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Safe injection sites: Surrey at a crossroads

How policy makers decide to address the growing drug problem will shape the city for years to come.
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A pair of heroin users inject the drug at a pop-up safe injection site in Whalley.

Surrey needs to cool the rhetoric and find a recovery-focused approach to its growing drug problem, addictions experts say.

The city is home to a growing level of drug abuse, mounting overdoses and frequent deaths, causing many to call for safe injection sites.

Last year, Surrey Fire Services responded to an average of 4.5 overdoses per day. That has climbed to about seven per day this year.

According to the B.C. Coroner’s Office, Surrey had 378 overdose fatalities in the last 10 years, with 71 of those occurring last year alone.

In the first six months of this year, there were 44 overdose fatalities in Surrey.

Since last year, there has been a huge spike in the amount of fentanyl mixed with street drugs.

Fentanyl is an often fatal opioid that’s 50 to 100 times more potent than morphine.

There has also been a emergence of a drug called W-18, of which very little is known. It is a painkiller (a suspected opioid) that is believed to be several times stronger than fentanyl.

Fraser Health is now saying communities need to be open to “safe consumption sites.”

The model many community members are looking at is Vancouver’s Insite – a safe injection site.

Insite, which opened in Vancouver 13 years ago, has been subject to more than 30 peer-reviewed studies, including those published in the New England Journal of Medicine in the U.S. and The Lancet, in Britain.

Critics say the studies have been widely criticized and that The Lancet took heat among academics for publishing one of them.

Most agree, however, the outcomes look promising.

There have been 263,713 visits to Insite by 6,532 individuals.

Of those, there were 1,418 overdoses at Insite, none of which were fatal.

However, some experts in addiction say the Insite model is not the answer for Surrey, or any other community facing the growing problem of addiction.

South Surrey’s Dr. Ray Baker, associate clinical professor at UBC’s faculty of medicine, directed the university’s original addiction medicine curriculum in the 1990s and has spent 30 years in occupational addiction medicine.

Baker said Surrey may or may not need a safe injection site.

However, he did say that what Surrey must have is policy that is crafted carefully, without emotion, backed by strong science.

“It needs to be integrated into a comprehensive recovery-oriented system,” Baker told The Leader. “This is a highly specialized decision that needs quite a lot of medical input.

“So far, Surrey hasn’t got it,” Baker said.

He said Surrey needs to make careful changes rather than “knee-jerk” moves, the latter of which will serve no one well.

“Part of (the solution) may be some harm-reduction measures,” said Baker, who served on former premier Gordon Campbell’s task force on addiction and also describes himself as in long-term recovery.

“I’m not the one to say whether an injection site is a good idea or a bad idea,” Baker said. “I’m not convinced I’ve seen evidence that they are very effective because the science supporting them is questionable and flawed.”

Marshall Smith, the executive director for Cedars Society, a recovery centre in Surrey and on Vancouver Island, agrees with Baker’s approach.

Smith said the people who are most affected are very sick people who have tremendous barriers to recovery, Smith said.

He said Surrey needs a “full and wholesome continuum of care.”

That should span from harm reduction measures such as safe consumption sites to long-term recovery.

“I would also call on the mayor to bring people who are in recovery into the conversation,” Smith said. “Bring people with lived experience, who have been out there, who have gone through treatment, who have found recovery, who are now in long-term recovery, who can look back and say ‘this is what I needed.’ “

The push for a safe injection site here has been swift and loud.

Ann Livingston, a volunteer with Vancouver Area Network of Drug Users, set up a pop-up safe injection site in Whalley last week and said she will continue to push the issue in the future.

City officials have been watching closely, but have not yet shut down the makeshift site on 135A Street in Whalley.

Mayor Linda Hepner said she wants to see a full suite of services, including harm reduction, education, recovery and enforcement.

Any safe consumption services, she said, would be contained within existing supports, such as homeless shelters.