Insite is the first legal supervised safe injection site in North America, located at 139 East Hastings Street, in the troubled Downtown Eastside neighbourhood of Vancouver, British Columbia. The site provides a clean, safe location for injection drug use, primarily heroin, cocaine, and morphine. Medical staff are present to provide addiction treatment, mental health assistance, and first aid in the event of an overdose or wound.
Over a two year period ending March 31, 2006, the site recorded an average of 607 visits per day and 453 overdoses total, with none resulting in a fatality. Health Canada has provided $500,000 per year to operate the site, and the BC Ministry of Health contributed $1,200,000 to renovate the site and cover operating costs.
Since opening, the site has been the focus of numerous scientific studies, in peer-reviewed journals such as the New England Journal of Medicine, The Lancet, the British Medical Journal, and the Canadian Medical Association Journal. Findings have shown that the site has led to a reduction of public injections, neighbourhood litter, and needle sharing. It has also led to an increase in detoxification and addiction treatment, and has not been shown to increase crime or rates of relapse in former drug users.
Partners include the City of Vancouver, the Vancouver Police Department, and the PHS Community Services Society. The site also has the support of the current Vancouver mayor, Sam Sullivan, and former high-profile Vancouver mayors Larry Campbell, Mike Harcourt, and Philip Owen. The International AIDS Society and the B.C. Centre for Excellence in HIV-AIDS, and the Canadian Union of Public and General Employees also support Insite. Though originally opposed to the safe injection site, Chinatown and Gastown merchants associations now support it. International supporters include the UK-based think tank Senlis Council and the Australian Parliamentary Group for Drug Law Reform.
The site has drawn criticism from the Bush administration; the director of the White House Office of National Drug Control Policy called it "state-sponsored suicide" at the time of its opening. The Royal Canadian Mounted Police do not support Insite, despite the fact that a report commissioned by the RCMP (conducted by two criminologists) concluded in favour of the safe injection site.
Operation and possible closure
Insite has been operated since 2003 by Vancouver Coastal Health, under a special exemption from the Controlled Drugs and Substances Act, granted by the Liberal government via Health Canada. The site was slated to close on September 12, 2006, as the exemption was for a three year pilot project. Insite's future is currently being decided by the new Conservative government; a temporary extension has been granted until a final decision is made.
Conservative Prime Minister Stephen Harper has voiced opposition to the site in the past, saying that "We as a government will not use taxpayers' money to fund drug use." In mid-July, Conservative government MP David Fletcher stated that the current government would let the exemption lapse before deciding whether to continue the project. The following week a spokesman for Tony Clement, the Minister of Health, refuted that statement, saying that a decision had not been made yet. During the XVI International AIDS Conference, held in Toronto, two high-ranking Liberal MPs (Bill Graham and Keith Martin) put their support behind the centre, and criticized the Conservative government for delaying their decision. Insite supporters also demonstrated in Toronto during the conference, prompting the government to further delay any announcement, citing the week's 'politicized' nature.
On September 1, 2006, Health Minister Tony Clement deferred the decision of whether to extend the exemption for the site, citing a need for more research. However, on the same day the government cut all funding for future research, amounting to $1.5 million in lost research money. Insite will stay open until as late as December 31, 2007, while its fate is decided.
MY TAKE ON IT:
This is the DTES, a postal code that is simultaneously the poorest in Canada and recipient of the highest per-capita social service spending in the country. It is in this area that Insite, the city operated supervised injection site for intravenous drug users, operates with a certificate exempting it from the Canada Health Act. This is harm reduction in action and everyone, including the Vancouver Police Department, local business improvement associations, academics, and the mayor all agree it is worth pursuing because nothing else works.
Harm reduction is the “fourth pillar” of Vancouver's drug policy with the other three being prevention, enforcement, and treatment. Harm reduction acknowledges that addicts are going to shoot up and if it is done in a supervised site then it won't be done on the street, where infections from impure water and dirty, shared needles abound, and the dangerous blight of abandoned drug paraphernalia and broken needles endangers everyone. Nurses are on site and overdoses are responded to immediately.
To date there has never been a single fatal overdose at the supervised injection site, unlike on the street. Each patron is given a sterile needle, saline water, and whatever else they need to shoot up their own junk without making themselves worse. “Canada's New Government”, the Stephen Harper Conservatives, are against the safe injection site because of moral ideology and are undertaking a review of the program with the stated intention to see if it should not be shut down. The peer-reviewed scholarly studies of the project, and there are plenty since it is the only one of its type in North America and the DTES is crawling with epidemiologist researchers, are uniform in their findings that a safe injection site slows the spread of HIV and is an effective tool to support the other three pillars of drug policy. Moreover, it gets it off the streets and reduces the harm open-air drug use causes to a city.