Pubdate: Mon, 26 Sep 2016
Source: Hamilton Spectator (CN ON)
Copyright: 2016 The Hamilton Spectator
Contact:  http://www.thespec.com/
Details: http://www.mapinc.org/media/181
Author: Susan Clairmont
Page: A1

IT'S TIME TO DEBATE A SAFE INJECTION SITE

Each day 700 people line up to get into the Insite supervised safer
injection facility in Vancouver.

They come to inject pre-obtained heroin and cocaine in a clean
environment, with clean needles, under the watchful eye of nurses,
addiction doctors, counsellors and peer volunteers.

Between 60 and 100 clients overdose at Insite each month. Yet not one
of the three million intravenous drug users (IDU) who have been to
Insite has died since the harm-reduction clinic opened in 2003. Does
Insite save lives? Yes. Would a similar site in Hamilton save lives?
Likely. This answers just one of many questions our community has as
our public health officials, city councillors, addiction community
members and neighbourhood associations wrestle with the proposal of a
supervised injection site for Hamilton. But it is the biggest question.

Also high on the list is what impact does a safer injection site have
on its surroundings?

Study after study shows Insite causes no discernible harm to its
community. In fact, it does some good.

Insite, a publicly funded clinic in the impoverished Downtown Eastside
of Vancouver, was North America's first safer injection site and is
the gold standard in Canada which has two other similar programs, also
in Vancouver.

Insite has been studied more than 30 times by external researchers
whose peer-reviewed work is published in journals such as the New
England Journal of Medicine, The Lancet and the British Medical Journal.

"Harm reduction is a legitimate form of addiction treatment," says
Anna Marie D'Angelo, senior media relations officer for Vancouver
Coastal Health, which operates Insite. "We're not viewing it as a war
on drugs; we're viewing it as a health issue."

The life and death reality of intravenous drug use has become more
dire now that fentanyl is in 90 per cent of drugs tested at Insite,
says D'Angelo. In British Columbia, a public health emergency has been
called due to the rise of fentanyl.

The fentanyl scourge is happening in Hamilton, too. The opioid and its
counterfeits, which can be 100 times more powerful than morphine, are
causing a crisis in Ontario according to a number of health agencies
and the Ontario Association of Chiefs of Police.

Launching Insite wasn't a cakewalk. In fact, it was one of the most
controversial public health interventions in North America, according
to one particular study. Vancouver had the same concerns Hamilton
does. And, D'Angelo says, there are still many for whom it is a "black
and white issue" of drug use versus no drug use.

"But there is a cost to doing nothing."

Consider some of the data researchers gathered in a 2009 report called 
Findings from the Evaluation of Vancouver's Pilot Medically Supervised 
Safer Injection Facility - Insite:

Insite users are more likely to be younger, inject in public, be
homeless or to live in unstable housing, be daily heroin or cocaine
users and have recently had a non-fatal overdose. The findings suggest
Insite attracts drug users at a particularly high risk of health
problems who were previously public drug users.

After Insite opened there was no substantial increase in former users
going back to drugs and no decrease in number of users getting clean.

A study found the average Insite user had been injecting for 16 years.
Only one person out of 1,065 reported performing their first injection
at Insite.

Insite has a detox centre upstairs. Individuals who used Insite at
least weekly were 1.7 times more likely to enrol in a detox program
than those who visited the centre less frequently. In the year after
Insite opened, there was a 33 per cent increase in detox service use
compared with the year prior.

Vancouver Police Department stats show assaults and robberies in the
neighbourhood increased from 147 in the year before Insite to 180 in
the year after. Drug trafficking incidents dropped from 124 to 116.
Vehicle break-ins and thefts lowered from 302 to 227.

After Insite there were "significant" decreases in publicly discarded
syringes and people injecting publicly in the area.

Intravenous drug users (IDUs) who use Insite are 70 per cent less
likely to share syringes than IDUs who do not use the facility.

IDUs who use Insite increased their use of condoms. Free condoms are
given out at Insite.

This is an opportunity for our city to educate itself, have an
informed debate and decide if what was right for Vancouver could be
right for Hamilton.
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MAP posted-by: Matt