With the public health emergency related to opioid overdoses, the University of Victoria and CARBC study identifies shelter washrooms as being de facto safe consumption sites. The report states:
Homeless shelter washrooms have been identified as places where injection drug use is particularly prevalent, which negatively impacts other shelter residents and creates significant challenges for shelter staff. Shelter residents complained about the lack of access to toilets that are continually occupied by people using them as a place to inject drugs. Issues around safety and sanitation were also identified by residents and as one described:
Shelter staff described the washroom situation as serious challenge and one staff recognized that providing harm reduction supplies without a safe place for use “leads to safety issues where then you have like people overdosing in the bathroom and not, like not finding them.” Another staff expressed that they are “maybe turning a bit of a blind eye in the sense that I think the majority of the staff recognize that kind of every washroom in this city is a de facto supervised consumption site, whether we want that to be the case or not, whether everyone agrees with that or not.” As one staff person further warns, “without actually having anyone being there watching you, it’s like a half-assed safe injection site.” Shelter staff conducting periodic safety checks is currently serving as a primary response to washrooms acting as de facto sites for injection drug use. One staff member reminisced that bathroom checks in the past were to ensure residents were not dealing drugs or using drugs in the washrooms whereas now they are mainly checking to see if people are overdosing.
The increasing rate of illicit drug overdoses occurring in Victoria creates a serious predicament and as a staff person explains, “though it is against our policies to use in our bathroom and we’ll discourage that behavior, when everybody was potentially dying in other places, it was much easier to have them use in here”. Shelter washrooms were repeatedly described as being inadequate and unsafe locations for injection drug use but also a preferable alternative to having people inject alone or in public.
Staff reported that having to respond to overdose events in shelter bathrooms with naloxone meant that it becomes “your responsibility now and as a shelter worker you are now responsible for administering naloxone and you feel responsible for that person’s life or death.” As another staff person describes, “we’ve been working with these guys, people who have died, right. We’ve been working towards goals and things like that, and then suddenly you come to work and find out they’re dead.” A shelter staff person went so far as to describe the situation as “traumatic” as they are constantly witnessing their “community hitting the floor and potentially nearly dying on us, a lot, and it probably does leave a lot more trauma within staff than we necessarily recognize or have talked about maybe.” As one shelter staff explains, “you come into work wondering if you’re going to have to try to save someone’s life and the emotional impact that has on you and people.”
University of Victoria, Centre for Addictions Research BC - Every Washroom: De facto consumption sites in the epicentre of an overdose public health emergency report.