Safety without stigma at the Moss Park site

Organizers behind an overdose prevention site in Moss Park are willing to stay open all winter to help drug users get through the cold weather.

Before coming to Ontario, Leon Alward — better known by his street name, Pops — had been sober and not using drugs for more than nine years.

He had been using street heroin to combat chronic back pain.

The “chill out and smoke” tent is a safe space for users to consume their drugs in a warm, relaxed environment. (Photo by Devika Desai)

Although doctors in New Brunswick had prescribed the fentanyl patch, he was refused the same by six different doctors after moving to Ontario.

The process to get medical coverage took months, which barred him access to methadone, an alternative.

“My option was only one,” Alward said. “I had to go to street drugs.”

Heroin, Alward said, was the easiest to find, and so it became his drug of choice. “I didn’t like it,” he said.

What he didn’t know was that street heroin is often laced with fentanyl. He found out the hard way.

“My son’s friend was dope sick,” Alward said, “I had a little bit of money and I said, ‘Listen, I’m going to help you.’”

He took the boy to a Tim Hortons bathroom to inject, while his son lined up to buy them coffee.

“But when I went to use, it was fentanyl and we didn’t know that,” said Alward. “Because I was treating us both, I put a little extra into the mix and because it was fentanyl, it was two to three times the dose I was used to.”

Both men immediately overdosed and dropped to the floor.

“(My son) came in to find out why we were taking so long, and his dad and his best friend were on the floor,” Alward said. “No heartbeat. No respiration.”

Alward said that once both were rushed to the hospital, it took staff hours to revive him. His son’s best friend, on the other hand, was in the hospital for days.

Alward now volunteers at the Moss Park Overdose Prevention Site at the corner of Shuter and Jarvis streets.

The volunteer-run initiative was started by five people in August. In a matter of three months, the number of volunteers has risen to more than 170.

As of last Friday, the site has reversed 107 overdoses.

“A lot of us are drug users ourselves, and a lot of us work in the harm reduction field so we really know what we’re doing,” said Sarah Ovens, one of the five main co-ordinators who oversee the site.

The impetus for the site, according to Ovens, came from a weekend in July when six people died from overdoses, all within a 10-minute walk from the park.

“There was a meeting with the mayor where we realized, ‘Holy shit, they’re not doing anything,’” she said.

It was at that point that she, along with others, started a GoFundMe page. With the money obtained, they bought two tents and pitched them in August.

The Moss Park Overdose Prevention Site is the first unsanctioned injection site set up in Toronto.

Weeks after the site started up, a permanent supervised injection site also opened at the Works, a harm reduction facility near Yonge-Dundas square. Plans for this site were approved in March by the city.

The other two sites at South Riverdale Community Health Centre and Queen West-Central Toronto Community Health Centre are scheduled to open as permanent sites later this month and next month, respectively.

The site at Moss Park operates every day from 4 to 10 p.m. Volunteers who are on duty for the evening arrive at around 3:30 p.m., laden with medical and food supplies.

With the cold weather fast approaching, the two tents have now been replaced by a trailer and a heated tent supplied by Ontario’s Emergency Medical Assistance Team (EMAT). The trailer was funded by the Canadian Union of Public Employees (CUPE).

Leon (Pops) Alward draws on his own experience of using street drugs to support other users at Moss Park. (Photo by Devika Desai)

The EMAT tent comes with 24-hour security supervision and staff to operate the generator, a cost that Megan Lowry, a registered nurse and site volunteer, said was a “deterrent” to the operation of the site.

The tent, she said, was also “too small.” The team requested a trailer to accommodate more people, but she said neither the municipal or provincial governments were able to help.

“At a certain point, we just decided to go on ahead and get a trailer on the support of CUPE,” said Lowry.

Lowry dedicates her time to treating users in the trailer and overseeing the clinical volunteers who work at the site.

“Part of the agreement we had with Toronto police is that we always had a clinician who was able to run it,” she said.

The trailer is staffed with one clinician and with one peer support worker — a person who has a lived experience of drug abuse and/or harm reduction.

According to Alward, although peer support workers may not have clinical know-how, their experience and familiarity with overdoses is essential to ensuring an effective procedure is followed when treating someone with an overdose.

“As soon as your emotions get involved, you lose focus and you focus on the person, rather than the objective,” he said.

Alward said it took more than three and a half hours of negotiation between volunteers and the police to allow the tents to be set up on the first day.

“They (the police) initially came here and were set on arresting everyone, as soon as we allowed the first person to use the facility,” said Alward.

“We were able to convince the superintendent and the police chief that this was a crisis,” he said. “They knew people were dying.”

Evan Dwinnell came to Moss Park even before the site opened up.

“I’d be sitting behind the arena (doing drugs), and there’s a community centre, so I’d feel terrible about that,” he said.

“I’m not a bad person, I’m not a criminal, but when you’re in an anxious state to that degree, it’s torture.”

Dwinnell first began using opioids when he discovered a prescription of morphine hidden in a beam he was tearing down during a construction job. His addiction eventually progressed. Soon he was using OxyContin and heroin.

“I struggled with that during my whole twenties and I was off and on methadone, which is just a very, very miserable way to live,” he said.

Although he finally entered a program to tackle his addiction, he fell into using cocaine and later crack cocaine.

“(There are) times that I can remember when I was needle-using … in a Tim Hortons bathroom or whatever. You don’t feel good about it, but there weren’t any alternatives,” he said.

Dwinnell said that despite being a drug user, he never associated with other users.

“In a sense, I’ve always been really alone with my addiction uses,” he said.

He doesn’t come to the site to make friends, but there, “everybody is in the same boat.”

“Everybody at least treats each other with some measure of respect,” he said. “The people down here that are trying to foster a spirit of recovery. It’s not unnoticed. You definitely feel it.”

Lowry agrees.

“The community that has been built around this place has been really positive and really supportive,” she said.

While volunteers work to aid and assist those who visit the site, they ensure that their presence is as minimally intrusive as possible.

During her first shift as a volunteer, social work student Laura H. was assigned to stand at the entrance to the “chill out and smoke” tent — the place where people visiting the site can consume their drugs in an environment that is safe, warm and relaxed.

While it is her responsibility to note down how many people enter the tent and what kind of drugs they carry with them, she will not enter the tent.

“It’s not my space and I’m very aware it’s not my space,” said Laura, who currently studies at George Brown and has applied for advanced standing in social work at Ryerson.

“I’m trying not to be a watchdog. It’s their space and it’s their tent, and I really need to be mindful of that.”

There’s no doubt that the site is popular, not only among drug-users but also among members within the community.

According to Lowry, once the site was established, others started visiting the site to talk to clinicians about other health-care-related problems.

“There’s definitely a huge need for health care that’s more accessible to folks in this community,” she said.

Currently, Moss Park is the only site in Toronto that remains unsanctioned by the city. According to Ovens, there are no plans to sanction it.

“To operate a legal sanctioned site, you have to go through a lengthy, difficult application process,” she said.

Part of the application involves getting approved for an exemption from criminal laws around possession of drugs, so that those using small amounts of drugs within the facilities cannot get arrested.

Application criteria range from the policies used to operate the facilities to the types of ventilation and heating systems used.

While the site has been set up primarily to serve and help people, Ovens added that they want to show that running a safe injection site is “not that complicated.”

“There are a number of places that would like to open up space tomorrow, but they can’t because of the exemption process,” she said, adding that it can take up to a year to get a site approved.

Peter Leslie, a former paramedic, is involved with the sites at the Works and at Moss Park.

“I would say (Moss Park) is more relaxed,” he said. “We actually are able to assist people with injections and accommodate people who smoke various drugs,” he said.

While staff at the Works are able to instruct users on the best methods and needles to use when injecting themselves, they are not allowed to inject for them.

Currently, there is no definite plan of action for the operation of the site once winter settles in. But Ovens is determined to keep it open.

“All of us live this 24/7,” she said. “This was basically my life before this started because I had lost so many people and a lot of us are advocates in other ways.

“We sit on task forces, provincial advisories, work at the services offered, advise the government. We’re all doing everything we can.”

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