Supervised injection sites are sensible health care interventions

Supervised Injection sites are sensible health care interventions based on the notion that health care is actually about improving health, and also about caring.

Drug addicts should have access to ‘consumption rooms’ where they could inject prescribed heroin legally, Durham police and crime commissioner Ron Hogg was yesterday reported as saying.

Liz Evans, founder and executive director of the PHS Community Services Society in Vancouver, writes exclusively for Left Foot Forward on the success of so-called ‘shooting galleries’ in Canada

In Vancouver, ‘Insite’ is a supervised injection site that has just celebrated its ten-year anniversary. I wanted to share this experience as the debate around Supervised Injection has been raging in the UK.

We celebrated this ten year anniversary in Vancouver because this milestone did not come easily; and yet in the time that it’s been open over 2 Million injections have taken place under the watchful helpful eyes of the nursing and support staff. Over 14,000 registered addicts have come to the site with their own drugs since it opened, and with an average of 30 overdoses happening in the site each month, no one has died. Dead people don’t detox.

The reason I care about this issue is that for the last 23 years I’ve been part of this community – where I started out as a 25-year old, naïve and optimistic nurse – working in a 70 room residential hotel, trying to ‘help’. I had no idea what I would discover, but the people I have met profoundly affected me, and I have come to know drug users who while struggling to cope with their lives, have been inconceivably weighed down by baggage.

Much of this baggage was handed to them early in their lives – and stories of extended childhood trauma, foster care, poverty and and failed supports are rife. However ironically, some of this baggage we have handed to them in our efforts to ‘fight addiction’ but actually it is a fight with the addict. People, who really are just people…. end up being hated, dehumanized, socially outcast, followed by security guards, beaten up, cut off from friends and family, sent to jail, work in the survival sex trade, develop life-threatening illnesses, overdose, and die.

The consequences of addiction in our modern ‘civilized’ society should not be death. We need to get out from under the blame and fear and start to care about people with some wisdom and clarity. We need to stop thinking about the drug user as the ‘other’. People use drugs across every sector of society, and we need to understand the difference between the things that we do to drug users that help them, and the things that we do because we don’t like the fact that they use drugs.

Supervised Injection is a pragmatic response. While first and foremost it is a health intervention aimed at keeping drug users alive – it provides a place of refuge where people who use drugs can inject, access nursing care, access referrals into housing, drug treatment, methadone treatment and detox. The health benefits of Insite have been now so well documented and researched that it’s safe to say Insite is one of the most studied Health Care Interventions of its size in Canada.

There has been a 35 per cent decrease in drug overdose deaths in the four blocks around Insite in a Province where hundreds died each year, 400 people in1998 alone, of drug related deaths. The evaluation shows that people who use Insite are over 30 per cent more likely to access Detox and treatment than those who do not.

When people coming to Insite are ready to try to get clean, they can go upstairs to ‘Onsite’ where we have detox and transitional recovery housing.

Research published in the British Medical Journal confirms that Insite has not prompted adverse changes in community drug use patterns. Research published by Health Canada shows the neighbourhood residents and businesses view Insite as making a positive difference and reduces public disorder. Research published in the American Journal of Public Health shows that Insite does not promote drug use and the average Insite user has been injecting for 16 years.

Insite has contributed to a 90 per cent reduction in new HIV cases caused by intravenous drug use in British Columbia, impacting health care savings massively, given that each HIV infection costs on average approximately $500,000 in medical costs alone.

Supervised Injection sites are part of a solution. They are simply physical spaces in which drug users aren’t criminalized – but helped. On our 10 Year anniversary, there has been much to celebrate as people now live 10 years longer than they did 20 years ago in our community, and people who use Insite are connected into a system of services and supports that were simply not there before.

I think it is our fear of acknowledging drug use that has created the brutalizing conditions that create suffering for all of us. Supervised Injection sites are sensible health care interventions based on the notion that health care is actually about improving health, and also about caring.

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