 On
September 21 of last year, Vancouver became home to Canada's
first government-approved safe injection site. Called
Insite, it aims to address Vancouver's notorious intravenous
drug problem not through trial and punishment, but through
harm reduction. While the project isn't even a full year
into its three-year testing period, local response has
been in the main positive.
The safe injection site is a radical shift away from old
school approaches to tackling drug abuse. It operates
with
the support of the city of Vancouver, the local police,
and Vancouver Coastal Health. For legal reasons, the site
was granted an exemption under Section 56 of the Controlled
Drugs and Substances Act, allowing users to possess illicit
substances on the premises.
"I don't believe the war on drugs is the approach
of the Canadian government," says Dr David Marsh,
Vancouver Coastal Health's Physician Leader for Addiction
Medicine and an attending physician at Insite. "The
approach of this site is to create a safe place where
people who are already going to inject drugs can do so
in a safe and supervised environment."
COMFORT
ZONE
The site is situated in Vancouver's Lower East side,
and was opened following efforts from the Vancouver
Area Network of Drug Users and then mayor Phillip Owen.
One of the principal goals was to reduce the skyrocketing
rates of blood-borne infections among drug users.
"What we have in the downtown East side is a pocket
of injection drug users -- about 4,700 users,"
says Viviana Zanocco, a spokesperson for Vancouver Coastal
Health. "We estimate that over 90% are hepatitis
C positive and over one third have HIV."
The program also hopes to trim Vancouver's overdose
rates. Over a five-year period, 524 fatal overdoses
were reported in the city. Advocates of the site say
that these cases are avoided by providing a supervised
and stable environment for drug users, and while there
have been some cases of overdose on the site, none have
been fatal.
Users are given a disposable injection kit, with clean
needles, cookers, tourniquets and clean water. In the
12-seat injection room, they prepare and inject their
drug under the supervision of medical staff. After injecting
they go to a post-injection chill out room before returning
to their normal lives, and can receive treatment for
wounds or abscesses from the in-house medical staff.
They are also given access to an on-site addiction counsellor,
who processes an average of four referrals per day.
Despite initial criticisms that mandatory user registration
and police presence would be a deterrent, the site has
received positive feedback from the users themselves.
"It's actually turned out to be better than I thought
it would be," says Greg, a heroin and cocaine user
who asked to be identified only by his first name. "The
majority of people there are very friendly, and I actually
enjoy interacting with them. It's clean and convenient
for me. I recommend it."
"HORSE FEATHERS,"
SAY SOME
And while police have reported that both open drug use
and drug-related public disorder have diminished since
it opened, Insite is not without its detractors. Randy
White, an MP for Abbotsford who served as vice-chairman
of the Parliamentary Special Committee on the Non-Medicinal
Use of Drugs, says merely keeping drug use out of sight
isn't the solution.
"Rather than sustain them on drugs, we need to
focus on getting people off of drugs," he says.
He suggests that convicted addicts be given the choice
of serving part of their sentence in a rehabilitation
facility. Mr White adds that there's significant opposition
to safe injection sites from the medical community,
but doctors have been unwilling to step forward. "Say
it publicly, folks -- it's time," he says. "This
is a crisis that's hit this country."
In fact some of the loudest dissent is coming from outside
the country. In March a United Nations board criticized
Insite, saying it violates international drug treaties.
A report issued by the International Narcotics Control
Board, an independent UN organization that monitors
international drug use, said the site basically allows
people to "inject drugs acquired on illicit markets
with impunity." Insite supporters respond that
the UN board is biased and is largely funded by a bunch
of quixotic war-on-drugs hawks, namely -- you guessed
it -- the US government.
Those behind the project insist safe injection sites
are beneficial for users and the community. "People
are going to use drugs or smoke cigarettes or whatever
until they're ready to say that they don't want to do
that anymore," says Ms Zanocco. "What I would
point out is each case of HIV costs the health system
between $150,000 and $225,000. If we can prevent 10
people from contracting HIV every year, then the site
pays for itself. That kind of solved it for me. I thought,
'Wow, we're going to save money as a hospital system'."
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