Matthew Bonn, a recovered opioid user and one of the leaders of a movement for an overdose prevention site (OPS).Darren Calabrese
Matt Bonn wants to be done with breaking the law.
A former intravenous drug user, he did time in prison but now spends his days promoting harm reduction in Halifax’s North End neighbourhood, walking the streets with a naloxone overdose prevention kit dangling from his backpack.
“Drugs always fascinated me. I loved them,” Mr. Bonn said in a recent interview. “It took a while for me to realize I can be part of the solution instead of the problem.”
Mr. Bonn is part of the community coalition HaliFIX, which has begun working to establish Atlantic Canada’s first overdose prevention site in the city. Similar supervised drug-use sites in other parts of the country have been lauded for reducing overdose-related deaths, including from opiates. But in Halifax, the group’s effort to win provincial support and funding has stalled, leading organizers to contemplate whether they will be forced to set up their site unlawfully.
“We don’t want to have to set up a tent in an alleyway and do that but we might,” Mr. Bonn said, adding: “This is going to happen with or without provincial support.”
Nova Scotia’s health department is “reviewing information about an overdose prevention model and how it could fit into the province’s overall harm-reduction policies,” spokesperson Barbara MacLean said.
Overdose prevention sites are designed to provide supervised drug-use facilities as well as connections to a range of health-related treatment and other support services. While many operate with provincial support, federal exemptions have been granted in some cases to extend legal authority to operate without provincial backing. Those include several supervised drug-use sites in Ontario that recently had their funding pulled by Premier Doug Ford.
Bonn goes through collected data and letters of support at a partnering health care facility in the North End of Halifax on April 15, 2019.Darren Calabrese/The Globe and Mail
Applying for that same exemption in Halifax is not yet an option, Mr. Bonn said. First, HaliFIX needs to nail down a stable source of funding.
“Everyone seems to acknowledge this is a needed service in our community,” said Tommy Brothers, a resident at Dalhousie University’s medical school. “They acknowledge the robust evidence and research behind it – we haven’t heard from anyone who thinks this is a harmful service to offer.”
But some prominent voices have expressed uncertainty about the proposed location.
Marcus James is a long-time North End resident, a black community organizer and co-founder of 902 Man Up, a non-profit formed in 2016 as a response to violence in the community.
“This is a marginalized community. North End Halifax, over the years, has been used as a dumping ground for a lot of services that are needed,” Mr. James said. “By continuing to put these types of services … in this particular community, it really puts our community at risk.”
He is not alone in calling for more information and dialogue.
Patty Cuttell Busby, executive director of the North End Business Association, questions the impact of building a new site on her community’s main thoroughfare, Gottingen Street, which is tackling gentrification, race relations, economic issues and more.
“Too many people have just jumped on the bandwagon in support of this because they think it’s a good idea without doing the due diligence,” she said, adding: “It’s okay for us to have questions about this and to try to get some answers.”
In an effort to provide those, the folks at HaliFIX have stepped up their advocacy and outreach efforts. Their GoFundMe account has raised just more than $3,000. To establish the bricks-and-mortar vision the group has, though, they will need about $100,000.
“We want sustainable funding – we don’t want to open this service up and have to shut it down,” Mr. Bonn said. “We’re dealing with a population that has absolutely nowhere to go. People are using in condemned buildings, in alleyways, in churches, on the street.”
Many are dying this way and contracting diseases.
Of the 325 opioid toxicity deaths in Nova Scotia between 2011 and 2016, “intervention was not possible” for nearly half the cases, according to Nova Scotia Medical Examiner data in the proposal submitted by Mr. Bonn’s group to government.
“This means that the [deceased] was alone, others were unaware, and they were in a non-public or low-traffic space,” the report said.
A spike in HIV cases – Nova Scotia saw 29 new cases in 2018 compared with 15 in 2017 – has been classified as an outbreak and attributed, mainly, to the use of intravenous drugs.
Letters advocating for the overdose prevention site have been written by a wide range of supporters, including the chief of the emergency and trauma centre in downtown Halifax and the medical director of the Nova Scotia Emergency Substance Use Treatment Initiative.