Needle-dispensing vending machines could be installed at five locations across central Ottawa, making it the first city in Canada to offer sterile syringes in machines to reduce drug-related virus transmission.
Vera Etches, the deputy medical officer of health, said Ottawa Public Health hasn’t yet decided what material would be available in the vending machines, but needles and crack pipes are definite possibilities.
The machines would fill a gap in service for drug users who need clean needles when a community program is closed for the day. There are no 24/7 services that provide clean needles.
“This is about making sure people have sterile supplies in the off-hours,” Etches said in an interview Wednesday.
The health unit doesn’t know yet how much the five machines would cost, but Etches said the expense would be covered by the province.
“This is not city dollars going into a new harm reduction service,” she said.
The health unit is currently pricing out the machines and identifying suppliers.
It would run as a pilot project. The timeline for the pilot and the delivery of the machines is flexible, even though the health unit has told prospective vendors it wants the machines delivered near the end of February.
“We can’t rush things,” Etches said. “These kinds of initiatives are making sure the community is involved.”
The likely scenario for a person using a machine would involve getting a token or card from an existing social service. Access to the machines would be restricted to people who need harm-reduction services.
The machines could also be filled with other sterile supplies and information to help drug users protect themselves.
Etches said the machines would not be filled with naloxone, which is used to treat narcotic overdoses, because there needs to be counselling on how to respond to overdoses.
One knock against the vending machines is the limited amount of information available to users, compared to what they would receive from staff at service providers. Etches said the machines won’t replace the face-to-face interactions, but instead complement them.
Some countries in Europe, along with Australia and New Zealand, have needle-dispensing machines.
In 2014, some locations in Vancouver installed vending machines offering crack pipes as part of a harm-reduction program.
A staff report to Ottawa’s public health board last June indicated as many as 5,000 people in this city use injection drugs. The report cited a University of Ottawa study from 2014 that says 13.9 per cent of people who inject drugs indicated they had taken drugs with a previously used needle.
The health unit also learned that, based on 2011 data, Ottawa has a higher prevalence of HIV for people who inject drugs, compared to Toronto. The prevalence of hepatitis C for people who inject drugs in Ottawa is higher than those in Montreal, according to the data.
A survey by the health unit last summer indicated that 62 per cent of respondents (2,263 people completed the survey in total) believe harm reduction dispensing machines would be “beneficial” in Ottawa. In the same survey, 51 per cent of respondents had “no concern” about the units.
The five potential locations for the vending machines are the city’s sexual health clinic on Clarence Street, Centretown Community Health Centre on Cooper Street, Somerset West Community Health Centre on Eccles Street, Sandy Hill Community Health Centre on Nelson Street and an addictions treatment clinic on Montreal Road.
David Gibson, executive director of the Sandy Hill Community Health Centre, said the organization has discussed the machines with the health unit but haven’t made a decision.
The key issue remains the availability of clean needles when programs are closed for the day.
“The hours of operation are not sufficient,” Gibson said, noting that the vending machines could be one answer.
“We would be interested in exploring a pilot,” he said. “Our site is one of the busiest sites in the distribution of crack kits and clean needles.”
We cannot disagree that this seems like a good idea, since clean needles inevitably reduce the disease transmission rate. However, why charge for them with a vending machine, instead of some other secure mechanism managed by an exchange scheme that invests in public health protection.
And we must keep fingers tightly crossed that some arrangement is made for sharps disposal, at the vending machine site or elsewhere, but freely accessible and adequately serviced, to further reduce the burden of needle sharing, and encourage safe disposal.