An open letter to the mayor of medicine Hat Alberta in support of SCS

I grew up in Medicine Hat and consider it my hometown, although I now live and work in BC as a school psychologist. The topic at hand is an issue that no one is immune to – addiction and mental health. More specifically, I am writing in support of the proposed Supervised Consumption Site (SCS) in Medicine Hat based on first-hand lived experience as a sister and daughter of loved ones whose lives were lost to this epidemic, and as a professional who is informed about the science and evidence in support of these sites. I am also an ally of the group Moms Stop the Harm (MSTH), which is a network of Canadian families whose loved ones have died due to substance use or who hope for recovery. MSTH calls for an end to the failed war on drugs, which is a war on the people we love. We envision a new approach based on reducing harm, where people who use drugs are treated with respect, compassion and support.

First, I’d like to say that the landscape and consequences of drug use have changed drastically over the decades with the rise of opiates and methamphetamine use. Speaking as a sister, I have been completely devastated by the suffering that I watched my brother endure that eventually ended in his early death at the age of 36. He spent nearly 25 years in active, severe addiction beginning as a pre-teen, fuelled by complex trauma, untreated mental health and neurodevelopmental challenges, and access to prescription opiates in the household as a teen. Those who knew him would remember his generous, soft-spoken nature, and the love he had for his little dog and for me, his sister. I can’t imagine loving anyone more than I love him. Though there were signs that his drug use had become extremely problematic, I never once entertained the idea that he was injecting drugs…because I believed it was “those people” – the dirty, disgusting ones living under a bridge who would resort to that sort of awful behaviour. Did I ever wake up when I found out that my handsome younger brother had been injecting for almost 10 years, and had by that time destroyed nearly all of the veins in his body through his drug use. He had also suffered a serious case of flesh eating disease that almost resulted in an amputation of his arm that he did not tell me about out of shame that I would find out about the extent of his disorder. I saw my brother deteriorate from a physically healthy young man to a person completely overcome by the devastating physical and mental effects of his addiction from which he saw no possible way out. No one in their right mind would continue self-harming behaviour with such devastating consequences if they were able to simply make a choice to stop. Addiction is a complex brain disorder that affects cognition, behaviour, and impulse control.

It is for him, and for all our affected sons, daughters, mothers, fathers, friends and partners that I write to advocate for the supervised consumption site in Medicine Hat. While I understand and appreciate the concern of the general public about this site, I implore each and every person to consider all of the evidence, statistics and probabilities involved in this particular issue in order to take an informed stance.

If my brother had access to the supervised consumption facility, I believe he would still be alive today. The reasons for this, based on his lived experience, are as follows.  1) Promotion of safe injection behaviours, meaning primarily, for my brother, that his veins would not have been destroyed. He would have been instructed on the proper methods, using the proper equipment and techniques to minimize the physical damage to his veins and skin. He avoided seeking medical help and treatment in general due to the intense shame he felt as multiple people tried repeatedly using fancy lights and techniques to locate veins in his body, all the while turning white and almost vomiting due to the intense anxiety and shame he felt. When a medical emergency arose that threatened his life, which happened multiple times due to the significant health complications associated with his drug use, doctors would have been able to draw blood and administer IV fluids and drugs quicker, an issue that was related to the cause of his death. 2) Increased positive interactions with medical/clinical personnel, meaning that he might not have had such intense fear and aversion to interactions with health care professionals. If he was more willing to engage with the health care system, he would have been much more likely to engage with supports to treat his disorder. 3) Increased likelihood of engaging him in treatment. I encouraged my brother at length in many ways to engage in various treatment options. The only interest he expressed was in connecting with a peer mentor he met in the community who had showed him personal interest and care. This peer did not provoke shame in him because he was kind, compassionate, and had experienced recovery. This peer made him feel like he mattered and that he was cared for. Each and every interaction with staff at the SCS is a relationship building exercise in which the client is treated with respect and dignity, which is often not the case for these individuals in the rest of society at large. It is through that relationship that trust is built, self-worth is discovered, and the chances of engaging in further treatment options is greatly enhanced.

Speaking as a professional who values science and research-based evidence, a recent meta-analysis of 75 studies found that at the population level statistically, supervised consumptions sites 1) enhance access to primary health care and social services, 2) greatly reduce overdose and death, 3) do not increase drug injecting, drug trafficking or crime in the surrounding environments, and 4) reduce public drug injections and dropped syringes (Potier et al., 2014). In Alberta, SCS’s have helped people who use drugs close to 85,000 times. Each of those visits represents a care episode where someone like my brother was treated with compassion and offered an opportunity to move towards positive change. The Alberta sites have saved lives by reversing 1070 overdoses, and the Edmonton site alone has received 5372 referrals to other health and social supports. (The availability of those supports is another issue that we as a society need to collectively tackle!).

Let’s provide our loved ones with dignity rather than shame, and with hope rather than despair. While I understand fears such as increased risks to the neighbourhood or decreases in sales, we are talking about our loved ones’ lives, and their deaths. They deserve access to evidence-based treatment and respect as much as your families and businesses do. Let’s come together in our common humanity and find ways to mitigate the risks that some community members are concerned about, while also providing respect, compassion and evidence-based treatment for those suffering wit substance use disorder. Each of those affected is somebody’s someone.

Dana Dee on behalf of my late brother.