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Vancouver supervised injection site cuts drug user deaths

Kathleen Blanchard's picture
Vancouver injection site

An analysis of the first supervised injection site in North America shows providing drug users with a clean, safe facility can save lives. The study, published in the Lancet, compared death rates around the Insite facility to overdose deaths in the rest of Vancouver. The authors say the outcomes show supervised injection sites “could literally be the difference between life and death for many people.”

The analysis found a 35 percent reduction in overdose deaths from injecting illegal drugs near Insite that currently operates at full capacity. During the same period, overdose deaths were down just 9 percent in other areas of Vancouver.

No mortalities after supervised injection site open

The site was established in response to the high number of drug mortalities and escalating HIV rates in the area. The study data was collected between January 1, 2001 and December 31, 2005. The findings also showed there were no mortalities after Insite opened.

Co-author of the study, Dr. Julio Montaner, says the findings show facilities where drug users go to inject themselves while supervised by a nurse are “saving lives and playing a vital role in reducing the harms associated with illicit drug use.”

Insite is located in downtown Eastside Vancouver. Drug users obtain their injectables under the supervision of nurses in a safe and clean facility that is modeled after Europe’s approach to drug abuse. Afterwards they go to a room where they wait before going back to the streets.

The area has approximately 5000 injection drug users. Clients also have access to referral programs, counselors and health services that are incorporated into the facility’s program.

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According to the Vancouver Coastal Health site, “About half of the people who use Insite are marginalized, which means they are homeless or living in shelters or have significant mental health issues.”

Drug users can detox when they’re ready in one of the 12 beds at Onsite, a program offered in conjunction with the supervised injection center. From there, clients are provided transitional housing, addiction services and community support before discharge.

The BC Supreme Court ruled the facility is under provincial jurisdiction at the beginning of last year. Previously, the Supreme Court ruled the drug injection center provided a needed health service, but the federal government has appealed to close the facility.

"Supervised injection facilities clearly have an important part to play in communities affected by injection drug use, writes Dr. Chris Beyrer, of the Johns Hopkins Bloomberg School of Public Health in Baltimore in an accompanying editorial to the Lancet study

A previous analysis from the Addiction and Urban Health Research Initiative showed the supervised injection site lowers health care costs by reducing risky behavior and rates of HIV, boosting access to addiction treatment programs and improving access to health care services. Whether Insite stays open remains to be seen, pending a May 12, 2011 hearing.

The Lancet: doi.1016/50140-6736 (10) 62353-7
"Reduction in overdose mortality after the opening of North America's first medically supervised
safer injecting facility: a retrospective population-based study"
Brandon DL Marshall PhD, M-J Milloy MSc, Evan Wood PhD, Prof Julio SG Montaner MD, Thomas Kerr PhD

Image credit: Wikimedia commons