A new inhalation site that harm-reduction advocates say will help mitigate toxic drug deaths in Nelson has been delayed by Interior Health following local backlash from neighbouring businesses and residents who argue the location is inappropriate and unsafe.
The service would have offered a supervised and clean area to smoke substances at the Nelson Friendship Outreach Clubhouse that was to begin Friday, but on Interior Health announced Thursday it would reconsider its plans.
Lannon de Best, Interior Health’s executive director, clinical operations for the Kootenay Boundary, said the health authority will instead work with the city to make sure the Clubhouse is properly suited for an inhalation site. He said it will also consider alternative locations, but added none are available right now.
“The decision was that it’s in our interests to continue to work collaboratively with the city and our partners, and have those components in place before initiating the service.”
Nelson already has two safe injection sites, but neither is set up for inhalation. Smoking, and not injection, is the most common mode of consumption among people who have been killed by illicit drugs.
A BC Coroners Service report in February 2022 found the rate of smoking-related deaths increased from 31 to 56 per cent between 2016 and 2020, while injection fatalities dropped from 39 to 19 per cent.
“We know that the injection overdose prevention sites serve a purpose to support users who inject and there is an absolute gap in supporting those who inhale their drugs,” said De Best. “The statistics are clear that more people are dying of inhalation-related toxic drug effects than those from injection. This is a gap in service, and we see a need.”
The toxic drug supply has killed nearly 12,000 people in B.C. since the crisis was declared in April 2016. In the Nelson local health area, which includes Salmo and part of the Slocan Valley, 11 people were killed last year while 40 fatalities have occurred between 2016 and 2022.
Safe injection services are already available in Nelson at ANKORS and the Coordinated Access Hub, the latter of which is a federally funded program managed by the Nelson Committee on Homelessness. Inhalation services, De Best said, are not possible at either location.
That led Interior Health to consider the Clubhouse, which it owns and is located at 818 Vernon St. next to Stepping Stones shelter.
The health authority uses the building for services such as life skills and nutritional training as well as mental health support outreach. But there is no security fencing surrounding the site, and its front porch is typically used by Nelson’s homeless population as overnight shelter. Businesses near the Clubhouse have complained to the Nelson Star about vandalism to their own properties.
Mayor Janice Morrison, who at Tuesday’s council meeting said she had only just learned the inhalation site was planned to open later in the week, said Interior Health is working with city staff on fencing requirements for the Clubhouse.
Morrison hopes Interior Health also initiates public consultation if it goes ahead with installing an inhalation site at the Clubhouse. Community members, she said, are frustrated by the lack of communication.
“They’ve wanted a fence for I don’t know how long. Something simple that could have eased the minds of the community thinking that they were being heard. And now, are we getting the fence because they want an inhalation site there? Or are we’re getting a fence because they actually want to try to make the neighbourhood feel safer, and have less trespassing?”
Chief Donovan Fisher of the Nelson Police Department said in an email that he believes Interior Health should have engaged local residents more than it has prior to the announcement.
“We have concerns about an inhalation facility in the middle of a residential neighbourhood and will continue to work with everyone to limit the impact of the site and ensure the safety of everyone.”
The Kootenay-Columbia MP Rob Morrison also issued a statement Friday opposing the proposed site. In it, Morrison said seniors who use the Nelson and District Seniors Coordinating Society near the Clubhouse are regularly harassed, and that urine, feces and broken windows are routinely found nearby.
“In the face of that sobering reality decisions are being made right now by the B.C. government that will place toxic drugs – poison – right in the path of the most vulnerable of Nelson’s population – our seniors and young people.“
The inhalation site was to be managed by Holly Trider, a peer health navigator with ANKORS and the Rural Empowered Drug Users Network.
Trider said she is disappointed by Interior Health’s decision to delay the service. Trider and a co-worker had already been providing a mobile inhalation service Friday and Saturday evenings but had advocated for a fixed site at the Clubhouse.
“That’s a place that people gather and feel safe, and the peers have been reversing overdoses there for quite some time. Because it’s on health authority property, it seems like a perfect fit as it’s the health authorities responsibility to be responding to this toxic drug crisis that we’re in.”
Interior Health told the Nelson Star it has already added new signage, an extra security camera and lighting at the Clubhouse. Along with a planned rear fence and private screening along the property, it is also waiting on a consultant’s recommendation for a front porch enclosure and it is looking into on-site security staffing.
But the Clubhouse’s location is also viewed as problematic.
It is inside the city’s core commercial zone that allows for care and health services, but residential zoning begins just across Cedar Street adjacent to the Clubhouse.
The inhalation site would also be near the Civic Centre, which includes Glacier Gymnastics, and Nelson Soccer Association’s indoor facility. There are no rules stipulating location requirements for supervised consumption sites in Nelson, but a city bylaw does prevent cannabis stores within 150 metres of youth-related facilities including the Civic Centre.
Health Canada’s Controlled Drugs and Substances Act requires community consultation to take place prior to the opening of a supervised consumption site. That might include an open house, door-to-door canvassing, flyers or an online survey, as well as details on how community concerns were addressed.
Mike Stolte lives across the street from the Clubhouse. He says he supports an inhalation site in Nelson but is concerned by the lack of security at the building and wants Interior Health to host a public engagement session.
“Any issue in the community that is somewhat contentious needs to have the light of day shone on it. To me, that’s just good community engagement and that’s democracy in action. And today, I haven’t seen anything like this.”
Janice Morrison, who recently retired after 40 years working in health care, said she isn’t sure there should be a third supervised consumption location in Nelson.
Trail and Castlegar, she pointed out, have no permanent sites, and Interior Health does not run a rehabilitation facility in the West Kootenay. The region, she said, needs more substance-use services than a cluster in Nelson.
“The issues are not lost on me, the societal issue of mental health and addictions. This is not a crime, it’s a disease. We have to get together as a community and as a region, we have to get the services in place to help these people and [overdose prevention sites are] a stop gap.”
Trider meanwhile has no security concerns for the Clubhouse, and said she doesn’t think nearby residents would either if they met with substance users who access the site.
“Once you get to know people, none of this scares me. We take training as peer workers and with ANKORS, de-escalation and things like that. There are times when the police do have to be called. But most of the time, things can be dealt with and emotions can be settled just by hearing people.”