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More security, outdoor drug-use sites help address illicit drug use in B.C. hospitals

Measures are being taken after Ottawa granted Premier David Eby’s B.C. NDP government’s request to roll back parts of its hard drug decriminalization experiment.
Handout photograph of the Outdoor Overdose Prevention Site for patients who inhale and inject, at St. Paul's Hospital in Vancouver. PROVIDENCE HEALTH CARE

B.C. regional health authorities are responding to address illicit drug use in hospitals that was putting nurses and patients at risk, including by stepping up security.

Other measures include an “outdoor overdose prevention site” at St. Paul’s, a Vancouver inner city hospital, that opened on May 13. That outdoor site had seen 2,111 visits since it opened, about 45 visits a day.

At other hospitals, patients who use drugs are being directed to safe-use sites outside the hospital.

Other actions include putting ups signs that say illicit drug use is prohibited in hospitals.

The changes have taken place seven weeks after Ottawa granted a request by Premier David Eby’s B.C. NDP government to roll back parts of its hard drug decriminalization experiment.

While the hospital issues came to light this spring during a political outcry over decriminalization, B.C. Nurses Union president Adriane Gear said health authorities always had the power to stop the drug use in the hospitals and protect nurses and patients but hadn’t.

Nurses went public with specific instances including having drug smoke blown into their faces, use of drugs in bathrooms and in shared rooms next to other patients.

“It was really the health authorities not enforcing existing policy. And I don’t think anywhere in the whole sort of piece around decriminalization that it indicated it would be OK for people to be consuming openly in hospital spaces,” Gear told Postmedia News this week.

“So, I think what’s changed is that the health authorities are now doing their job.”

In April, Gear had said that while nurses support harm reduction as a way to prevent overdoses, the decriminalization policy had “been interpreted as everything goes.”

In response to Postmedia questions, officials at Providence Health Care, whose sites include St. Paul’s, said all of its policies have been updated to reflect the decriminalization changes.

In a written statement, Providence spokeswoman Ann Gibbon said members of the substance-use team visit patients to educate them about the new rules and to tell them the outdoor site is the only place in which they can use illicit drugs, as well as to connect patients to resources to help them deal with substance use if they choose.

At the outdoor site, about 80 per cent of users inhale and the rest inject.

“The St. Paul’s outdoor [overdose prevention site] has greatly decreased unintended exposures to smoke among staff and others in the hospital,” said Gibbon. “There was a clear need for this type of service at St. Paul’s.”

Members of the public who wish to use illicit substances are directed to the nearby Thomus Donaghy overdose prevention site on Howe Street in downtown Vancouver, she said.

In the midst of the outcry, Health Minister Adrian Dix announced in April that the province would set up a task force to make sure the policies are consistent across B.C. He said the province had hired 320 security officers to try to crack down on drug use and illegal activity inside hospitals.

Providence Health officials said 60 of those security officers had been hired at St. Paul’s in the past year.

B.C. Health Ministry officials said this week that a new provincial policy has already been finalized and distributed across health authorities, superseding their previously inconsistent policies on a zero-tolerance policy for drug use in hospitals.

Fraser Health Authority officials said this week that injecting, inhaling and smoking illicit drugs is prohibited in hospitals outside of designated overdose prevention services and sites. Signs have also gone up at Fraser hospitals. When patients bring illicit drugs into a hospital, they’re asked to store them securely with their belongings.

“If a patient does not comply with hospital policies, our relational and on-site security teams will address the situation in consultation with the patient’s clinical team,” Fraser Health spokeswoman Krystle Landert said in a written statement.

The original decriminalization exemption, granted on Jan. 31, 2023, allowed for the possession of small amounts of drugs such as heroin, fentanyl, cocaine and methamphetamine.

In addition to the concerns raised by nurses, local government leaders had raised concerns it meant people could now use hard drugs in public spaces, such as parks and playgrounds with impunity.

Chilliwack Mayor Ken Popove, co-chairman of an informal 16-city urban mayors’ caucus, said it’s too early to say what is the effect of the rollback of decriminalization.

But Popove said it has given back tools to the police and there have been some seizure of drugs by the RCMP in Chilliwack as a result.

In April, Fiona Wilson, deputy chief of the Vancouver Police Department and president of the B.C. Association of Chiefs of Police, had told a House of Commons Health committee that the B.C. NDP’s decriminalization program had tied the hands of police to respond to problematic drug use both in public and in hospitals.

With the rollback of decriminalization, Vancouver police spokesman Sgt. Steve Addison said the biggest change is that once again officers have legal authority to intervene when a person is using illicit drugs in inappropriate public places.

He said they’re taking a compassionate approach and don’t support putting people in jail for personal drug possession.

“However, we are now able to better respond to public complaints about problematic public drug use, to encourage people to move along, and to take enforcement action when necessary,” said Addison.

Drug-user advocacy groups continue to be concerned that the rollback of decriminalization will push people to use drugs in less safe places that are hidden from view.

There has definitely been a bigger presence of police in the Downtown Eastside since the rollback, said Brittany Graham, executive director of the Vancouver Area Network of Drug Users.

“People are afraid to be out on the street a bit more,” she said.

And ultimately, rolling back decriminalized access to drugs isn’t helpful when issues such as homelessness aren’t being properly addressed with more shelter spaces, affordable housing and higher welfare rates, and there remains a lack of access to drug treatment, observed Graham.