Inside Insite

Abstract

The debate around supervised injection facilities (SIF) rages on more than a decade after the opening of Insite, Canada’s first supervised injection site in Vancouver. Recently, an article published in the journal Addiction reignited the discussion when it made a financial case for introducing facilities in Ottawa and Toronto. The model predicts that the introduction of two SIFs in Ottawa and three in Toronto would be a cost-savings measure to prevent the spread of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) among intravenous drug users (IVDUs). Over 600 total cases of HIV or HCV are projected to be averted in a 20-year period, saving over $40 million in healthcare costs in Toronto and over $30 million in Ottawa. Opponents deny the benefits of safe injection sites despite research conducted on Insite, which suggest that these facilities have tremendous utility and are economically viable. Insite targets and attracts high-risk IVDUs, fosters safer injection habits and prevents transmission of needle-sharing diseases. Insite’s facilities also offer complementary detoxification and rehabilitation services and encourage users to register for these programs. In contrast to arguments made by opponents, Insite has not been found to increase incidental overdoses, neighbourhood crime rates, or public disposal of needles. Given the outcomes of research conducted on Insite, the viability of similar facilities in Ontario should be further explored.

Drug consumption rooms: A systematic review of evaluation methodologies

“…Since 2013, an increasing number of papers analysed SIF‐related laws and policies . In 2016 and 2017, a larger number of publications emphasised the need to expand DCRs/SIFs , including studies that examined the willingness to use SIFs/DCRs among people who use drugs (PWUD) , community support for these services and cost‐effectiveness of scaling them up (Figure ). The need for scale‐up was expressed mainly in papers from Canada and from counties where there are no SIFs such as the USA or UK (Figure , Figure ).…”