Insite’s findings cast concern if facility closes: study

published on November 21, 2006

(Vancouver) – Peer-reviewed findings from the three-year evaluation of Vancouver’s pilot supervised injection site, known as Insite, suggest a “high potential for negative impacts” if the facility should close, says a study published in the Canadian Medical Association Journal.

The paper highlights that evaluations of the facility by the B.C. Centre for Excellence in HIV/AIDS have documented a large number of health and community benefits, and there have been no indications of community or health-related harms. However, despite the recommendations of Health Canada, the CMAJ study notes the health minister rejected an application to extend an exemption for Insite to legally operate for an additional 3.5 years.

Instead, the health minister approved a much shorter 16-month extension (to Dec. 31, 2007) and froze research into safer injecting facilities in other Canadian settings. In light of the accumulated evidence to date, the minister’s judgment is a concern, says Dr. Julio Montaner, Director of the Centre and one of the study’s authors.

“The minister’s decision followed declarations of several national law enforcement bodies who, without providing any data, suggested that the facility has been unsuccessful,” says Montaner. “Although the health minister’s justification was that ‘initial research has raised new questions,’ federal research funding of the evaluation was halted.”

Peer-reviewed findings published in various medical literature show the supervised injection site has been successful in attracting injection drug users (IDUs) in the community who have a number of characteristics associated with an increased risk of HIV infection and overdose, as well as IDUs who were more likely to inject drugs in public.

There have also been large reductions in public drug use, publicly discarded syringes and syringe sharing among Insite users after the facility opened. Use of the facility has also been associated with increased uptake of detoxification services. The facility has also been a central referral mechanism to a range of other community and medical resources and a key venue for education about safer injecting.

Additional research has indicated that the facility has not resulted in increases in drug dealing in the facility’s vicinity, in drug acquisition crime or in rates of new IDUs or relapse into injection drug use among former IDUs.

Given the success of the program to date, it is unclear why the government would halt the creation of injecting facilities in other settings, says Montaner

“Based on the summary of findings, this program appears to be saving lives and health-care dollars. Banning facilities in other settings implies the government is ignoring the scientific evidence to pursue an ideological agenda,” says Montaner.

The summary states: ”Although the effect of closing the facility is unknown, the findings suggest a high potential for negative impacts on health and the community.”

The benefits demonstrated in the evaluations of the Vancouver facility are largely consistent with reports from several European settings and Australia, says Dr. Thomas Kerr, a Centre investigator and study co-author.

“The universally positive findings should be useful to international agencies concerned about the impacts supervised injecting facilities and to those in a large number of national and international settings currently debating the merits of such facilities as a strategy to address the injection drug use problem,” says Kerr. “The evidence is too strong for the federal government to ignore any longer.”

BC Centre for Excellence in HIV/AIDS

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Insite’s findings cast concern if facility closes: study

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