Methamphetamine growth impacts role of consumption site

By Lethbridge Herald on June 29, 2020.

Drug paraphernalia, including a lighter and pipes, sit on a table in one of the inhalation rooms at the city's supervised consumption site. Herald file photo by Ian Martens @IMartensHerald

Tim Kalinowski
Lethbridge Herald
tkalinowski@lethbridgeherald.com
There are various reasons why Lethbridge has the most highly used supervised consumption site in Alberta, according to a report presented at city council during Monday’s public meeting, but the worrying rise of methamphetamine usage among local addicts will require a major rethink of the community’s drug response going forward.
The academically rigourous report comparing various similar-sized jurisdictions to Lethbridge presented during Monday’s council meeting was commissioned by city council in September 2019 to try to answer the question of why the City’s SCS has a much higher user rate than other sites in Alberta.
Lead researcher and co-author Alina Turner says the report identifies six contributing factors.
“One is the (ready) availability of substances, the availability of methamphetamines and their relative (inexpensive) costs,” she explains. “The regional service catchment, and the migration pressures to Lethbridge. You are serving a much bigger catchment area: as many as 300,000 people. That puts you in a different context than, say, someplace like Medicine Hat. Another piece is adverse childhood experiences, PTSD, racism and generational trauma that are impacting Indigenous populations in nearby communities as well as in Lethbridge. The homelessness crisis. And that lack of an adequate addiction treatment continuum; so the availability of services to deal with these complex issues, and the availability of those resources, isn’t where it needs to be.
“And lastly, specific on supervised consumption operations, the SCS pre-COVID, they have a much richer offering of services than other communities as well — one of those offerings includes the inhalation booths,” Turner adds. “In our analysis that seemed to factor into the higher use.”
The Herald asked Turner to elaborate particularly on that last point. How does the offering of “richer” services and inhalation booths contribute to increased usage at the SCS?
“Meth is a different beast (than opioids),” she says. “Meth is often co-used with fentanyl as well so the stats from the SCS show that is exactly what is happening. The community responses need to be tailored to the behaviours that come with this use.
“We do have some indications communities that have created a tailored response to meth — not getting rid of the fentanyl response — but a complementary meth response. That would include approaches to safe-sobering that are going to be very different than the ones for fentanyl.”
That being said, The Herald asked Turner if perhaps the supervised inhalation of meth should be withdrawn from the services offered at the SCS? Or whether or not we should have an SCS at all? She says the SCS is one response to the drug crisis, but cannot be the only response to the drug crisis.
“Supervised consumption sites were never meant to be the be-all and end-all response to substance use, and I see there has been a conflation of that in some of the public discourse,” she says. “To me a complex issue like this needs a very fulsome response, and it is never going to be one program or one approach to solve it. I think a recovery continuum includes a range of options. And what has happened in Lethbridge over a number of years is you have introduced a new component of that continuum, which is the SCS, but it was introduced without supportive housing on the back end, it was introduced without adequate mental health supports. The treatment capacity isn’t what it needs to be, and treatment isn’t what it needs to be either. So there is a whole lot that is missing, and so unfortunately that has contributed to the challenges you now see.”
She says one of the important findings of her report is there must be more Indigenous-led efforts brought into the drug crisis response, but it would be false to suggest the problem is only an Indigenous one here in Lethbridge. About 60 per cent of users at the SCS prior to COVID-19 were Indigenous, but the other 40 per cent were largely Caucasian, representing 34 per cent of total drug users at the SCS. What do many addicts have in common regardless of ethnicity? She says many users come from histories of family abuse, intergenerational substance dependency and mental health problems. Many are also homeless.
“Intergenerational trauma, while it is over-represented among Indigenous people, happens in war-torn countries,” she explains. “It happens in terms of family abuse you might be experiencing and also that your parents experienced. That is something that happens in all demographics and all ethnicities as well. We all have folks in our family tree that we can point to and say there was abuse there, or there were things going on in that family. And you can see that connection between mental health and addictions runs in all demographics and all walks of life, but it is certainly over-represented in populations that are marginalized.”
Given we are in an era of increasing fiscal austerity, and many of the things currently missing or underserved in our local continuum of care will likely just not get the levels of funding needed either from the City or the province in the near future, The Herald asked Turner how might we find ways within our existing resources to meet the challenges identified in her report.
Turner points out there are 1,700 local organizations on top of public services dedicated to different aspects of the homelessness, mental health and drug problems in Lethbridge. By combining resources and working more efficiently together, Turner says resources can likely be found to go some of the way toward addressing the current gaps even with limited provincial government supports. COVID-19 might have already shown how this could be done effectively, she says.
“The City has been co-leading with local organizations and provincial government departments with this whole community well-being and safety strategy, and that has prompted a whole restructuring and rethinking of the supports eco-system in Lethbridge,” Turner explains. “I think you have seen that come full circle when COVID hit, and how quickly the social response came into play. What they are doing is looking at the resources they already have and redesigning how those are delivered to be more impactful. Yes, there are gaps in the continuum, but there is also a lot of capacity and a wealth of support and goodwill in the community as well.”
Turner’s full report to council is available on the City of Lethbridge website.
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