Review concludes Vancouver safe injection site is effective -

Review concludes Vancouver safe injection site is effective

Authors encourage government to drop legal action that would close facility


An article in the Canadian Medical Association Journal reviewing the history and effectiveness of Vancouver’s safe-injection site has concluded that the facility reduces needle sharing, cuts overdose deaths and allows for addiction treatment. Its authors are also urging the federal government to give up its Supreme Court of Canada challenge aimed at shutting the facility down. Insite opened in 2003 in Vancouver’s Downtown Eastside, allowing drug users to inject their own heroin under the supervision of a nurse. The Conservative government has been long opposed to the site, arguing that it fosters addiction. The B.C. Supreme Court and B.C.’s Appeal Court both ruled that the site is a health care facility that is under the province’s jurisdiction, and should operate with federal government money. The Supreme Court of Canada is expected to hear arguments on the issue later this year.


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Review concludes Vancouver safe injection site is effective

  1. Let me guess: Evidence says (the long-gun registry) Insite is cost effective, efficient, and worth the money. Am I hearing an echo?

    Bunch of elite doctors. Whadda they know?

    • Clearly, more than you do!

      • Hmm.Forgot to press the "INDICATE SARCASM" button again.

    • Here's a paradox, you're not even worth replying to.

      • Paradox?
        What? Are there two elite doctors?

  2. How does this study been conducted? Have they included in this study how many of those involved in using safe injection sites become more entrenched in their drug dependency?

    • It was conducted using strict methodology and observational, measurable results. And yes they study those involved to see if there is an increased dependency. It's all in the report. But I suppose that doesn't really matter now does it…..

    • Really…trying to pick apart the methodology of something published and peer-reviewed by the CMAJ is a waste of your ammunition. Go pick a fight you can win.

      • All that science just can't measure up when the question is, "What would Jesus do?"

        And I don't mean the Jesus who dined with society's ne'er-do-wells to the consternation of his disciples, but Jesus 2.0 (what version are we on again?) who rejects social justice and most definitely hates IV drug users.

        • Just wait until we get to Jesus 3.0. I hear it includes USB support.

        • The answer: A lot of coke

      • Anything CMAJ published cannot be questioned? Remember Aspirin and many other things?

        • Nope. I'm saying the methodology is published along with the study, which the poster would know had he/she read the study. The poster could have answered his/her own question by reading the study.

          As to picking apart methodolgy? It happens, indeed, and many scientists like nothing better than to poke holes in somebody's prize theory. It's part ego, and part love of knowledge. It's how the system works. Sometimes, poor science comes in under the radar, but generally, it gets sniffed out. Like Dr. Wakefield's bogus Autism/Vaccine research in England.

    • RTFM

  3. Well, if it wasn't doomed before, it certainly is now.

  4. The problem with Insite is that while your average Canadian taxpayer is working hard on a Tuesday afternoon, an addict is (rather than working hard like the average taxpayer) shooting up in a nice, air-conditioned office paid for by said taxpayer, using paraphernalia purchased by said taxpayer, while being babysat by public nurses whose salaries are covered by said taxpayer. (not to mention the whole bureaucracy associated to the clinic being funded by that poor schlep of a taxpayer)

    The government has no right to use my money to help some guy shoot up.
    Now, if Insite were to operate solely by charitable donations…

    • Have you considered the arguments in favour of keeping it alive?
      It may even change your perspective.

    • Exactly. Here's an idea: suppose we handed each addict a million dollars to live in a luxury home and have their own personal medical teams. That would also "reduce needle sharing, cut overdose deaths and allow for addiction treatment". Which is why studies like this are such a ridiculous waste of time. These people do not deserve our taxpayer money to shoot drugs into themselves. It's the most objectionable use of public money that anyone could possibly imagine.

      • Like Pele, your view is one-sided. You're only looking at the individual addict. From a collective societal stance, it does make sense though: less propagation of HIV, hepatitis and other blood borne disease for one thing, plus it gives the addict better access to potential treatment, because surrounded by properly trained personnel at the facility, which one would not get in a back alley.

        • I'm still waiting for you to say how it helps the rest of society to pay drug addicts to not catch diseases from other drug addicts. How does this benefits someone who is not a drug addict? It doesn't. Like I said, it's taking money that people earned with hard work and handing it to people who use it to shoot drugs into themselves.

          We might as well be buying the drug addicts luxury condos and vacations to the Bahamas. After all, it's healthy for them to have tropical vacations to reduce their stress.

          • Yes. There is nothing I enjoy more than explaining to my nieces and nephews what 'dirty needles' are, and why one should avoid them.

          • I am mostly convinced that the benefits of Insite warrant the costs.

            But I'm also convinced that the cost of buying the drug addicts luxury condos and vacations to the Bahamas would greatly exceed any potential benefits, and so I wouldn't be in favour of that idea.

          • "I'm still waiting for you to say how it helps the rest of society to pay drug addicts to not catch diseases from other drug addicts"

            Okay. Each overdose/site infection/broken needle incident or stabbing as a result of fighting for "gear" avoided by free needles and medical supervision prevents an emergency room visit and saves thousands of dollars, reduces unnecessary waiting of others in the emergency rooms, and frees up ambulances for other calls.

            Each case of Aids, Hep C, Hep B, and others delayed or prevented by free needles and safe injection protocol has the potential to save hundreds of thousands of dollars for the health care system. A year of the three drug cocktail most common for aids treatment can sost up to $15,000 per patient, and you can bet the province will be picking up that tab as it's unlikely folks living on the street have a drug plan. Also, all of those conditions lead to further complications which bring patients into hospital. Most of these folks, without a family doctor, use the emergency room as their primary care provider. An emergency room visit can cost the system between $600 and $10,000, even without admission. A visit to a nurse practicioner at Insite billis in at around $40.

            Want more?

          • Did you think before making this comment? It helps because a) most people aren't sociopaths and don't want others to get diseases when it can be avoided. b) it makes it so you don't have to pay for their substantially more expensive treatment from diseases. c) you personally will have less chance to catch a disease when you have sex (it's amazing but sometimes drug addicts look just like real people, hard to believe when you demonize them, but it's true!), and you don't even need to have sex with a drug addict … but with a person who may have had sex with someone who had sex with a drug addict with a disease.

            Seriously, there are more important things in the world than MY TAX DOLLAR$$$.

    • Yeah, like those shirkers lying in an air conditioned hospital room getting kidney dialysis. Why should my taxes go to people who can't even take care of their own kidneys? They should work hard and buy a new kidney on the international black market with their own damn money. After all, if we keep subsidizing kidney transplants, we'll just get more people wanting them. And don't even get me started on those irresponsible insulin junkies…

      • If you can't tell the difference between what you said and what we're talking about, you have issues.

        Perhaps the analogy would work if the kidney failure was caused by someone intentionally piercing their own kidneys repeatedly with needles and intentionally delivering toxins into their kidneys.

        • " and intentionally delivering toxins into their kidneys."

          Whats the difference between drinking your organs to death and damage through intravenous drug use? Effect is the same.

          • Your point? Are you saying we should be giving free drinks to alcoholics with tax dollars?

          • We're not giving them 'free drinks' or 'free drugs' – just a place to consume them under medical supervision. Much cheaper than paying for ambulances when they o.d.

          • Oh, you mean we should create a taxpayer funded bar for alcoholics!

          • Bars sell drinks, so the analogy is flawed. However, if I were to play along just for fun, I would point out that if alcoholics were dying daily from alcohol overdoses and leaving broken bottles all over the streets of Vancouver, then it might be time to try something new.

            Edited to add: every level of government in B.C. over the past 10 years (or so) have supported Insite – and these governments are often ideologically very far apart. Insite is a solution that works for the particular problems that exist in Vancouver. The federal government needs to respect that.

          • no, If you can't tell the difference between what you said and what Mike is talking about, you have issues.

            Mike is rightly noting that we take care of folks with a broad array of health problems that could be considered to be at least partially self-infllicted (people who abuse alcohol; eat poorly etc), but some people, like you, are drawing artificial lines in the snow that excludes some people from the same.

        • Your kidney example is actually closer than you think. In some cases, those with diabetes end up with kidney failure. Many doctors believe a failure to maintain constant good blood sugar control causes the kidneys to fail. So, it's clear it must be the fault of the diabetic who didn't take care of himself. This is the actual reality of your example.

          So, a 35 year-old guy who went wild for a couple years in his teens and didn't take care of himself doesn't deserve a transplant, right? Or maybe he didn't exercise enough. Maybe he forgot to test his blood sugar once a week. What's your moral cutoff? Two months of bad behaviour? One month? One year?

          Your logic is more full of holes than a nephrotic kidney.

    • These addicts are generally homeless, suffering from psychiatric problems, coming from awful histories of sexual and physical abuse, and, of course, physically and psychologically dependent on injectable narcotics. They didn't choose to become addicted, but that's what happened nonetheless. Some people can use and experiment with, say, heroin or cocaine and not develop a significant dependence. Such people are not going to Insite – and Insite requires that users bring their own drugs.

      Simply put, your (self-)righteous moral indignation is quite misplaced – not to mention inhumane. These vulnerable people are not less deserving of adequate medical care than anyone else, and treating overdoses and wound infections at Insite is much cheaper than in a hospital, particularly when matters have progressed further and the patient has developed bacterial endocarditis.

  5. Effective only in ensuring it attracts every drug user in Canada for the free needles and cheap drugs.

    • and once again… democracy, the least bad of the alternatives.

    • f"ree needles and cheap drugs."

      The free needles are available everywhere. Have been for years.Not sure where the "cheap drugs" come into it. Th study says "allowing drug users to inject their own heroin"

      Facts: Wrecking good arguments since 1993.

    • a) drug addicts outside BC probably have more immediate needs than getting a bus to downtown Van. The allure of one free needle here and there pales in comparison I'm sure. b) what's the street price of smack now compared to before Insite opened? I'm genuinely curious to know, but doubt Insite has affected that price one bit.

      • c) Where in Canada can you find the greatest concentration of addicted drug users. Vancouver East side! That is also a fact! My bet would be that "Insight" has contributed to that number!

        • Really? What's your logic? That drug addicts get up the initiative and money, which they spend on securing passage to Vancouver instead of buying drugs, just to get some free needles and supervision while they inject? Not damn likely.

          Unless you mean that some addicts from other parts of Vancouver might have migrated to the East Side, which is entirely possible. But my understanding is that the East Side is where most of them ended up, anyway. That's why Insite was built where it is in the first place.

          That said, I think that we should have places like Insite wherever there's a significant problem with injected drugs. It's a health issue, for both the addicts and general public, not to mention one of compassion.

        • The Downtown Eastside of Vancouver had the greatest concentration of addicted drug users in Canada before Insite opened. Insite helps to mitigate the associated medical and criminal problems that result from addicts shooting up in back alleys. It also provides services (in the same building) for those addicts who are finally ready to get off drugs. That doesn't happen in the back alleys.

  6. "The problem with Insite is that while your average Canadian taxpayer… air conditioned room… poor schlep of a taxpayer)"

    What I don't understand when I see stuff like this is, why don't you further post what must really be the logical conclusion to this: taxpayers have no roll in paying for the healthcare of addicts. That is what this boils down to. If you'd like to shift this topic to "my tax dollars should be specifically funneled to hip replacements, cancer treatment and car crash victims only (or we should abandon public healthcare altogether)" then we'd have a more realistic conversation, because places like Insite actually *save* money to the system— and you're never ever ever going to magically simply get rid of drug abuse. So if you don't want to pay for emerg visits and the HIV treatment for addicts, fine (well not fine by me but you know what I mean), advocate for the dismantling of our system. Otherwise, it's preventative and money saving in the long run.

    • Bingo. For many conservative their world view depends on less fortunate people as an example of what will happen if you don't follow orders. So they NEED the unemployed or people in poverty as an example to their family and friends as what will happen if you don't study hard, get a job, work hard, etc. (See Johnny what will happen if you don't get a college degree) So they NEED desperate people who didn't follow their narrow moral code as an example to their family and friends as what will happen if you break any rules. (See Amanda what will happen if you don't "just say no to drugs") So they NEED lonely people who are excluded from their society by rules they establish to make all society look, think, act and believe just like them. (No child of mine will ever get the homosexual affliction.)

      And they will very often justify this need for these rations of poverty and suffering and their exclusion of others, by claiming to be Christians and referring to some obscure line in the Old Testament, while ignoring the fact that their behaviour contradicts the most basic teachings of Jesus Christ.

  7. My tax dollars should not go to ease the misery of any self-inflicted malady! That includes gluttony, drug use, drinking, unprotected sex and/or smoking (among other things). I focus on balanced eating and drinking, good health, rest and exercise. Why should I be required to pay for the lack of common sense among the public. Why not put the money into education toward health rather than continuing to support an addictive lifestyle. People who possess and sell illicit drugs should be prosecuted not protected and encouraged in their habits. Preventative and saving my ass! Show me the long term converts from drug use to a healthy lifestyle through Insight and maybe I'll buy in, but the stats for that are not there and no amount of wishing it were so will change that.

  8. Why is there no educational drive in place against drug use? There is for drinking driving and smoking, yet for drugs – nada, instead we have safe injection sites? Could somebody explain that to me? Is Safe injection sites all we can do? Is there no better alternative?

    • There is education in place against drug use? I'm not sure why you would comment on something that is factually false. Schools teach that doing drugs is bad. But guess what, when you're already addicted, that message doesn't mean terribly much. But getting people off of their addiction can mean a whole lot.

      • Have you seen anything on TV like the way they do drinking and driving? Have you seen anything other than school an anti drug drives? None!

  9. research from Washington state has shown that every dollar spent on community-based drug treatment saves $18 in taxpayer costs, including prison expenses. In that jurisdiction, community-based drug treatment provides better crime reduction results than prison'
    Now, since as far as I know, Washington state doesn't have tax payer funded healthcare yet, I'm guessing that the $18 figure is even higher here in Canada (that's for all you 'not with my tax dollar" naysayers!)
    Though I don't have them handy, the figures on avoided overdoses at the Insite centres are quite high too.
    And for paying for free needles? MANY cities have been doing that for years….matter of fact, some cities are paying for crack pipes too to slow the spread of hepatitis, etc.
    Our tax dollars treat these folks like it or not – sugar and tobbaco addicts, alocoholics and IV drug users alike!. Should we not be looking for the most cost -effective way for doing so? Instead of spending oddles of tax dollars fighting something that has been proven to work?!?!?

  10. washington does have a form of tax-payer funded healthcare. its called BASIC health. its for low income patients, but its still completely free. and the closest we have right now to socialist medicine in the states (many states have their own version).

    just to correct !

  11. There is for drinking driving and smoking, yet for drugs – nada, instead we have safe injection sites? Could somebody explain that to me? Is Safe injection sites all we can do? Is there no better alternative? Go Ped

  12. can I see this article that you are referencing i need it for a research project