Pubdate: Wed, 16 Mar 2016
Source: Globe and Mail (Canada)
Copyright: 2016 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Andrea Woo
Page: S1

DATA FROM VANCOUVER'S INJECTION SITES GIVE OTHER CITIES INSIGHT

As more North American cities push for supervised injection sites to
address soaring fatal overdose rates, they can find a dozen years of
lessons in Vancouver, which has the only such facilities on the continent.

Health officials in several Canadian cities - including Montreal,
Victoria and, most recently, Toronto - are somewhere along the path to
opening their own supervised injection sites, emboldened by a Supreme
Court of Canada ruling and the election last year of Prime Minister
Justin Trudeau's Liberals.

As local, provincial and federal governments weigh new proposals in
those cities and elsewhere, Vancouver's health agencies, experts, drug
advocates and police say they should look to the West Coast city's
experience as a model for what works.

Vancouver is currently home to the only two legally sanctioned
supervised injection sites in North America.

The most well known is Insite, a detached facility located in the
heart of the city's impoverished Downtown Eastside, which opened in
2003. Lesser known is the Dr. Peter Centre, a renowned HIV/ AIDS
centre in the city's West End, which has offered clients a small-
scale version of the service as part of an integrated model since
2002. The Dr. Peter Centre's site was officially approved by the
federal government earlier this year.

Proponents note that supervised-injections er vice saves lives, while
also serving as a gateway to further health care, and they point to
several academic studies that have found the facility reduces overdose
deaths and the transmission of blood-borne illnesses while reducing
open- air drug use.

Since opening, nurses at Insite have supervised roughly two million
injections; nurses at the Dr. Peter Centre, more than 15,000. There
has not been a single fatal overdose at either facility. As well, a
2011 study by the B.C. Centre for Excellence in HIV/ AIDS, published
in The Lancet, found that the fatal overdose rate within 500 metres of
Insite decreased by 35 per cent after the facility opened, compared
with 9 per cent for the rest of Vancouver.

A 2014 study by the centre found that the harm-reduction policy at
the Dr. Peter Centre "fostered an atmosphere in which drug use could
be discussed without risk of punitive action, and thus increased
openness between residents and staff."

This led to decreased drug-related risks and improved health outcomes,
including adherence to HIV treatment.

Andrew Day, operations director for Vancouver Coastal Health, urged
skeptics to temporarily suspend any visceral reaction they may have at
the idea of injection-drug use and look at the evidence.

"Drug use is an uncomfortable subject," he said.

"The idea of people injecting in sort of an official capacity, and
being supervised, is an uncomfortable subject - and maybe so it should
be - but we have to go with what seems to work, scientifically, not
what our gut instincts tell us we should do."

Maxine Davis, executive director of the Dr. Peter AIDS Foundation,
advised prospective operators to engage with the neighbourhood to
quell fears over what a supervised injection site actually looks like.

"If I had any recommendations, it would certainly be for health
clinics to invest in building relationships with key community leaders
and inviting the neighbours in," she said.

When it applied to Health Canada for its recent approval, the Dr.
Peter Centre received letters of support from the local residents'
association, business improvement association and church.

Vancouver police are also supportive of Insite, saying it has both
saved lives and reduced open- air drug use in the area.

Hugh Lampkin, a former drug user who is now president of the Vancouver
Area Network of Drug Users, spoke of the importance of having
counselling and addiction services connected to the site.

"Over a period of time, when people's lives change, they will [ use
those services]," he said. "It does happen. It happens in every [
addict's] life, where they hit that part and they want to stop, they
need some help. You need to have these services there, so when they
reach that point, you can help them."
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