Transcript Public Health in Action

Safe Injection Sites
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 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.
Insite
 Insite 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.”
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
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
Supporters
 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.
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.
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.
Homework
1) 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?