Abstract
InSite is North Americas first supervised injection site and a landmark public heath initiative operating in Vancouver since 2003. The program is a vital component of that cities internationally recognized harm reduction approach to its serious problems with drugs, crime, homelessness and AIDS. InSite currently operates under a waiver of Federal rules that allow it to provide services as a research project. An extensive evaluation has produced very positive results for thousands of users. Normally such strong evidence documenting the successes of such a program, and the medical and public health significance of these positive outcomes, would be the basis for celebration and moves to expand the model and provide similar services elsewhere in Canada.Instead, there is a distinct possibility that InSite will be closed by the newly elected Canadian Prime Minister Paul Harper – a conservative who has traveled to the US to visit George WQ Bush and come back antagonistic to harm reduction in all its forms. Because InSites federal waiver is expiring and up for renewal in September, the fear is that Mr. Harpers will not renew the approval and that the program will be forced to close down. The risks associated with the potential closure of InSite need to be fully understood. This editorial lays out these public health risks and the associated economic impact if InSite were to be closed.In addition to preventable deaths and disease, InSites closure will cost Vancouver and British Columbia between $3.8 and $ 8.8 million in preventable health care expenses over the next two years.
Highlights
Insite is North America's first supervised injection site – a landmark public heath initiative that has been operating since 2003 in Vancouver's Downtown Eastside
The program is a vital component of that cities internationally recognized harm reduction strategy addressing it's serious problems with drugs, crime, homelessness and AIDS
Insite serves more than 7,200 registered clients with 15,000 to 20,000 visits each month – all active intravenous users at the highest risk for HIV transmission and overdose
Summary
Insite is North America's first supervised injection site – a landmark public heath initiative that has been operating since 2003 in Vancouver's Downtown Eastside. InSite has been the subject of rigorous, independent research and evaluation since it opened its doors and the data collected so far are compelling in their implications. These studies convincingly demonstrate Insite's positive impact as a life saving public health program that does not increase drug use nor produce any adverse outcomes. Harm Reduction Journal 2006, 3:24 http://www.harmreductionjournal.com/content/3/1/24 tional file 2) these studies uniformly and persuasively find that the Insite program is producing important public heath and social outcomes and exceeding all of its targets. 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. In addition InSite has not increased crime, public disorder, or drug dealing in its neighborhood, not led to increased relapse among former drug users, nor been a negative influence on those seeking to stop drug use altogether
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