Insite making positive changes in injecting behaviour, study confirms

published on August 25, 2006

(Vancouver) – Three-quarters of Insite users report the facility has positively changed their injecting behaviour, says an extensive survey undertaken by the B.C. Centre for Excellence in HIV/AIDS at St. Paul’s Hospital.

The evaluation is the first study published-to-date that explores injection drug users' experiences and opinions regarding a supervised injection facility.

Of 1,082 injection drug users surveyed in the study published by Addictive Behaviors, 809 (75%) reported their injecting behaviour had changed as a result of using Vancouver’s pilot supervised injection site, known as Insite. Among these individuals, 80% indicated that Insite had resulted in less rushed injecting, 71% indicated the facility had led to less outdoor injecting, and 56% reported less unsafe syringe disposal.

The results reaffirm statistical data published in the past three years, says Dr. Evan Wood, Centre researcher and co-investigator of Insite.

“The evidence of Insite’s positive impact is now fairly overwhelming,” says Wood. “In some ways the findings are not surprising given what previous epidemiological studies have shown and that drug users would naturally prefer to inject in a safe environment rather than parks, alleyways and other public places.”

The recent study underlines Insite is meeting its goals of decreasing public injecting and reducing HIV-risk behaviour, says Dr. David Marsh, Physician Leader, Addiction Medicine, Vancouver Coastal Health.

The Centre study is also the first to examine barriers to using Insite and areas where the facility could be improved. The three most common reported features limiting use of Insite were: travel to the facility (12%), limited operating hours (7%), and waiting times (5%).

When asked in what ways Insite may be improved, some common responses included: longer hours of operation and reduced waiting times (53% and 46% respectively); addition of a bathroom and shower facilities (51%; 25%) and more on-site addictions treatment (24%).

“We welcome clients' suggestions regarding improvements, including the addition of more treatment at the location, which is currently being developed," says Marsh.

The Centre was contracted to conduct an arms-length evaluation of Insite’s impact on public order and public health over the facility’s current three-year federal exemption to operate. The exemption expires Sept. 12.

The study was published online Aug. 22 for Addictive Behaviors’ website subscribers and will be featured in the printed version of the journal this fall.

Backgrounder

Past Insite-related studies have revealed:

Insite plays a significant role in managing overdoses on-site, including saving lives and reducing hospital visits and ambulatory services (International Journal of Drug Policy)
Insite is leading to increased uptake into detoxification programs and addiction treatment. Regular use of the facility and any contact with the facility’s addictions counsellor, were both strongly tied to quicker initiation into detoxification. (New England Journal of Medicine)
Insite has not led to an increase in drug-related crime. (Substance Abuse Treatment, Prevention, and Policy)
Insite has reduced the number of people injecting in public and the amount of injection-related litter in the Downtown Eastside, both notable improvements for people who live and work in the neighbourhood. (Canadian Medical Association Journal)
Insite is attracting the highest-risk users – those more likely to be vulnerable to HIV infection and overdose, and who were contributing to problems of public drug use and unsafe syringe disposal. (American Journal of Preventive Medicine)
Insite has reduced overall rates of needle sharing in the community, and among those who used the supervised injection site for some, most or all of their injections, 70% were less likely to report syringe sharing. (The Lancet).
Nearly one-third of Insite users received information relating to safer injecting practices. Those who received help injecting from fellow injection drug users on the streets were more than twice as likely to have received safer injecting education at Insite (International Journal of Drug Policy).
Insite is not increasing rates of relapse among former drug users, nor is it a negative influence on those seeking to stop drug use. (British Medical Journal)

BC Centre for Excellence in HIV/AIDS

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Insite making positive changes in injecting behaviour, study confirms

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