Here in Ottawa, Canada, we are in the midst of a very heated, controversial debate over Safe Injection Sites (SIS). One of our local Community Health Centres has announced its intention to integrate an SIS into its existing facility and is conducting several community consultations to address the concerns and fears of residents and neighbours.
What is a Safe Injection Site?
An SIS is a public health facility where people with addictions can bring their own drugs to a safe, hygienic place and inject under the supervision of medical professionals. It's based on a harm reduction model with goals that are designed to:
- Reduce the spread of HIV and Hep C by providing sterile equipment and safe disposal of used needles
- Reduce the risk of death by overdosing
- Decrease public drug use and drug paraphernalia litter
- Serve as a portal to help addicts access social services and treatment
- Provide First Aid treatment
This is an issue that deeply divides the community. Many people look at it as an issue of public health and the fact that SIS models have evidence- based research showing the reductions of overdoses, deaths, and transmission of diseases. Here in Ottawa, the Chief Medical Officer has come out in support of SIS's. On the other hand, it is perceived as a crime issue, with people feeling that SIS's simply condone criminal activity by allowing addicts to bring illegal drugs into a public facility to engage in an illegal act by shooting up. Our mayor and Police Chief , not surprisingly, do not support SIS's.
Some local officials have stated their belief that we should be investing our scarce health dollars into treatment facilities, instead of places that normalize drug activity. Fair enough: There are long, lengthy waiting lists to get into treatment facilities, sometimes taking up to a year to get help. I think that anyone who supports SIS's would also be in favour of investing in more treatment programs. What's funny is how it was our same federal (and dearly departed) Conservative government that opposed SIS's that was also responsible for cutting back funding to treatment centres. An SIS can be operated at a fraction of the cost of a truly substantial strategy to invest in treatment programs. The debate should not be framed as an 'Either-Or' proposition, since both options can save lives. Secondly, you can't force every addict into treatment, and an SIS can help keep them safe, alive and connected to community support, until they reach the stage when they are ready for treatment. The SIS proposed in Ottawa would be integrated into a facility with a full range of medical and social service providers.
In Canada, we have an SIS that was opened in Vancouver in 2003. Insite is Canada’s ﬁrst SIS. It has succeeded in beneﬁting the health and safety of the community in many ways and it has provided clear, consistent evidence that SIS's work.
- 35 HIV infections are prevented each year, with estimated health cost savings of 8.7 million in health care dollars.
- Fatal overdoses in the vicinity of Insite decreased by 35 percent
- Not a single person died of overdose
- Insite users are 30 percent more likely to seek treatment
- 458 people entered detox through Insite in 2010
- Insite has not led to an increase in drug use or crime in the area
The mayor of Vancouver, Gregor Robertson stated that Insite saves lives, connects people to treatment, counselling and medical help as it reduces crime. After thirteen year in operation, Insite has the full backing of the police department, municipal and provincial governments. Our recently elected federal government has indicated that SIS's are among several strategies the government is bringing forward to deal with addictions and overdoses.
There are approximately 90 Safe Injection Sites around the world and support is growing for trying new models instead of continuing to spend billions and billions of dollars on the futile 'war against drugs.' A Safe Injection Site treats addicts with compassion, support, it minimizes risks to the community, and serves to help people access treatment programs. In my view the evidence outweighs the rigid ideology of being tough on crime.