The Fix: Safe injection sites

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MONTREAL (WCAX) "You've got bankers that are using heroin, you've got... law people using heroin, you've got cops using heroin, you've got people who work in the courthouse using heroin. Half the people I sold drugs to work in the courthouse in Vermont."

Insight from a self-proclaimed junkie who spends most days in City Hall Park in Burlington. While he's not backing up his claims with evidence, he's right about one thing: Drug users come from all professions and backgrounds.

Right now, communities across our region, the country and the globe are scrambling to find a fix to save lives. One highly controversial option is the safe injection site. That's where people can shoot up without being arrested and can get medical help, if necessary.

Vermont leaders thought about it but recently decided against it-- at least for now.

"We believe that safe injection facilities at this time should not be established in the state of Vermont," said Jolinda LaClair, the governor's director of drug prevention policy. "The legal aspects are insurmountable. It is illegal to establish a safe injection facility."

But leaders in Denver, Colorado, are considering them. The City Council is expected to vote Monday night on a proposal for a pilot program.

Right now, there are about 80 safe injection sites around the world.

WCAX News crossed the border into Canada to visit the one closest to us, in Montreal, to learn what it's about and if it works.

A horrifying crime scene picture illustrates the ugly truth about the drug crisis in our region. A man in his 30s found dead in a bed with a needle still stuck in his neck, after injecting a fatal dose of heroin. First responders arrived too late to save him.

A woman, also in her 30s, found overdosing in her car, parked in the back corner of a cemetery. Someone called 911 and, this time, first responders got there in time to save her life.

In nearby Montreal, a similar challenge. The public health director, Dr. Carole Morissette, says cases like these are exactly why safe injection sites are a necessity.

"They have a place, legal, secure, with well, you know, with the community workers, peers and nurses there to help them and to be, at least be able to have good counseling about the way to inject properly, but to prevent overdoses and that if something happens," Morissette said.

Our Celine McArthur got an inside look at how CACTUS Montreal is set up: A long, buffet-style counter lined with bins of clean needles, syringes and other injection necessities, not including the drugs; individual stations with armchairs that make it more comfortable to inject; stainless steel counters that are easy to disinfect; containers to safely dispose of used needles; and a lot of mirrors.

"So that the staff can always have a look on the people's faces if the color changes, or if the eyes are rolling. If someone is nodding a little too much, the staff can always keep an eye on everybody from wherever they are in the room," explained Sandhia Vadlamudy, the executive director of CACTUS Montreal.

When they're done, users leave the injection room and are encouraged to hang out in the lounge to rest. WCAX News was not allowed in either room when in use, but Vadlamudy says one or two nurses are always there to help.

"But the staff will not help the person to inject. They can guide, they can advise, but the person has to inject themselves, by themselves," Vadlamudy said.

Since CACTUS Montreal opened in July 2017, Vadlamudy says the staff has supervised about 80-100 injections a day. No specifics on how many of those led to overdoses or medical complications. But Vadlamudy said, "There hasn't been one death in a safe injection facility, so that speaks for itself."

But that does not speak to any deaths outside of the facility once a user leaves.

"Of course, some people leave the facility and we're not always reassured on how they are feeling and how the next few hours or the next few days are going to go for that person," Vadlamudy said.

These centers are legal because of an exemption from Health Canada and cooperation from police, who enforce the law.

"At first, I was not impressed," Montreal Police Cmdr. Simon Durocher said. "It's zero-tolerance outside, but we're not on the corner of the street watching them because we know that they're having drugs in their pocket coming over here, you know. It's like cohabitation."

Reporter Celine McArthur: From a police officer's perspective, is that hard to come to terms with?
Cmdr. Simon Durocher: Ah… pause. When you see the benefit, no. But if you're going very coldly and you see very rationally, yeah, it's weird, because why.

Durocher says thanks in part to a heightened police presence in the area, the crime rate hasn't gone up and there have been fewer overdoses and needles found in public spaces like parks and alleys. Still, that doesn't mean the injection site is completely safe.

Celine McArthur: Have you ever had to have anyone come in here? Like law enforcement because someone was...
Cmdr. Simon Durocher: Not, maybe two or three times-- max-- that they called because somebody snapped.

"You want to feel safe where you live," said Sean Denny, who lives in the apartment building right next to CACTUS Montreal.

While there are more people hanging around the site, Denny hasn't had a single negative encounter.

"But to be honest, the impression I had at the beginning and then the actual experience of living next to the place, it was more of just a perception I had personally then the actual nightmare scenario of people wandering around in a drug frenzy, which is not the case at all," Denny said.