City aims to open supervised drug-use space in Hamilton men’s shelter

The city hopes to create a supervised drug-use site in a men's shelter as part of an overall strategy to prevent overdose deaths in Hamilton amid a relentless opioid crisis.

The 18-month pilot project aims to provide men with a safer option to use potentially deadly opioid mixes with trained staff on hand.

The initiative would mirror a safer-use program at the YWCA's downtown overnight drop-in space for women and gender-diverse people who are homeless.

But it's uncertain if any of Hamilton's three men's shelter operators will apply to host the pilot project with space and staffing constraints amid overlapping homelessness and mental-health crises.

The shelter system right now is quite pressured and struggles to maintain even the staffing they have, so I don't think that this will be easy," city housing director Michelle Baird told council Monday.

But the hope is that city funding will encourage operators to apply for the pilot, noted Melissa Biksa, manager of mental health and harm reduction. They don't have the financial resources to support this within their own operating budgets."

The $667,000 men's shelter pilot is among a suite of measures in the Hamilton Opioid Action Plan that city politicians backed Monday to rein in overdoses driven by powerful and unpredictable fentanyl mixes on the street.

Other cornerstones of the action plan, informed by feedback from a steering committee and community members, include increasing access to addiction medicine through doctors, bolstering rapid detox and residential treatment programs, and establishing more supervised consumption sites throughout the city generally.

We need to start really putting our shoulder to the wheel and getting some programs in place to help us manage these crises," Mayor Andrea Horwath said.

In the first four months of this year, there were 336 opioid-related paramedic calls in Hamilton, which was more than the same period in 2021 and 2022, a staff report notes.

Between January and April this year, there were 62 suspected opioid-linked deaths. Of those, 42 were in private residences. Hamilton's death rate, meanwhile, is consistently higher" than that of the province, the report points out.

In addition to the YWCA's overnight space, Hamilton Urban Core Community Health Centre operates a provincially funded consumption and treatment services (CTS) site at St. Paul's Presbyterian Church on James Street South.

In particular, harm-reduction advocates have called on the city to open supervised drug-use spaces in shelters in response to the persistent problem of overdoses on premises.

A nuanced and layered and resourced response in this community is absolutely essential," Katherine Kalinowski, chief operating officer of Good Shepherd, told The Spectator.

And I don't think that it's unreasonable to think that emergency shelters might be one of the venues where that kind of response needs to happen."

But Good Shepherd, which operates a men's shelter on Mary Street, would have to consider a variety of factors, including staffing, space and details of the city's proposal, before applying for the pilot project, Kalinowski said.

The emergency shelter system is already operating at or over capacity on a nightly basis. It's already facing tremendous pressures as a result of increased homelessness, a housing market that is not accessible to the people we serve, so we have a bottleneck."

Nonetheless, Kalinowski pointed to some real successes" realized by the YWCA's supervised overnight space, Carole Anne's Place, on MacNab Street South.

Earlier this year, the YWCA told council there had been no fatal overdoses since the program began in April 2022.

If the city pilot gets off the ground, it wouldn't be the first instance of a supervised drug-use space in a Hamilton men's shelter - albeit for a short period.

In early 2021, the city, health-care professionals, volunteers and the Salvation Army collaborated to set up a temporary arrangement that allowed men to use drugs under supervision at the charity's Booth Centre on York Boulevard during a COVID-19 outbreak.

The emergency response, which ended after the outbreak subsided, aimed to prevent those from leaving isolation to acquire drugs on the street and potentially spreading the virus in the process. There were no deaths during the four-week initiative.

In an emailed statement Monday, the Salvation Army said it has no immediate plans to participate" in the city's 18-month pilot at the Booth Centre, which has been a focus of concern due to fatal overdoses.

However, the Salvation Army strives to be an innovative partner" and looks forward to continued dialogue" with the city and partner organizations, said Glenn van Gulik, divisional secretary for public relations of the charity's Ontario Division.

Mission Services, which is moving its men's shelter from its longtime James Street North location to a renovated building on King Street East, near Victoria Avenue, couldn't immediately be reached for comment.

During the public health session, Coun. Cameron Kroetsch suggested the call for applications could be offered to women's shelters if none emerge from the men's sector to prevent the city initiative from dying on the vine.

Also Monday, city politicians backed $178,000 in funds for a one-year, drug-checking pilot that would allow users to screen substances with take-home test strips and health-care professionals through mass spectrometry devices to flag volatile mixes.

Coun. Brad Clark urged legal advice from the city's legal division on the potential consequences of tragedies unfolding despite drug-checking efforts. There very well could be liability for the municipality."

Teviah Moro is a reporter at The Spectator. tmoro@thespec.com