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  So the second thing they're providing is mental health
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  treatment. The hub includes A Concurrent
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  Disorders Act. So this includes a team of
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  psychiatrists, nurses, social workers and peer support
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  workers. They treat people who have both
• 5:52
  addiction and mental illness. Sounds great, doesn't it?
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  It focuses on the third thing, primary healthcare.
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  Many people who using drugs lack basic medical care.
• 6:02
  So the hub will aim to provide wound care, STI treatment,
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  vaccinations, foot care and General Healthcare.
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  Now, this is big because a lot of homeless people, unhoused
• 6:14
  people face untreated medical issues. 4 detox and withdrawal
• 6:20
  management. So the plan includes 10
• 6:22
  withdrawal management beds. This helps people obviously
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  safely detox from substances. And then so 5 supportive
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  housing. Another key part, allegedly
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  there will be 25 supportive housing units.
• 6:35
  And as we know, recovery is difficult enough, but when you
• 6:38
  don't have a home to go to, you don't have one of your basic
• 6:42
  needs, shelter, how the fuck is anyone going to stay sober?
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  Nearly impossible. Stable housing dramatically
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  improves recovery outcomes. And then case management, the
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  sixth thing, which each client will be assigned social workers,
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  counselors, case managers, and they'll help people navigate
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  treatment, housing, employment and healthcare.
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  So the controversy, here's where the debate begins.
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  The province requires the hard hubs do not include supervised
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  consumption sites, like I said, safer supply programs, drug
• 7:11
  checking, so checking if your drugs are actually what you
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  think they are and not toxic fentanyl doses and needle
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  exchange services. We're not going to have any of
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  that. So this is a major policy shift.
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  Some harm reduction advocates, including myself, argue that
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  yeah, your overdose risk increases, people may be
• 7:32
  avoiding the hub. They're not going to go all
• 7:34
  together. Harm reduction becomes weaker.
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  I don't want to stop yet. I'm not ready, so I'm going to
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  go use on the street. Why would I go to this treatment
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  hub? I don't want to stop.
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  And then the other side is arguing the focus should shift
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  towards treatment. So like I said, abstinence based
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  recovery, housing, mental health care, which yes, all good
• 7:52
  things, but if you're not ready, you're not ready, you're not
• 7:56
  going to do it and you can't be forced into doing it.
• 7:59
  So the potential benefits of this, if implemented properly,
• 8:02
  the model could reduce ER visits, connect people to
• 8:06
  treatment faster, improve housing access, reduce overdose
• 8:11
  deaths. I don't know about that one.
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  Coordinate services that currently operate in silos.
• 8:16
  So put everything in one place. That's the big thing you hear is
• 8:19
  it's hard to get connected with everything and that's the point
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  of a social worker. The biggest strength of the
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  model is the integration of the services, like I said.
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  So instead of fragmented clients, get coordinated care,
• 8:29
  treatment pathways, case management, all in one place,
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  one stop shop. The real challenge is the
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  success of the hub will depend upon typical government things.
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  Can the government keep the funding stable?
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  Are the number of treatment beds going to be enough?
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  Housing availability? What are we going to do?
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  Create more houses? We already have a problem with
• 8:47
  price of houses, outreach effectiveness and client trust
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  in the system if the system can't deliver enough detox beds.
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  Housing long term recovery programs, then the hub could
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  become another overloaded service and we don't need any
• 9:03
  more of those. Everything is already full,
• 9:05
  evidenced by the six month to 8 month wait list to get AO hip
• 9:10
  covered treatment bed in Canada right now or at least in
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  Ontario. So I want to know what you
• 9:15
  think. What do you think the about this
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  policy change about these implementations?
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  Do you think that closing down supervised consumption sites is
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  the right answer? Do you think we should be
• 9:27
  forcing people? Or, you know, that's a strong
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  word, forcing, but essentially we are into abstinence based
• 9:33
  recovery. Were you ready to quit when you
• 9:36
  first got introduced to recovery?
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  I know I wasn't. For me, I was given an ultimatum
• 9:41
  by my family to go to treatment and it was only in there that I
• 9:45
  started to discover the recovery message and I started to listen.
• 9:49
  I think that forcing people is not the right way to do it.
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  I think that mandating rehab for a lot of people is going to lead
• 9:58
  to a a deeper bottom and possibly an overdose death.
• 10:02
  And I think the literature reflects that is, and don't
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  quote me here, but the evidence shows that harm reduction is
• 10:10
  actually the answer to lower overdose deaths.
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  We're again, we're this sounds kind of sinister, but we're
• 10:16
  keeping people alive long enough so that they can hit their
• 10:19
  bottom and become the humans, the children of God that they're
• 10:23
  meant to become. Because again, I've seen people
• 10:26
  in the lowest of lows become lawyers, doctors.
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  I've seen strippers turn it around and escorts and sex
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  workers addicted to crack turn into great lawyers in the system
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  and doctors I've I've seen it around recovery.
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  There are miracles here, but I think we have to be careful with
• 10:45
  pushing people into abstinence based recovery.
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  I was listening to somebody talk on the phone the other day and
• 10:51
  they were telling me that their counselor wouldn't work with
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  them because they wouldn't accept abstinence based
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  recovery. They would only work with people
• 10:59
  that were ready to quit altogether.
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  And that is a huge disservice. Could you imagine?
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  You went to a counselor and they said, Oh no, I can't help you,
• 11:06
  you have to quit or else we're not working together.
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  I'm going to go out drinking and I'm going to show that person.
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  Fuck them. There must be no way.
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  I must. It's either all or nothing.
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  There's no in the middle, there's no reducing, there's no
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  control, there's no harm reduction.
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  We have to come to the conclusions ourself that we are
• 11:23
  now ready to stop altogether. We can't be forced into
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  abstinence because that is a huge mountain for a lot of us to
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  climb. I can't fathom in the beginning
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  thinking when I went to treatment, they said, you know,
• 11:36
  do you think you're an alcoholic?
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  I said, no, no, I'm just a drug addict.
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  I can drink again. And it wasn't until staying in
• 11:41
  that treatment center long enough because I had the
• 11:44
  privilege to do so and I had the support to do so, where I
• 11:48
  discovered, yes, I actually am. I can't have one of anything.
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  And I am an alcoholic and I am an addict and I need to find my
• 11:55
  own way and my own resolution to this problem through the help of
• 12:00
  others. Nobody can force me to stay
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  sober and that's the case with everybody.
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  So let me know what you think. This was a short 1 today but I
• 12:08
  just wanted to touch on this. In my opinion, sad news in
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  Ontario and I hope that it works out.
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  I hope that the funding is there and I hope that we reduce
• 12:18
  overdose deaths and get people into recovery because at the end
• 12:21
  of the day we need addiction is not going anywhere and we need
• 12:24
  more services to help the people that can't access the services.
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  So don't ever forget recovery is simple, not easy.