Insite

Insite is the first legal supervised safe injection site in North America, located at 139 East Hastings Street, in the Downtown Eastside neighborhood of Vancouver, British Columbia. The area is since many years known as a residence for several thousands of injection drug addicts. [http://www.city.vancouver.bc.ca/fourpillars//pdf/report_vancouver_2005.pdf Vancouver site report for the Canadian Community Epidemiology Network on Drug Use (CCENDU), 2005] ] The site provides a clean, safe location for injection drug use, primarily heroin, cocaine, and morphine. Medical staff are present to provide addiction treatment, mental health assistance, and first aid in the event of an overdose or wound. Over a two year period ending March 31, 2006, the site recorded an average of 607 visits per day and 453 overdoses total, with none resulting in a fatality.Staff Writer. " [http://www.vch.ca/sis/research.htm Research Results] ." "Vancouver Coastal Health: Insite." Retrieved August 1, 2006.] Health Canada has provided $500,000 per year to operate the site, and the BC Ministry of Health contributed $1,200,000 to renovate the site and cover operating costs.

Operation

Insite has been operated since 2003 by Vancouver Coastal Health, under a special exemption of Section 56 of the Controlled Drugs and Substances Act, granted by the Liberal government via Health Canada. The site was slated to close on September 12, 2006, as the exemption was for a three year pilot project. The new Conservative government granted a temporary extension, then added a six month extension that ends mid-2008.

Research

Since opening, the site has been the focus of numerous scientific studies, in peer-reviewed journals such as the New England Journal of Medicine, The Lancet, the British Medical Journal, and the Canadian Medical Association Journal. Findings have shown that the site has led to a reduction of public injections, neighbourhood litter, and needle sharing. [cite journal | author=Wood E, Kerr T, Small W, Li K, Marsh DC, Montaner JSG, Tyndall MW. | title=Changes in public order after the opening of a medically supervised safer injecting facility for illicit injection drug users | journal=Can. Med. Assoc. J. | year=2004 | pages=731–734 | volume=171 | issue=7 | format= PDF | PMID |11867313 | url=http://www.cmaj.ca/cgi/reprint/171/7/731.pdf | doi=10.1503/cmaj.1040774] It has also led to an increase in detoxification and addiction treatment, [cite journal | author=Wood E, Tyndall MW, Zhang R, Montaner JSG, Kerr T. | title=Rate of detoxification service use and its impact among a cohort of supervised injecting facility users | journal=Addiction | year=2007 | pages=916–919 | volume=102 | issue=6 | doi=10.1111/j.1360-0443.2007.01818.x] and has not been shown to increase crime or rates of relapse in former drug users.

upport and criticism

Partners of Insite include the City of Vancouver, the Vancouver Police Department, and the PHS Community Services Society. [Staff Writer. " [http://www.vch.ca/sis/about.htm About Insite] ." "Vancouver Coastal Health: Insite." Retrieved August 1, 2006.] The site has the support of Vancouver's mayor Sam Sullivan,Staff Writer. " [http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20060718/vancouver_safe_injection_060718/20060718?hub=Health Support grows for Vancouver's safe-injection site] ." "CTV/Canadian Press." July 18, 2006.] British Columbia's premier Gordon Campbell,Bailey, Ian. " [http://www.theglobeandmail.com/servlet/story/LAC.20071003.INSITE03/TPStory/National Fate of safe-injection site remains up in the air] ." "The Globe and Mail." October 03, 2007.] and former high-profile Vancouver mayors Larry Campbell, Mike Harcourt, and Philip Owen.Mickleburgh, Mike. " [http://www.theglobeandmail.com/servlet/story/LAC.20060822.BCINSITE22/TPStory/National Vancouver ex-mayors speak up for injection site] ." "The Globe and Mail." August 22, 2006.] The International AIDS Society and the B.C. Centre for Excellence in HIV-AIDS, [Branswell, Helen. " [http://www.cbc.ca/cp/health/060815/x081532.html Supporters of Vancouver's safe injection site turn up the heat on Ottawa] ." "CBC/Canadian Press." August 15, 2006.] and the Canadian Union of Public and General Employees [Staff Writer. " [http://www.nupge.ca/news_2006/n21jy06a.htm Tories asked to keep Vancouver's safe injection site open] ." "NUPGE.ca." Retrieved August 1, 2006.] also support Insite. Though originally opposed to the safe injection site, Chinatown and Gastown merchants associations now support it.International supporters include the UK-based think tank Senlis Council [Hainsworth, Jeremy. " [http://www.cbc.ca/cp/health/060728/x072814.html U.K. think-tank supports continuing B.C. safe-injection site for heroin users] ." "CBC." July 28 2006.] and the Australian Parliamentary Group for Drug Law Reform.

The site has drawn criticism from the Bush administration; the director of the White House Office of National Drug Control Policy called it "state-sponsored suicide" at the time of its opening. Though it is not within their jurisdiction, the Royal Canadian Mounted Police (Canada's national police force), has spoken out against Insite. This is despite the fact that a report commissioned by the RCMP (conducted by two criminologists) concluded in favour of the safe injection site.Staff Writer. " [http://www.cbc.ca/story/canada/national/2006/09/01/injection-announcement.html B.C. injection site to continue operating, for now] ." "CBC." September 1 2006.]

Risky or safe

A frequent word in the context of Insite is the word "safe". The word safe is used very frequent by proponents of the project. Critics of the project argue that the project proponent misusing the word safe, someone can think that it is safe to inject illicit drugs. From the medical point of view, there is no safe way to daily puncture the skin and do injections, not even in a hospital. Injecting illicit drugs is risky not safe. Moreover becomes the risks bigger if the person holding the syringe may be under the influence of illicit drugs.

Government

While the Liberal government allowed Insite to open, since 2006 its fate has been the responsibility of the new Conservative government, which has not been as supportive of it. Conservative Prime Minister Stephen Harper has voiced opposition to the injection site in the past, saying that "We as a government will not use taxpayers' money to fund drug use."Staff Writer. " [http://www.cbc.ca/story/canada/national/2006/08/17/safe-injection.html No AIDS announcement during 'politicized' week: Ottawa] ." "CBC." August 17 2006.] In mid-July 2006, Conservative MP David Fletcher stated that the their government would let Insite's special exemption lapse before deciding whether to continue the project. The following week a spokesman for Tony Clement, the Minister of Health, refuted that, saying that a decision had not been made yet. [Salinas, Eva. " [http://www.theglobeandmail.com/servlet/story/LAC.20060726.BCSAFE26/TPStory/National Safe injection site's fate debated anew] ." "The Globe and Mail." July 26, 2006.] During the XVI International AIDS Conference, held in Toronto, two high-ranking Liberal MPs (Bill Graham and Keith Martin) put their support behind the centre, and criticized the Conservative government for delaying their decision. Insite supporters also demonstrated in Toronto during the conference, prompting the government to further delay any announcement, citing the week's 'politicized' nature.

On September 1, 2006, Health Minister Tony Clement deferred the decision of whether to extend the exemption for the site, citing a need for more research. However, on the same day the government cut all funding for future research, amounting to $1.5 million in lost research money.Gohier, Philippe. " [http://www.macleans.ca/topstories/national/article.jsp?article=2006_12_11_1165872748 Unwelcome Insite] ." "Macleans.ca." December 11 2006.] On August 13, 2007, the Portland Hotel Society and two drug addicts filed suit in the BC Supreme Court to keep the centre open, arguing that its closure would be a violation of the Charter right of Insite users to "security of the person."Staff Writer. " [http://www.cbc.ca/canada/british-columbia/story/2007/08/17/insite-lawsuit.html Advocates of B.C. safe-injection site go to court to keep it open] ." "CBC." August 17 2007.]

On October 4, 2007, during the announcement of its $64-million drug strategy, the Conservative government announced that Insite will be granted another six month extension, allowing it to operate until June 30, 2008.

The future of Insite continues to be in limbo. In May 2008, the B.C. Supreme Court struck down sections of the Canadian Criminal Code prohibiting drug trafficking and possession, ruling that they contravened the Canadian Charter of Rights and Freedoms. This decision would give the site legal grounds to continue operating. However, the federal government has announced plans to appeal that decision to the Supreme Court of Canada. [ [http://canadianpress.google.com/article/ALeqM5gXytn257cSIqQRGeOCo61Rw9o1YQ The Canadian Press. "Vcr safe-injection site case headed for Supreme Court of Cda, lawyer predicts". Accessed 3 July 2008.] ]

References

External links

* [http://www.vch.ca/sis/ Insite official website]
* [http://www.vch.ca/ Vancouver Coastal Health]
* [http://maps.google.com/maps?f=q&hl=en&q=139+East+Hastings+Street,+vancouver&ll=49.2827,-123.101206&spn=0.024747,0.078535&om=1http://maps.google.com/maps?f=q&hl=en&q=139+East+Hastings+Street,+vancouver&ll=49.2827,-123.101206&spn=0.024747,0.07853%20 Insite location on Google Maps]