Doctor defends harm-reduction vending machine for Hamilton hospital as councillor's bid to stop it fails

A Hamilton councillor's attempt to stop a hospital from providing harm-reduction supplies like needles and crack pipes in a vending machine has been quashed. 

The majority of councillors rejected the motion from Coun. John-Paul Danko at a public health meeting Monday after hearing from experts, including Dr. Robin Lennox, a family physician who specializes in substance use care. 

She helped develop the vending machine initiative, called Our Healthbox, for Hamilton General Hospital in part because health-care workers don't have the capacity to supervise distributing "each and every needle and syringe necessary to meet the needs of the community." 

And the need is great, Lennox said. Providing people with safe injection and inhalation supplies (24 hours a day, seven days a week) reduces the risk of HIV, hepatitis C and bacterial infections, and prevents long and expensive hospital stays and premature death. 

"I've heard the concerns from some members of council that providing harm reduction supplies somehow enables drug use," Lennox told councillors.

"I cannot emphasize strongly enough that this is simply not the case." 

Our Healthbox vending machines are set up in 10 places across Canada, including Winnipeg. 

In Hamilton, a vending machine is to be set up at the hospital as part of a pilot run by the city's public health department and Greater Hamilton Health Network (GHHN).

Lennox said she's treated thousands of patients with substance use disorders in clinics, hospitals and shelters across Hamilton, and not one person started using drugs because harm-reduction supplies were available.

"If anything, many of my patients have only learned about harm-reduction supplies too late in their trajectory when they were already exposed to harms," Lennox said. 

Vending machine creator defends program

Danko's motion would have requested that the Ministry of Health not provide funding for harm-reduction supplies in the Healthboxes and declare the public health committee does not support the "unsupervised distribution of paraphernalia for illegal drug use."

"This is an opportunity for us to say, 'No, a vending machine that distributes crack pipes, meth bowls and needles is not acceptable to the residents of the City of Hamilton,'" Danko said. 

The committee does not have the power to stop the program from rolling out, public health staff said. 

The Ministry of Health does not fund the Healthboxes and "does not support providing the means to use illicit drugs," said spokesperson Hannah Jensen in a statement. 

Danko was backed by Coun. Esther Pauls, who said the vending machine sends the wrong message. 

"I raised four boys and the first thing I say is, 'No drugs ever,'" Pauls said. "But we don't hear that no more. We hear, 'We will help you, we will enable you.'" 

Dr. Sean Rourke, a clinical neuropsychologist at St. Michael's Hospital in Toronto, developed the Healthboxes for hospitals and organizations to provide clients with a range of low-barrier supplies from HIV self-test kits to underwear and socks, depending on what's needed. 

He told the public health committee the Healthboxes are a "health-care intervention" that also shares with users where they can access treatment and collects real-time data such as who is using them and when. 

About two dozen Healthboxes are already in use across Canada, including three in Ontario, said Rourke, also a psychiatry professor at the University of Toronto. 

"When someone goes to the machine, they don't have to ask for permission for things," he said. "They get them and they don't have to feel the shame." 

After Rourke spoke, Danko said to him, "I don't understand why you're here today," and questioned why he was "travelling around the country" making similar presentations. 

"Why would I be doing this? Because it actually helps to improve people's lives and communities and families across the country," Rourke responded. 

Mayor Andrea Horwath voted against Danko's motion, stating it's not the committee's role to decide what goes into the Healthboxes and it should be left up to the experts.