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A wall inside Sarah Torraville’s office in St. John’s is stacked high with medical-grade supplies: syringes, alcohol swabs, naloxone kits, test strips and glass pipes.
She fills a box with supplies and tapes it shut for delivery. Torraville has been assembling packages like these for years. The supplies are intended to make using unregulated street drugs a little less dangerous.
“I just really care about making sure they can be as safe as they can,” Torraville said of the clients she serves.
Sterile needles prevent the spread of HIV and Hepatitis C, she said. There’s also naloxone, which could save someone from overdose. The drug test strips could find traces of fentanyl or benzodiazepine in a bag of cocaine.
The Safe Works Access Program, known as SWAP, can send their boxes to anyone who uses drugs in the province, not just to pharmacies and partnering organizations — directly to people’s homes.
“A lot of people do depend on us to get safe supplies to use, and especially in small communities,” Torraville said.
Gillian Kolla has a doctorate in public health sciences and works as a harm reduction researcher and assistant professor at Memorial University.
She has worked for years as a social worker and counsellor, serving people who use drugs in different parts of the country. Kolla said SWAP’s method of distributing supplies by mail is innovative.
“That’s actually a model here that I think the rest of the country can learn from, because in a lot of parts of the country, we’re not doing a great job of actually addressing rural and remote communities and making sure that their needs are met,” Kolla said.
Major cities are dabbling in safe drug consumption sites. Some are shutting down, while other cities are championing the effort.
Kolla said the strategy might work for some cities like Vancouver, but may not work in St. John’s or Gander. In a province spread over a large distance, the rural communities of Newfoundland and Labrador are far away from the services in downtown St. John’s.
Mailing out the supplies bridges that gap.
Torraville also said it helps with the stigma attached to using drugs in small towns.
“Having a discrete package delivered makes it accessible so that they don’t have to be seen going out and accessing it from a certain point where people know there are supplies available,” she said.
Kolla said with SWAP’s option to distribute supplies by mail, Newfoundland and Labrador takes an especially unique approach.
In 2024, 71 people died from accidental overdose in Newfoundland and Labrador, according to the province’s chief medical examiner. In that same year, Canada saw 7,146 deaths due to overdose.
Kolla said Newfoundland and Labrador must act fast to prevent a worsening public health crisis.
“We’ve already seen an increase in overdose-related deaths here in Newfoundland and Labrador,” she said. “So now is the time to come in with well-resourced harm reduction and evidence-based treatment services so that we can actually get ahead of this before it becomes an absolutely dire crisis.”
Torraville said safe use supplies could lower the chance of overdose, and lessen the weight on the health-care system by avoiding preventable injuries and diseases.
“People don’t realize that you can also even get an infection from reusing your own supplies,” she said.
Torraville said it’s common for people in rural areas to place big orders, which can then serve others and their community.
“So they’re not sharing amongst each other and they have enough that they can use a needle once and not reuse it and inflict more damage to themselves,” she said.
SWAP partners with dozens of other organizations, pharmacies and offices around the province that hold and distribute these supplies.
Torraville said her relationship with clients makes her — and other workers like her — the first step toward recovery, should clients choose seek out other health services.
She said some clients are looking for support to get into a rehabilitation facility, and others want help with reducing or stopping their own drug use.
“We tend to be, like, in some cases, the only people that they feel comfortable being open and honest with about their drug use, because they know they’re not going to get judgment from us,” she said.
In the meantime, Torraville hopes the safe use supplies keep people safe, and said the demand is ever growing.
