MONTREAL, August 11 – For five years, L’Anonyme has operated a supervised mobile drug injection site, providing drug users with a legal place to get clean supplies, connect with social services, and avoid overdosing in a secluded and dangerous place.
Trained staff on the mobile unit, which travels across the city of Montreal in Canada, will provide clean syringes and needles, administer naloxone to rapidly reverse the effects of overdose from opioids, as well as offer psychosocial support and referrals for addiction treatment. Users bring their own drugs to the site.
In an effort to reduce rising overdose deaths caused by increasingly toxic street drugs, the Canadian government in 2017 passed legislation that made it easier to open supervised drug injection sites across the country. About a month after the bill became law, L’Anonyme launched its mobile safe injection unit here in the city of Montreal in Quebec, Canada.
“Our goal is very simple. It’s really to prevent overdose and ensure that people have a safe space to inject drugs and for us to support them if there are any complications,” said Kim Brière-Charest, an outreach programme coordinator at L’Anonyme, a Montreal non-profit organisation.
Brière-Charest said arrangements have been made with local law enforcement so that people with drug addiction can use the mobile site without fear of arrest.
The mobile supervised drug injection site is part of the country’s harm reduction strategy to curb overdose deaths that have been driven by synthetic opioids such as fentanyl – a drug 50 times stronger than heroin.
According to government data, more than 29,000 people died of suspected opioid overdose in Canada between 2016 and 2020.
Opioid-related deaths nearly doubled during the first year of the Covid-19 pandemic, surging to 7,362 deaths from April 2020 to March 2021, and have remained high.
In the Quebec province alone where the city of Montreal is located, some 547 deaths linked to opioid and other drug poisoning were reported over the same period. In 2021, Canada recorded 7,560 apparent opioid toxicity deaths, averaging at about 21 deaths per day.
Public health officials have attributed the worsening of the overdose crisis over the course of the Covid-19 pandemic to increasingly toxic drug supplies, heightened feelings of isolation, stress and anxiety, and disrupted harm reduction services for people who use drugs.
“We see a few (maybe four to six) people per night. On some nights, we saw dozens of people, but with Covid, it really, really went down,” Brière-Charest told reporters during a media tour last July 29 at the 24th International AIDS Conference (AIDS 2022) in Montreal.
The mobile unit by L’Anonyme complements three other fixed supervised injection sites found in Montreal that are run by separate organisations – namely, Cactus Montreal, Dopamine, and Spectre de Rue – that have been working for many years with people who use injection drugs. They all operate at different hours in different locations.
“No site in Montreal right now is open 24/7,” Brière-Charest said. “We would love to extend our hours, especially during the day when the shelters are closed. Some of the fixed sites are open at 9am so we would love to fill that gap (from 6am to 9am),” she added.
The L’Anonyme mobile unit runs daily from 11pm to 5am.
L’Anonyme’s 2021/2022 annual report showed that 9,485 total interventions were carried out by the outreach programme over the past year. Some 150,214 syringes, 13,399 Pyrex tubes, 68,827 condoms, 711 naloxone, and 757 fentanyl test strips were also distributed.
Since its establishment five years ago, the L’Anonyme mobile supervised injection site has reversed 12 overdoses, Brière-Charest said. “As I’ve said, this is a site that does not require the biggest number of people. But it impacts populations that are usually difficult to reach.”
“Most people appreciate that it’s a small space,” Brière-Charest said. They include people who are homeless, sex workers, and individuals with mental or physical health issues.
“We have people who have given us flowers (as a gesture of their gratitude) and there are drawings of the mobile that people gave as well,” Brière-Charest said, pointing to a laminated watercolour painting pasted along the walls of the mobile unit. “It’s nice.”
Supervised injection sites have been legally operating around the world, especially in Europe, Canada, and Australia, since 1986. In September 2003, Canada’s first legally sanctioned supervised injection site, Insite, opened in Vancouver.
New York, the most populous city in the US, became the first city in the country to allow authorised injection sites for illegal drugs.