Pubdate: Fri, 14 Apr 2017
Source: Calgary Herald (CN AB)
Copyright: 2017 Postmedia Network
Author: Yolande Cole
Page: A3


Calgary's police chief is backing calls for a local site where drug
users could consume substances under medical supervision. Roger
Chaffin said preliminary discussions are underway about what a
supervised consumption site in the city will look like. He added that
police will work to ensure that community members feel safe.

Dr. Thomas Kerr is the co-director of the Addiction and Urban Health
Research Initiative at the British Columbia Centre for Excellence in
HIV/AIDS and the principal investigator of several large cohort
studies involving people who inject drugs and people living with
HIV/AIDS. He spoke to Postmedia about community concerns when
supervised injection facility Insite was established in Vancouver's
Downtown Eastside in 2003.

Q: What were the community fears when Insite was initially

A I think there were people who had a number of fears that this would
make public order worse by either attracting drug users to the area or
creating a bit of a honeypot effect where everybody kind of gathers in
one area. There were some people who felt that it would undermine
efforts to get people into abstinence-based treatment and some,
although not many, who also were concerned that it would send the
wrong message to youth and it might make injection drug use

Q: How were those fears addressed?

A I think a lot of the fears simply went away once the site opened and
people saw that it didn't actually create this chaos, that there
wasn't this escalation in crime or people congregating in the Downtown
Eastside. In fact, the Chinese merchants' association, which initially
opposed the supervised injecting site but did agree to the three-year
evaluation experiment, actually wrote a letter at the end of three
years in support of the site, saying that they'd noticed improvements
in public order.

Our independent scientific evaluation of Insite specifically targeted
potential negative effects as well as potential benefits. We were able
to publish those results in peer review journals, and we released them
publicly through the media and through the creation of summary
documents and briefing notes. And that included a study that used the
Vancouver police department's own crime statistics for the Downtown
Eastside, which showed that there was no impact on crime. We showed
that it didn't make drug use patterns in the community worse and, in
fact, we showed also in a paper … that people were going to
abstinence-based programs at a higher rate than before Insite opened,
and that contact with the counsellor within Insite was something that
strongly predicted people going into a detoxification program.

My sense is that when people imagine these facilities, they picture
the worst, all chaos breaking out. Then when you actually see it open,
it just looks like any other health clinic.

Q On the impact that Insite has had:

A Supervised injecting sites are one of the only tools we have to deal
with overdoses when they occur, and there's never been a death due to
overdose in a supervised injecting site anywhere in the world, despite
the fact that there's over 90 of them and millions of injections have

We also published work showing a 35 per cent reduction in overdose
deaths in the area immediately around Insite, and we know that there's
been literally thousands and thousands of overdoses there and nobody's
ever died. So while supervised injecting sites don't necessarily
prevent the overdoses from happening in the first place, they minimize
the harmful effects, including potential fatalities.

Also right now in Vancouver, Insite is offering a drug testing service
where people can test their drugs for fentanyl, which in turn could
affect behaviour.

Q Does the success of a facility like Insite depend on a concentration
of drug users, or can it still be successful if users are more
distributed across a larger area?

A They do work best if it's an area where not necessarily just people
live, but where they acquire and use drugs. I know that a number of
cities in Canada have been looking at a more distributed model where
you have a number of smaller sites spread out over a bigger area to
accommodate a more distributed population.

I think in that case, if that's the nature of the population, more
geographically dispersed, then that's a sensible approach to go with.
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