(Vancouver) – Use of Insite, Vancouver’s supervised injection site, not only leads to increased uptake into detoxification, but initiation into addiction treatment and reduced drug use, says a new study published in the June issue of the medical journal Addiction.
The study, authored by scientists at the B.C. Centre for Excellence in HIV/AIDS, reveals that Insite’s opening led to a 30% increase in detoxification use by facility users. Importantly, new findings suggest Insite users who began detox were more likely to both enrol in longer-term addiction treatment and reduce injecting.
The findings specifically address concerns voiced by the federal government in its decision to reject a long-term extension for Insite to legally operate, says Dr. Julio Montaner, Director of the B.C. Centre for Excellence in HIV/AIDS.
“In the federal health minister’s decision not to grant a full extension for Insite’s continuation, it was stated that it remains unknown if the facility contributes to lowering drug use and fighting addiction,” says Montaner.”These findings clearly show Insite has had a positive impact in these regards. However, the government has seemed intent on ignoring scientific evidence to pursue an ideological agenda at the expense of lives in the Downtown Eastside.
“It is time for the federal government to accept the evidence and move the debate to a higher level.”
The Centre study determined Insite’s opening to be directly linked to elevated uptake into detox services. The monthly average of injection drug users entering a withdrawal program rose from 21.6 to 31.3 in the evaluation period. Followup evaluations revealed enrolment into detox by Insite users directly led to methadone use and other addiction treatments. As well, use of Insite decreased significantly upon an injection drug user’s discharge from detox, says the Centre’s Dr. Evan Wood, one of the study’s co-authors.
“There have been many benefits of Insite in terms of public order and reduced HIV risk,” says Wood. “However, the fact that it appears to be pulling people out of the cycle of addiction by leading them into programs that reduce drug use is remarkable.”
Previously published Insite research in the New England Journal of Medicine showed that more regular use of the facility and any contact with the facility’s addictions counsellor were both strongly tied to quicker initiation into detoxification. The Addiction study followed up this work to determine if entry into detox led to enrolment into other forms of addiction treatment and reduced use of Insite.
Detox is considered the entry point into longer-term addiction treatment. Detox offers medically supervised withdrawal and referrals to health services. Longer-term addiction treatment services include methadone maintenance, individual and group counselling, in-patient and out-patient treatment centre care, and referrals to other supports.
Peer-reviewed findings from the three-year evaluation of Insite 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 federal health minister rejected an application to extend an exemption for Insite to legally operate for an additional 3.5 years.
Instead, on Sept. 1 2006, 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.