BC safe-injection site saves lives

Shot in the arm for program; Should be replicated in other cities: scientists

With a Supreme Court of Canada case looming this summer that could decide its future, Vancouver's safe-injection drug site has received an extra shot in the arm from a new report that says it has helped reduce the number of fatal overdoses in the city by 35 per cent.

The report, compiled by Canadian scientists from the Urban Health Research Initiative, the BC Centre for Excellence in HIV/AIDS and St. Paul's Hospital, goes on to argue that Vancouver's Insite - the country's first safe-injection facility - should be replicated in other North American cities where drug use is a common problem.

The team's findings and recommendations were published Sunday in the medical journal The Lancet.

With help from the provincial coroner's service, the researchers gathered data on every drug-related overdose death that occurred in the city between 2001 and 2005. Using a technique called geocoding, the researchers tracked where each death occurred and marked how far it was from a safe-injection site.

They studied the population-based overdose mortality rate before Insite launched in 2003 and after from 2003 to 2005 to compare fatality rates within a 500-metre radius of the site to the rest of the city.

Results showed that 31 per cent of 290 overdose deaths occurred in the city blocks closest to facility. Once the site was opened, fatality rates in this area decreased by 35 per cent to 165 deaths from 254 per 100,000 people each year.

Fatal overdose rates elsewhere once the site opened decreased by only nine per cent.

"Our results suggest that (safe-injection facilities) are an effective intervention to reduce community overdose mortality in Canada and in other cities internationally and should be considered for assessment particularly in communities with high levels of injection drug use," Thomas Kerr, co-director of addiction research at the B.C. Centre for Excellence in HIV/AIDS, and his colleagues wrote.

Insite was set up in 2003 in Vancouver's Downtown Eastside so that drug addicts could inject drugs safely, with sterile needles. They also receive addiction treatment, mental health assistance and first aid. The region is notorious for its open drug market, HIV epidemic and large numbers of homeless people.

Other medical studies have also argued the clinic protects drug addicts from overdosing.

The Conservative federal government has been seen as keen on shutting down the facility, because of what critics have alleged are ideological differences with the Tories' "tough-on-crime"policies.

In May, the Supreme Court of Canada will decide if the Vancouver facility will stay open, potentially settling a jurisdictional dispute over the site between the federal and provincial governments.

The BC Court of Appeal ruled in 2010 that the facility falls under provincial jurisdiction over health care so federal officials did not have the authority to shut it down. The federal government appealed the decision.

In 2008, the BC court also decided that closing a healthcare facility that saves lives violates the Charter of Rights guarantee to life, liberty and security of the person.

Kerr, the report author, notes there are more than 65 safe-injection sites around the world where drug users can inject pre-obtained illegal drugs to help reduce risks involved with drug use, such as sharing needles and overdosing.