Insite is a safe injection site located in Vancouver’s downtown eastside. It has been operating for over eight years and is funded by both the Provincial Ministry of Health and Health Canada. The purpose of Insite is to address the concentrated and acute health problems associated with street-based intravenous drug use in Vancouver’s East Hastings area. This is done through the provision of a safe use site, clean needles and needed health and social supports. Insite is used by hundreds of people each day and successfully delivers first aid, addiction treatment and mental health supports to clients.
Insite has been rigorously evaluated and the results are in. It has reduced overdose risk (less people are dying), lowered levels of HIV risk behaviours (less individual infection and less cost to the health system), increased uptake of addiction treatment among Insite users, lowered levels of public injecting (and associated behaviours that can cause public disorder), increased safety for women users, and it has not caused increased drug use or crime in the neighbourhood. By any objective assessment that is a very effective program. And when you consider that it is supported by a substantive majority of Vancouverites you really have a winner.
Despite these facts there is still opposition to Insite. The current Federal Government has attempted unsuccessfully to have the program closed. A recent Supreme Court decision found supervised injection sites to be exempt from Federal drug laws. In the ruling the court found that “Insite saves lives; its benefits have been proven, and there has been no discernible negative impact on the public safety and health objectives of Canada during its eight years of operations.”
Even with this ruling the critics persist claiming that safe injection sites encourage drug use. The reality is that Insite has not increased use – as demonstrated by the evaluation studies – but it has enabled safer use by people already addicted. This distinction appears lost on those who favour ideology over facts.
Recently this debate has migrated eastward to Ontario with the release of a feasibility study on safe injection sites authored by St. Michael’s Hospital and the University of Toronto. In response to the study’s recommendations that both Toronto and Ottawa set up a network of sites to provide this needed health service, the Provincial Health Minister has declined to commit the Government to any action at this time, and has stated that the experts are divided on the results of safe injection sites. I’m not sure which experts the Minister is referring to but my quick research turned up just one quasi academic critique from an on-line journal that reportedly received funding from the US Department of Justice.
In Toronto there are approximately 9,000 intravenous drug users, and while the problem may be less geographically concentrated than the Vancouver situation, surely they could benefit from a similar approach.
At Fred Victor, we see the negative impact of addictions on people’s lives every day and we also see that people who “use” are underserved by our health and social service systems. A network of health service organizations that provide space and supports for safer injection drug use, in addition to the many other health services that they provide is urgently needed in Toronto, not a single site like Vancouver, but a system that provides adequately and humanely for the needs of poor and marginalized people with serious addictions.
Think about it. Less harm to individual Torontonians and less harm to our communities. Let’s start talking and planning to make these services a reality in Toronto.