Insite has not increased rates of initiation into injection drug use

(Toronto) – There is no evidence to suggest Vancouver’s pilot supervised injection facility, known as Insite, has prompted elevated rates of initiation into injection drug use, according to new findings to be unveiled by the B.C. Centre for Excellence in HIV/AIDS at the XVI International AIDS Conference.

Centre researcher Dr. Thomas Kerr is presenting”The results from the three-year evaluation of Vancouver’s supervised injection facility” at the Toronto conference Tuesday, Aug. 15, 11: 15 a.m., as part of the session, Getting to the Point: New Challenges and Solutions for injection drug users. Kerr will be available for interview immediately after the presentation.

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

“We look forward to sharing all of the unpublished and published findings to date, given the international audience of the conference,” says Kerr.”We are especially hoping that members of the federal government will be there because the science that we plan to present will undoubtedly be of interest given the decision they are faced with.”

A number of additional unpublished studies will be reviewed by Kerr during his talk, including a study pending to be published in an American health journal which directly addresses one of the government’s key concerns, that Insite may promote drug use. The forthcoming study highlights there is no evidence to suggest Insite has prompted elevated rates of initiation into injection drug use. The study follows similar findings published in the British Medical Journal that Insite is not increasing rates of relapse among former drug users, nor is it a negative influence on those seeking to stop drug use

Regular use of the facility and any contact with the facility’s addictions counsellor by Insite users have previously been reported to be strongly tied to quicker initiation into detoxification. However, new Insite data also shows an increase of initiation into detoxification programs after the facility’s opening. The incidence of detoxification program initiation was 23.2 per 100 person years during the year after Insite’s opening, a statistically significant increase over the 16.9 /100 during the year prior.

The recent findings follow several similarly positive studies published in leading peer-reviewed medical journals over the past almost-three years.

Past Insite-related studies have revealed:

  • Insite plays a significant role in managing overdoses, 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)
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