Alberta Health Services: Supervised Consumption Services


Updated: February 15, 2019

Alberta Health Services is committed to working with its community partners to find solutions to the increase in crime and social disorder near the Sheldon M. Chumir Health Centre.

We know that concerns expressed by residents and local businesses must be addressed quickly and effectively to ensure that supervised consumption services continue to operate at the site, and that the community is not adversely impacted.

We must find a balance where we can ensure the site can continue saving lives and helping people with addiction, while helping to maintain a safe, welcoming neighbourhood for residents, businesses and visitors.

The importance of supervised consumption services (SCS) in saving lives is clear. Studies of other sites in Canada, North America, Europe and Australian have determined that they provide a critical healthcare service.

Last month, the Chumir site responded to 52 overdoses. Between Oct 30, 2017 and Dec 31, 2018, Safeworks staff responded to 802 overdoses. This is a vital public health service.

Without it, those overdoses likely would have occurred in the community, in homes, parks or streets, without medical care nearby.

What is AHS doing to address concerns?

AHS has established a community liaison committee to bring together members representing businesses, residents, community groups, Calgary Police Service, City of Calgary and AHS staff, to discuss concerns and identify strategies to address them.

This committee meets monthly to discuss community concerns, potential solutions and provides advice on how to improve communication with the community.

AHS has increased protective services presence at SMCHC. Protective Services members are inside the Chumir supervised consumption site, and patrol the immediate area around the site 24/7 to help ensure staff, public and client safety and decrease loitering.

Shopping cart parking spaces have been designated outside of the entrance to the site to help ensure sidewalks are passable and orderly.

We are also working with community partners to improve needle debris collection.

We currently have an outreach worker that goes out once a week, on Tuesdays, to pick up needle debris across the street, in Central Memorial Park, and in the other areas surrounding the Sheldon Chumir.

Additionally, Grateful or Dead, a peer outreach organization supported by AHS, does needle pickup in the surrounding area once a week.

AHS was part of the initial collaboration with Alpha House, the City of Calgary and CPS that resulted in the Alpha House Needle Response Team. AHS Safeworks provides the Team with the sharps containers and incinerates them free of charge.

In 2017-18, the SMCHC increased access to needle disposal by adding two large mail box style bins outside of urgent care and supervised consumption services, and the bathrooms within the building are equipped with needle disposal bins.

Site staff have offered support to building owners in the immediate vicinity of the SMCHC that have requested assistance with needle debris collection, advice and distributing sharps containers.

In June we posted signage to make the rules and expectations of the site clear to clients.

When clients pick up harm reduction supplies, we always provide teaching around safe disposal including the distribution of personal sharps containers. In addition, we have trained staff on how to impose and enforce suspensions for clients who do not adhere to site expectations.

What are supervised consumption services?

Supervised consumption services are part of a range of evidence-based services that support prevention, harm reduction and treatment for Albertans living with substance use challenges.

Supervised consumption services provide a place where people can use drugs in a monitored, hygienic environment to reduce harm from substance use while offering additional services such as counselling, social work, and opioid-dependency treatment.

The Chumir site also provides the opportunity to connect SCS clients to additional healthcare services and programs, such as community-wide services for adults with severe or persistent mental illness and the AHS Opioid Dependency Program.

The site has made more than 400 referrals to other services including:

  • The AHS Opioid Dependency Treatment Program (ODP), which provides methadone or Suboxone maintenance treatment to people dependent on opioids and helps them access services they need to live healthy lives.
  • The injectable Opioid Agonist Therapy Program (iOAT), which has been introduced as a new alternative treatment in Alberta. It is a program designed for individuals that have tried other opioid agonist oral therapies without success.
  • Other services include Detox, Social Work, Alpha House Downtown Outreach Addictions Partnership (DOAP) Team, the Alex Community Health Bus, which helps to remove barriers to healthcare by providing direct services, education and advocacy to Calgary’s most vulnerable, Calgary Urban Project Society (CUPS),
  • Addiction Recovery Community Health at the Peter Lougheed Centre (ARCH PLC), Safe Communities Opportunity and Resource Centre (SORCe), housing supports, addictions and mental health, and other social services to help assist people access services to meet their basic needs.

We have two addictions counsellors that work directly with clients at the site. An addictions counsellor from the Opioid Dependency Program visits the site three times a week, and another counsellor from Adult Addictions Services visits twice a week. A social workers is also available daily to help clients.

In total, there are approximately 300 Addiction and Mental Health professionals working at the Sheldon Chumir site.

These wrap-around services mean that people who previously struggled to access the healthcare system are connected to vital services that can help them with their addictions, and other health challenges.

What is harm reduction?

The opioid and methamphetamine crisis is not isolated to the Safeworks supervised consumption services site at SMCHC. It’s everywhere and it’s affecting everyone, in all of our communities.

Addiction is a health condition – it is now well accepted that it is not a choice – and it does not discriminate. AHS has an ethical responsibility to provide compassionate care to all Albertans, including people who use substances.

They are not “druggies” or “junkies”. They are people who use substances, and they deserve to be treated the same as any other person needing healthcare. No one chooses to have an addiction, and no one chooses to be homeless.

Supervised consumption services are part of a larger harm reduction strategy that has been adopted by healthcare organizations in more than 80 countries. Safeworks has been offering harm reduction services in Calgary since 1989 – the 30 year anniversary of the program is coming up in June, 2019.

Harm reduction encompasses policies, programs, and practices that aim primarily to reduce the adverse health, social or economic consequences of the use of psychoactive substances without necessarily reducing consumption.

It is not realistic for people with a substance use disorder to simply stop using a substance. We must work to decrease the harm associated with psychoactive substance use while people continue to use, until they are ready to seek treatment. Harm reduction provides an important avenue to rebuild trust with the health care system that can improve treatment uptake.

Harm reduction takes the view that people will not – and cannot – simply stop using a substance, or give up their addiction. Instead, it aims to decrease the harm associated with psychoactive substance use, without requiring people to stop using.

Harm reduction acknowledges the importance of connection and community in treating addiction. By providing services where people feel valued and respected, we can begin to address the root causes of addiction and offer people the support that they need on their journey to health and wellness.

And it recognizes that people who use substances have the right to receive equitable, non-judgmental and evidence-based healthcare, and that they should be treated with respect and dignity, and without stigma.

We know that addiction is not limited to Calgary’s downtown core; Safeworks has 18 partner agencies across the city that offer harm reduction supplies. The Safeworks Mobile van also provides roving services including needle exchange and the only rapid HIV point of care testing service across the city; people can access these services by calling (403) 850-3755.

Some examples of harm reduction services provided by AHS include:

  • Supply distribution and collection;
  • Distribution of new supplies such as needles, alcohol swabs, tourniquets, sterile water, cookers, sharps disposal bins;
  • Collection and safe disposal of used needles;
  • Supervised consumption services;
  • Community Based Naloxone Program;
  • Peer support programs;
  • Outreach and education.

Evidence-based benefits of harm reduction include:

  • Reduced transmission of blood-borne infections;
  • Decreased emergency visits and lowered healthcare costs and wait times;
  • Increased employment among people who use substances;
  • Reduced injection substance use in public places, and reduced number of used needles discarded in public;
  • Increased referrals to treatment programs and health and social services;
  • Reduced overdose deaths;
  • Empowerment and opportunities for people to lead healthier lives.

Where can I learn more?

We know that more must be done to address neighbourhood concerns. AHS is committed to being a good neighbour and community partner in helping find solutions.

People with questions, concerns or feedback related to SCS are encouraged to connect with AHS by emailing SCS.Calgary@ahs.ca. This email is monitored regularly and responses often require collaboration with various AHS departments and our partners at the City of Calgary and CPS.

AHS strives to respond to inquiries in a timely manner; however, delays do occur and we are working to mitigate those instances and are committed to finding a solution to address it entirely.

For more information on addiction, opioids, and resources and tools available to reduce the harms of drugs and alcohol, check out www.drugsafe.ca.