Safe Injection Sites

IntroductionA safe injection site is a

legally sanctioned and supervised facility which is designed to reduce the health risk associated with taking illegal drugs intravenously (i.e. heroin).

They are also thought to reduce the public disturbance associated with these types of drugs and the drug litter.

Where are they located?There are very few in

existence.The majority are in

Europe.The European safe

injection sites are merely drug consumption rooms, which means it is a place to legally shoot up and safely dispose of needles.

There are no health care people associated with these places.

Any in the Commonwealth?There are no safe

injection sites in the United States.

There is one in Sydney, Australia.

There is one in Vancouver, Canada.

These sites are staffed by medical personnel.

They have safety equipment in case of overdose.

InsiteInsite is Canada’s first

and only safe injection site in North America!

It is in the downtown eastside (DTES) neighbourhood of Vancouver, which in 2000, had approximately 4700 drug addicts!

The B.C. provincial government says DTES is the “center of a drug injection epidemic in Vancouver.”

InsiteThe site provides a

clean, safe location for injection drug use, primarily heroin, cocaine, and morphine.

Medical staff are present to provide addiction treatment, mental health assistance, and first aid in the event of an overdose or wound.

Insite Stats From January 1 to December 31, 2010,

there were: 312,214 visits to the site by 12,236

unique individuals An average of 855 visits daily, up to a

maximum of 1,110 visits daily An average of 587 injections daily 221 overdose interventions with no

fatalities 3,383 clinical treatment interventions 26% of participants were women 17% of participants identified as

Aboriginal Principle substances reported were

heroin (36% of instances), cocaine (32%) and morphine (12%)

5,268 referrals to other social and health services, the vast majority of them were for detox and addiction treatment

458 admissions to OnSite detox

InsiteHealth Canada has

provided $500,000 per year to operate the site, and the BC Ministry of Health contributed $1,200,000 to renovate the site and cover operating costs.

InsiteInsite was initially run as a three year pilot project from

2003-2006, however the provincial government extended its use to 2008.

In 2008, Health Minister, Tony Clement, wanted it shut down, but the BC Supreme Court ruled that laws prohibiting possession and trafficking of drugs were unconstitutional because they denied drug users access to Insite's health services, so Insite is still open today under a constitutional exemption to the Controlled Drugs and Substances Act.

Recently the Supreme Court of Canada upheld this decision (September 29th 2011) after lawyers in BC started to make a stink about it.

Insite Supporters and DetractorsSupporters Detractors

The current mayor and former mayor of Vancouver

The Premier of B.C.The Vancouver Police

Department International AIDS society

and the BC Centre for Excellence in HIV/AIDS

Chinatown and Gastown merchants

Australian Parliamentary Group for Drug Law Reform

Senlis Council from the U.K.

Bush Administration (called it “state-run suicide”)

The Canadian Police Association

The RCMPThe federal conservative

government under Stephen Harper

Insite BenefitsInsite is leading to increased uptake into detoxification

programs and addiction treatment. (New England Journal of Medicine)

Insite has not led to an increase in drug-related crime, rates of arrest for drug trafficking, assaults and robbery were similar after the facility’s opening, and rates of vehicle break-ins/theft declined significantly. (Substance Abuse Treatment, Prevention, and Policy)

Insite has reduced the number of people injecting in public and the amount of injection-related litter in the downtown eastside. (Canadian Medical Association Journal)

Insite is attracting the highest-risk users – those more likely to be vulnerable to HIV infection and overdose, and who were contributing to problems of public drug use and unsafe syringe disposal. (American Journal of Preventive Medicine)

Insite BenefitsInsite has reduced overall rates of needle sharing in

the community, and among those who used the supervised injection site for some, most or all of their injections, 70% were less likely to report syringe sharing. (The Lancet)

Nearly one-third of Insite users received information relating to safer injecting practices. Those who received help injecting from fellow injection drug users on the streets were more than twice as likely to have received safer injecting education at Insite. (The International Journal of Drug Policy)

Insite is not increasing rates of relapse among former drug users, nor is it a negative influence on those seeking to stop drug use. (British Medical Journal)

Insite is preventing overdose deaths and reducing hospital visits (The International Journal of Drug Policy)

Insite NegativesMoney goes away from where it can

otherwise be used and is put into housing drug addicts.

It supports the habits of drug users and makes it easier for them to administer the drugs without fear of reprisal from the police.

May cause drug users to immigrate to that city/neighbourhood which people think will affect safety as well as lower property values.

Future Injection Sites in Canada?Currently, Montreal,

Ottawa and Toronto are investigating whether a safe injection site in some of their neighbourhoods with heavy drug use and crime would benefit the city.

The Ontario government wants to put three in Toronto and two in Ottawa.

Future Injection Sites in Canada?Montrealers put up such an outrage at an SIS in

the downtown core that the provincial government decided that if one is needed it would go in an already existing health facility.

Homework1) What is a safe injection site?2) What is the difference between the safe

injection sites in Europe compared to those in Australia and Canada?

3) Do you believe that safe injection sites are a good idea? Why or why not?