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Alberta doctors call for more drug-use sites to reduce strain on acute-care resources

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A group of Edmonton physicians says the Alberta government's overhaul of harm reduction supports for people who use drugs is needlessly straining acute-care resources as COVID-19 demands grow.

Members of the Edmonton Zone Medical Staff Association's opioid poisoning committee have penned a letter to Premier Jason Kenney, Prime Minister Justin Trudeau, and health and addictions officials calling for emergency action to address what they call a drug poisoning crisis.

The association says communities do not have adequate resources to respond to spiking drug overdoses, so people who face adverse reactions are needing help from first responders, emergency departments and intensive care units more often.

The group is recommending two emergency actions: expanding access to injectable opioid agonist treatment programs, also known iOAT, and bolstering supervised consumption and overdose prevention services.

"We know that Alberta’s current approach to the drug poisoning crisis unnecessarily strains acute-care resources and is directly contributing to an increasing number of deaths," the letter says.

"In the context of the COVID-19 pandemic, the above emergency policy actions are life-saving not only for people who use drugs but for all Albertans in need of intensive care."

Under Kenney's leadership, the province has limited access to iOAT, which can be used for people for whom oral therapies using the drugs methadone or suboxone have been unsuccessful.

The government was taken to court for its decision to close clinics specializing in injectable treatment but later committed to continue funding for existing clients.

The province forced the closure of a supervised consumption site in Lethbridge, Alta., — at one time the busiest in North America. It plans to close Calgary's site, but with the promise of two new locations, which have yet to be announced. The Boyle Street Community Services supervised consumption site in Edmonton was also shuttered.

Elaine Hyshka, an assistant professor at the University of Alberta's School of Public Health, said front-line workers have seen a "huge spike" in overdoses since the closure of Boyle Street.

"It's honestly, frankly, long overdue they consider reopening the programs that they have shut down during the pandemic," said Hyshka.

She said agencies and their staff in Edmonton are walking throughout the inner-city to find people who have overdosed, often arriving long after someone has become unresponsive.

"Why are we forcing staff to do that when we could very easily reopen a supervised consumption service with five booths that would accommodate hundreds of people a day and would have staff with oxygen and all of the emergency medical care that's required, right on site?" Hyshka said.

"We have the infrastructure. We just need the provincial government to step up and restore the funding for those services."

More than 145 people and 18 organizations from across Canada — including the Canadian Drug Policy Coalition, Moms Stop the Harm and Protect Our Province Alberta — have signed the letter in support.

Alberta Health declined to comment on the letter and Alberta Health Services did not respond to a request for comment.

Dr. Ginetta Salvalaggio, co-chair of the opioid committee, said every aspect of health care in Alberta is strained right now. Major components of triage have already begun, which means some critically ill patients may not get the help they need.

"Right now, we're just worried that the response is going to be slower and, like other Albertans, (people who overdose) may not be able to get life-saving care when they need it," said Salvalaggio, an associate professor at the University of Alberta's Faculty of Medicine.

People who initially survive a severe drug poisoning could end up requiring intensive care, but won't benefit if the response time is delayed, she explained.

"There are some pretty easy wins here to alleviate some of that strain," said Salvalaggio. "There are amazing experts in the community that can help with more timely overdose responses."

During a COVID-19 update on Tuesday, Kenney noted there were "a number of admissions" to intensive care related to drug poisonings. He said it served as a reminder "that COVID is not the only public health crisis that we are facing in Alberta."

This report by The Canadian Press was first published Sept. 24, 2021.

Alanna Smith, The Canadian Press