Transcript Public Health in Action

Safe Injection Sites
What do you think some pros and cons of Safe
injection sites are?
PROS
CONS
Introduction
 A 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 simply
drug consumption rooms,
which means it is a place to
legally inject drugs and
safely dispose of needles.
 There are no health care
workers associated with
these places.
Other Locations?
 There are no safe injection
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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.
Insite
 Insite is Canada’s first and
only safe injection site (the
only one in North
America!)
 It is in the downtown
eastside neighbourhood of
Vancouver, which in 2000,
had approximately 4700
drug addicts!
 The B.C. provincial
government says this area
is the “center of a drug
injection epidemic in
Vancouver.”
Insite
 The 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 – All in one year!
 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
Insite
 Health 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.
Insite
 Insite 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 Detractors FYI
Supporters
 The current mayor and former
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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.
Detractors
 Bush Administration (called
it “state-run suicide”)
 The Canadian Police
Association
 The RCMP
 The federal conservative
government under Stephen
Harper
Insite Benefits
 Insite 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 Benefits
 Insite 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 Negatives
 Money 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.
 https://www.youtube.com/watch?v=Hd1SIupqHNM
 http://www.cbc.ca/news/canada/montreal/story/2011/
12/16/montreal-safe-injection.html
 http://supervisedinjection.vch.ca/home/
Would you want a safe
injection site in your city?
 Why?
 Why Not?
 What do you think the most common answer is?
 Vote:
http://www.cbc.ca/news/yourcommunity/2012/04/woul
d-you-want-a-supervised-drug-injection-site-in-yourcity.html