Since it opened its safe and non-judgmental arms to intravenous drug users in 2003, an air of controversy continues to cloud Vancouver’s Insite facility and programs like it.
Boasting a status of being the first (and only) in North America, Insite describes itself as a health-focused place where individuals can safely inject drugs under the supervision of health care professionals in an effort to avoid death by overdose and the spread of infections, like HIV.
Insite operates under a harm-reduction model with a real-world view on abstinence. Insite is not unlike drug consumption rooms that operate around the world. Although the concept of safe injection and facilities like Insite have been a topic of heated debate in Canada recently, supervised injection sites have been around since the 1970s.
Europe is the front-runner when it comes to utilizing safe injection sites, with four countries currently allowing for such facilities. Outside of those European countries and Canada, Australia is the only other country that provides medically supervised injection sites.
The Netherlands
22 official drug consumption facilities are scattered throughout The Netherlands. Initial sites were established in the 1970s, when drug-use was no longer looked at as deviant, but became accepted as a personal lifestyle. Relaxed laws on drug possession allowed for facilities to open up earlier than most other countries. Facilities often incorporate both smoking and injecting rooms. They also offer services that include: drug-free treatment, medical care, counseling, food, laundry, and showers.
Switzerland
Switzerland’s first supervised injection centre was opened in 1986 when health workers noticed the congregation of injection drug users in public spaces. With 12 Swiss centres now in use, the facilities usually provide a sterile environment and access to medical care and counseling for individuals as well as needles, syringes, spoons, etc. Usually open for seven hours a day, five or six days a week, clients must be at least 16 years old and have a history of injecting before they are allowed to use the centre.
Germany
In 1994 Germany opened its first injecting centre, and currently operates 25 consumption facilities. Employees are mostly social workers, nurses, and medical officers. Clients must be at least 18 years old and adhere to the rules, which include: no violence, no drug-dealing, no sharing of drugs, no injecting of others, no staff assisted injecting, and a 30-minute time limit.
Spain
The most recent European country to incorporate supervised injecting rooms, Spain opened the doors to its first facility in 2000. Spain is home to the only injection facility that is open 24 hours a day.
Although research is limited, evidence suggests the benefits of safe injection sites lie in four important areas: reduced public nuisance, improved access and uptake of health and other welfare services, reduced opioid related overdose risk, and reduced risk of blood-borne virus transmission.
Vancouver’s Insite Program statistics reveal that, on average, the facility sees 491 safe injections daily. The program has had zero overdose fatalities, 2,492 clinical treatment interventions, and 411 admissions to Onsite detoxification. 6,242 referrals were given through Insite to other health and social service facilities, most of which were for detox and addiction treatment.
Resources:
1. Dolan K, Kimber J, Fry C, Fitzgerald J, McDonald D, Trautman F. Harm Reduction Digest 10: Drug consumption facilities in Europe and the establishment of supervised injecting centres in Australia. Drug and Alcohol Review (2000) 19, 337-346
2. Hedrich D. European report on drug consumption rooms. European Monitoring Centre for Drugs and Drug Addiction (Feb. 2004) p. 15-23.
3. Vancouver Insite Program, www.supervisedinjection.vch.ca/
This article was submitted by Jess Howat. Jess was a practicum student at AIDS Calgary in March. She is currently working towards a Communication Studies degree between SAIT and the University of Calgary. This blog was originally posted in June 2010 on AIDS Calgary's The A Word http://aidscalgary.blogspot.com/
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