It’s hard to imagine that a single political decision could simultaneously cause harm to a city and its residents, create death and disease, increase health care spending, create problems for businesses, and be ethically dubious. Yet, the Red Deer City Council has found a way.
Last Friday, our city council decided, in a 5-2 vote, to pass a motion to request that the provincial government close central Alberta’s only Overdose Prevention Site (OPS), located in Red Deer. This came after a two-day public hearing, in which 27 out of 33 speakers advocated to keep the OPS open.
I am a local physician who works in the Emergency Department at Red Deer Hospital and with people struggling with addictions, and I was proud to be one of those speakers. The presentations included people who work in the health sector, people who have been personally affected by addiction, and concerned citizens who recognize the need for this service in our community. The net effect was powerful, although apparently insufficient to sway our councillors (notable exceptions were Councillors Jefferies and Wyntjes, who were well-informed and a welcome presence in the dialogue and ultimately voted to keep the OPS open).
To briefly clarify the issue at hand, the OPS is a healthcare facility that operates legally under federal legislation. It allows people who are using drugs to use under the supervision of a health professional. Clean needles and supplies are provided by the site and are disposed of in medical sharps containers after use. These facilities exist all over the world, and ours is one of 39 similar sites in Canada. The OPS does not give out drugs, and they do not encourage drug use. They simply recognize that if people are doing drugs in our communities, it is better to provide them with a safe place to do this that minimizes the health risks (overdose, HIV, hepatitis) to those individuals, and minimizes the risks of their drug use to the public (by reducing drug use in public spaces and properly disposing of needles).
I assume that the council brought this motion forward in response to some downtown businesses that have expressed valid concerns about vandalism, crime, and sequelae of drug use in their places of work. I completely agree that these concerns need to be addressed. Unfortunately, as was made clear at the public hearing, closing the OPS will not help to address these problems; in fact, it will make these problems worse. The OPS safely disposes of 20,000 needles each year, so that they don’t end up in our streets and parks. They clean up needle debris from the 200m radius around the site every day. They facilitate our city’s efforts to get more people into drug treatment and recovery. Since June 2023, the OPS has made 2569 referrals of clients to social and health services, including detox, addiction treatment, and counselling.
The OPS also relieves the burden of drug use and poisonings from our already over-stretched ambulance and hospital services. The OPS responds to, on average, 1,253 opioid poisonings per year. This prevents EMS from getting called to these events and avoids a costly visit to our Emergency Department (ED). As an ED physician who is constantly struggling with long wait times, an overcrowded department, and no hospital beds, I am grateful that these patients can get good care elsewhere, so that we can make space for other patients in our department. Treating these overdoses at our OPS, rather than the ED, also saves about $2 million per year in health care costs. And, the OPS has never had a death on site in five years of operations.
At the public hearing, the councillors had the opportunity to ask questions of the presenters. Councillor Vesna Higham seemed to believe that the Virtual Opioid Dependency Clinic, a wonderful virtual/telephone-based addiction treatment service that operates in Central Alberta, could provide treatment to all the OPS clients if the OPS was shut down. She neglected to recognize that most people using the OPS don’t have access to a personal phone or computer, and therefore can’t access this program. She also seemed to believe that the two new addiction treatment centers in Red Deer are sufficient to solve our city’s addiction problems. While these are welcome new additions, she failed to realize that these treatment beds filled up almost immediately after opening and that the waitlist to access them is now months or years.
So, what is the solution to the problem of drug use and homelessness in the downtown? We need a plan for affordable housing in this city. At a minimum, we need our shelter expanded so that it can offer more services like bathrooms, showers, and food on site so that people have a safe place to go rather than being on the streets. We need more infrastructure, including public bathrooms and better garbage disposal systems, in our downtown. We need more services to address mental health, addictions, and social instability, without months-long wait times. Those would be good places to start.
With this decision, our city council has sent a clear message to the rest of the province: Red Deer will be a city that hand-picks what health care services its citizens deserve, based entirely on political opinion and ideology, and without regard for demonstrated need, evidence-based data, or the guidance of health professionals. Based on their performance this week, I have serious doubts about our council’s ability to navigate future healthcare conversations that are coming for our city, such as the expansion of our hospital, or our advocacy for a cardiac catheterization lab. On a personal level, I am unsure if I will ever be able to provide my patients with the high standard of care that they deserve under this leadership, and am strongly reconsidering whether or not my family and I have a future here.
As for the people of Red Deer, what should you expect now? Once the OPS closes, you should brace yourselves to witness more drug use and debris in public parks and spaces. You should expect longer wait times when you call an ambulance or visit the Emergency Department, because our ambulances and doctors will be stretched even thinner to deal with opioid poisonings. You should expect to see our downtown businesses suffering even more from the challenges that are already overwhelming them. When this happens, I urge you to speak out — write letters, call your representatives, and publicly demand that our city council reverse this ill-informed and misguided decision.
Our city council has ample information to understand that the OPS is not the source of our downtown’s very real problems. Yet, they have decided to use them as a scapegoat, and create a false sense that they are doing something about the problem by shutting them down. The short-sightedness of this decision would be laughable if it wasn’t going to cause such devastation for our city. Will they get away with it? That’s up to you.
Thara Kumar is a Red Deer Emergency Department Physician with a Masters in Public Health.