A report for the Alberta government has raised concerns that a large number of methamphetamine users are frequenting supervised consumption sites that were designed to respond to opioid overdoses.
Front-line health workers say, if anything, that finding should persuade the United Conservative government to bolster services.
The provincial government formed a panel last summer to look at how consumption sites were affecting crime rates, social order, property values and businesses. It didn’t address the benefits of harm reduction for users.
The report said meth constitutes up to half the drugs consumed at locations where multiple substances are permitted.
“This was surprising and seemed antithetical to the purpose of the sites, which is to address the opioid crisis,” said committee vice-chair Geri Bemister-Williams.
“The side effects of methamphetamine are characterized by agitation, aggressiveness, paranoia, psychosis and other bizarre behaviour that increases and adds to the … social disorder. We, as a committee, were concerned, as the sites were not equipped or designed to handle methamphetamine users.”
The report said meth users are generally less at risk of dying of an overdose unless the substance has been “adulterated.”
Bonnie Larson, a family physician who works with vulnerable communities in Calgary, said that’s exactly the problem. Meth is “very, very frequently” contaminated with street-level fentanyl, a powerful opioid.
“What we’re looking at is a contaminated drug supply, a poisoned drug supply,” she said. “Nobody’s meaning to overdose on fentanyl regardless of what drugs they’re taking, but they are at a high risk of overdosing and dying even if their whole intention was to use methamphetamines.”
Corey Ranger, a registered nurse who has worked in harm reduction programs across Alberta, said non-opioid drug users are at a higher risk of an overdose if they inadvertently take a fentanyl-laced substance, because they don’t have the tolerance.
“How in the world are they supposed to know if it’s adulterated or not? It’s like asking someone to play Russian roulette. Hopefully they’ve made the right guess and they don’t need the supports at those times.”
Ranger suggested providing more resources at supervised consumption services could help address some of the disorder that comes with increased meth use. Right now, the sites are too busy to accomplish that.
“If somebody has consumed a bad batch of a stimulant like methamphetamines, it presents very much like an exaggerated anxiety or panic attack, and the way that you treat that is you provide a supportive environment. You speak to them in a calm manner. You do crowd control and you give them time and space.”
Ranger said most sites are set up to handle all methods of consumption except inhalation. Arches in Lethbridge is one of the few in Canada that has supervised inhalation rooms.
“If anything, this report tells us that we haven’t gone far enough. If we’re able to offer safe places for people to inhale their drugs, then they’re less likely to inject it and the risk for overdose and the risk for blood-borne pathogen injection goes down significantly.”
The panel also flagged discarded needles, feces and garbage as common complaints about consumption sites.
Rebecca Saah, a community health expert at the University of Calgary, said people should consider what would happen to their communities if the sites were to disappear.
“What are the impacts of seeing people who’ve overdosed in the community?” she asked.
“If you don’t support supervised consumption, you’re supporting unsupervised consumption. And I do believe we’ll see more people overdosing in public on the street, in agency bathrooms, in restaurant bathrooms, in businesses.”