CATIE International Network on Health and Hepatitis in Substance Users (INHSU)

SABSA: Quebec City’s one-stop shop for people who use drugs

In the summer of 2022, CATIE visited Quebec City, Quebec to learn more about SABSA's programs, and to share the stories and voices of the people behind this work.

Quebec City is the capital of Quebec, and home to the Coopérative de solidarité SABSA, or “SABSA” for short. SABSA is a low-barrier health clinic that serves marginalized communities including those experiencing homelessness, are street involved or who use drugs.

The SABSA clinic is located in Saint-Roch, a historically working-class neighbourhood in Quebec City. The clinic was founded in 2011 by a group of providers who were confronted by the spread of hepatitis C and HIV in their community, and the realization that there was little or no access to services for many marginalized people.

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Fred and Isabelle are service users at Interzone, Quebec City’s only safe consumption service. (photo: Conor Ashleigh, 2022)

Today, SABSA offers a full range of health services for people who use drugs, including hepatitis C care, primary care, harm reduction services and substance use treatment. They also operate a mobile outreach service, providing hepatitis C care and basic primary care, and distributing harm reduction supplies.

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Marie-Christine, SABSA Nurse, prepares a client for STBBI testing, just one of many primary care services available at SABSA. (photo: Conor Ashleigh, 2022)

The centre uses a unique, multidisciplinary model to ensure they can provide low-barrier care. Most care is led by a nurse practitioner or nurse. This allows clients to receive care from a consistent and familiar provider, building more trust and connection. The clinic is also staffed by physiotherapists, psychiatrists, psychosocial workers and more. The goal is to create a “one-stop” shop, where people can have all their needs addressed, including healthcare, mental health, housing, harm reduction and more.

The centre also employs a number of people with lived experience. Many of them were originally patients of the clinic, but were supported to build their skills as employees. These workers bring expertise and experience from the street, and are a key aspect of low-barrier care.

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Gabriel and Elizabeth at the Interzone reception desk. A mural from a local artist creates a community ambiance inside the site. (photo: Conor Ashleigh, 2022)

SABSA also operates L’Interzone, Quebec City’s only safe consumption service. The service opened in  2020 a few blocks over from the SABSA clinic. It is one of Canada’s only safe inhalation sites, where a specialized ventilation system allows clients to smoke their drugs on site. SABSA has also brought many of their other services on site, such as hepatitis C and HIV testing, wound care and basic primary care.

By offering a full range of services under one roof, SABSA is creating accessible, low-threshold care. Many people face barriers to navigating a complex healthcare system, including stigma and discrimination. SABSA is creating a space for those who would otherwise not have access to life-saving care.

See other CATIE harm reduction films and stories from Saskatoon, Victoria, and Halifax.