I wrote this story for JOUR 3225: Reporting In Depth at Carleton. The assignment was to craft a longform feature piece.
By Emma O'Toole
Johnny Levesque sat in a booth, hunched over a plate of fries and a half-eaten club sandwich at Dunn’s Famous restaurant in Ottawa’s Byward Market. Sunlight streamed in through the window and struck the silverware, causing a reflection that made him squint. He picked up a fork and shuffled the fries around his plate. “You know, I’m not having a very good day,” Levesque said. “It’s just one of those days.” He wore an oversized blue coat and big winter boots. His eyes, brown and weary, remained glued to the fries. “I had to save two people’s lives last night.”
Levesque, 41, has been using drugs since he was 19. Over the past 22 years, he has seen countless overdoses and has used naloxone to save the lives of several people. Naloxone, a drug intended to reverse the effects of opioids during an overdose, is one of the most readily available harm reduction measures in Ontario. More controversial are the province’s supervised consumption sites, which provide spaces for people to consume drugs in a controlled environment.
There are 21 active supervised consumption sites in Ontario: four are scattered around Ottawa’s downtown core, 10 are in Toronto and the remaining seven are stretched thin across the rest of the province. Simcoe County, a region 120 kilometers north of Toronto and an epicentre for Ontario’s opioid crisis, is without a supervised consumption site. Levesque calls the number of sites in the province “unacceptable.” While Health Canada has approved more sites in recent years, many medical experts and supervised consumption site clients say for more locations to open, harm reduction needs to be destigmatized.
It has been nearly two decades since Canada’s first supervised consumption site opened yet the nation-wide opioid crisis rages on.
Levesque has been using supervised consumption sites for years, but he said there are far fewer sites in Ontario than there should be. Even harder to find, he said, are sites that feel welcoming. Levesque compared his experience with Ontario’s sites to sites he accessed in British Columbia, the province where Canada’s supervised consumption sites began.
“Out there, it was totally different,” Levesque said. He said the site he used in B.C. was clean, orderly and inviting; the site’s nurses cared about their clients. “They were watching you and making sure you had clean [supplies] and that you were safe,” Levesque said. “They gave everybody a nickname, like J.L.” His nickname, J.L., stands for Johnny Levesque.
According to Levesque, for supervised consumption sites to serve their purpose of helping the community, they must provide more than just a space for people to consume drugs. They should also be accessible, which means offering a clean space with supportive staff-client relationships.
Ottawa has four supervised consumption sites, but Levesque said he will only use the one at the Sandy Hill Community Health Centre (SHCHC).
He said SHCHC’s supervised consumption site, hosted by the centre’s Oasis program, is welcoming and well maintained.
Oasis program director Rob Boyd said he takes pride in the centre’s harm reduction services, but noted each of the city’s sites cater to drug users with different needs.
“Thank goodness we have choices in Ottawa. It’s something we wouldn’t have dreamed of all those years ago,” Boyd said.
He also said SHCHC’s additional services, which focus on other groups of clients such as non-drug users, mean the site is held to higher standards.
“We put a lot of emphasis on the physical space and making sure it is a place where people want to come,” Boyd said. He credits Oasis’s atmosphere to its natural light, fresh paint jobs and keeping the walls clear of posters. As minute as they may be, these details are what keep community members, like Levesque, coming back.
Boyd called SCHCH’s site more “medicalized” than others – most staff are medical professionals, such as nurses or social workers, who Boyd said are qualified to provide greater levels of care.
“People in the medical community have power that people can use to get what they need, so there are real advantages to having them involved in this,” Boyd said. “But we have to be very mindful about that and try to find ways to keep the community involved as much as possible and to have them as part of what’s driving these services.”
Another client of Ottawa’s supervised consumption sites Chris Forget said he prefers Shepherds of Good Hope (SGH)’s approach to harm reduction over SHCHC’s. To him, SGH’s community-focused peer support workers make all the difference.
“Their staff are people who have been there, done that, gotten clean and have now moved on to helping others,” Forget said.
Even with the variety of sites, Forget said some users are wary of accessing the services at all. He said there should be more sites, and they should all be clean, organized and approachable.
The lack of supervised consumption sites drug users feel comfortable using contributes to situations like the one Levesque found himself in: saving people from opioid overdoses on the streets.
Tyson Hunter was a drug user, too. He was a resident of Orillia, Ont., in Simcoe County. Hunter grew up in a red house with a big yard surrounded by farmland with his mom and two brothers, Brayden and Ethan. Brayden said he recalls the hours they spent together in the creek behind their home, catching catfish with makeshift nets and building forts between the trees. Brayden remembers flying kites with Hunter in the empty fields, getting swept away by gusts of wind and sailing off the ground, into the air. Brayden compares his brother as a teenager to “Dennis the Menace,” with trouble and adventure trailing behind him.
Throughout his life, Hunter battled anxiety, depression, OCD and PTSD. His mother, Angie Allen, said when Hunter started high school, he began to self-medicate with cannabis. Hunter experimented with other drugs over the next few years, such as crack cocaine and eventually heroin.
Medical trauma from when he was a child instilled a fear of needles in Hunter, which made him unable to inject drugs on his own. Allen said Hunter’s drug dealer would help him.
On Oct. 3, 2017, Hunter injected what he thought was heroin. The drug was later identified as pure carfentanil, an opioid 100 times more toxic than fentanyl and 10,000 times more toxic than morphine. Hunter was found dead at his dealer’s house that night. He was 19.
Allen said it is likely Hunter would have accessed supervised consumption sites. They could have provided him with a safe space to consume drugs or helped him on his journey to recovery, Allen said.
Because Hunter couldn’t inject himself, Allen said he would have benefitted from peer-assisted injection services offered at most sites.
Peer-assisted injection is an exemption sites can apply for through Health Canada which allows drug users to receive help injecting drugs from friends or other site clients. The service, legalized in 2018, is offered at 80 per cent of supervised consumption sites across the province, meaning if there had been a site in Orillia, chances are the service would have been available.
Allen is a member of a support group for people who lost loved ones to drug overdoses. Allen said for more sites to open and to prevent more overdoses, there needs to be greater access to resources for drug users. The people in her support group agree.
“They talk about these awesome people, these smart, talented, caring, loving people that were struggling,” Allen said. “They’re our leaders of tomorrow, they’re our teachers of tomorrow, and they’re our social workers of tomorrow, and they’re dying. But they’ve got so much to give.”
Orillia city councillor Jay Fallis said he supports the idea of a supervised consumption site opening in the city. For him, getting past the stigma is an important part of that process.
“From a councillor speaking to other potential municipal politicians: don’t go into this issue with preconceived notions,” he said. “Be willing to reach out. Do some research. Talk to people that are impacted by this and find out a bit more before you say no to it.”
According to an expert on harm reduction and community health, people’s emotional responses and personal values have the strongest influence on their opinions on harm reduction services.
Em Pijl is an assistant professor at the University of Lethbridge’s Faculty of Health Sciences in Alberta. She noted supervised consumption sites are a devise topic among Canadians.
A 2019 poll indicates 53 per cent of respondents – out of 1,100 randomly selected Torontonians over the age of 18 – don’t believe their community would welcome a supervised consumption site. Still, 64 per cent said they “generally approve” of sites in their city.
Pijl emphasized the importance of approaching the topic with empathy, from both sides of the argument.
“What I'm hoping is that the people who are totally against supervised consumption will be able to say, I'm uncomfortable with this, but I understand these services have a place in the continuum of care,” Pijl said. “And [I’m hoping] for the people who are totally hardcore for these sites to have a little more empathy and go, you know, I understand why people are struggling with this.”
To Pijl, empathy is the key ingredient in bringing more supervised consumption sites to Canada. To do this, she said we need less education and more understanding.
“Often what we do is we educate people,” Pijl said. “But information doesn’t change people’s minds. If anything, they just dig their heels in.”
Pijl said our instinct to reject information comes from our subconscious biases against topics. For harm reduction to flourish, she said we need more open minds. We need more curiosity. And, most importantly, we need more empathy.
Levesque’s beliefs are on par with Pijl’s. He said stigma is the main barrier between drug users and accessing harm reduction services.
“If the public was more accepting of us, I think we’d have more sites, not just in Ottawa but across the whole province,” Levesque said. “I think a lot of people don’t want [supervised consumption sites] in their neighbourhoods. But for people like us, it saves lives.”
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