Abstract

The debate around supervised injection facilities (SIF) rages on more than a decade after the opening of Insite, Canada’s first supervised injection site in Vancouver. Recently, an article published in the journal Addiction reignited the discussion when it made a financial case for introducing facilities in Ottawa and Toronto. The model predicts that the introduction of two SIFs in Ottawa and three in Toronto would be a cost-savings measure to prevent the spread of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) among intravenous drug users (IVDUs). Over 600 total cases of HIV or HCV are projected to be averted in a 20-year period, saving over $40 million in healthcare costs in Toronto and over $30 million in Ottawa. Opponents deny the benefits of safe injection sites despite research conducted on Insite, which suggest that these facilities have tremendous utility and are economically viable. Insite targets and attracts high-risk IVDUs, fosters safer injection habits and prevents transmission of needle-sharing diseases. Insite’s facilities also offer complementary detoxification and rehabilitation services and encourage users to register for these programs. In contrast to arguments made by opponents, Insite has not been found to increase incidental overdoses, neighbourhood crime rates, or public disposal of needles. Given the outcomes of research conducted on Insite, the viability of similar facilities in Ontario should be further explored.

Highlights

  • The debate around supervised injection facilities (SIF) rages on more than a decade after the opening of Insite, Canada’s first supervised injection site in Vancouver

  • The first supervised injection facility (SIF) in Canada, has been operating in the Downtown Eastside neighbourhood of Vancouver since 2003 with well-documented evidence supporting its benefit in infection control among intravenous drug users (IVDUs).[1]

  • Reports citing the potential benefits of introducing similar sites in Ottawa and Toronto[6] have been met with resistance.[3,4,5] financial case

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Summary

Introduction

The debate around supervised injection facilities (SIF) rages on more than a decade after the opening of Insite, Canada’s first supervised injection site in Vancouver.

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