Should North America’s first and only supervised injection facility (InSite) be expanded in British Columbia, Canada?

Abstract

BackgroundThis article reports qualitative findings from a sample of 31 purposively chosen injection drug users (IDUs) from Vancouver, Surrey and Victoria, British Columbia interviewed to examine the context of safe injection site in transforming their lives. Further, the purpose is to determine whether the first and only Supervised injection facility (SIF) in North America, InSite, needs to be expanded to other cities.MethodsSemi-structured qualitative interviews were conducted in a classical anthropological strategy of conversational format as drug users were actively involved in their routine activities. Purposive sampling combined with snowball sampling techniques was employed to recruit the participants. Audio recorded interviews were transcribed verbatim and analyzed thematically using NVivo 9 software.ResultsAttending InSite has numerous positive effects on the lives of IDUs including: saving lives, reducing HIV and HCV risk behavior, decreasing injection in public, reducing public syringe disposal, reducing use of various medical resources and increasing access to nursing and other primary health services.ConclusionsThere is an urgent need to expand the current facility to cities where injection drug use is prevalent to reduce overdose deaths, reduce needle sharing, reduce hospital emergency care, and increase safety. In addition, InSite’s positive changes have contributed to a cultural transformation in drug use within the Downtown Eastside and neighboring communities.

Examining the potential role of a supervised injection facility in Saskatoon, Saskatchewan, to avert HIV among people who inject drugs

“…The contraction and spread of HIV via People Who Inject Drugs (PWID) is not a problem exclusive to large cities and urban areas as small and medium sized towns have reported an increase in HIV infection (1). The Downtown Eastside (DTES) of Vancouver has historical shared similarities with many small cities in Canada in terms of HIV prevalence.…”

The role of nurse practitioners in outreach services and facilitating access for marginalized adult women in British Columbia

“…Other outreach centers across Canada provide access for marginalized populations to obtain harm reduction supplies, which essentially include clean needles, condoms, food, water, and telephone access (Krusi et al, 2012 Vancouver in 2003, has resulted in a decrease in the incidents of overdoses and the transmission of blood-borne diseases, and, an increase the retention rates for people in detox and treatment facilities, along with an increase in the exposure of the marginalized population to the health care system (Small, 2012). It has also been shown that the InSite program has resulted in a reduction in injections taking place in public places, has kept dirty needles off the streets, and has reduced the use of emergency services, while increasing access to health care providers (namely nurses) and other resources, and generally keeping people alive (Jozaghi & Andresen, 2013).…”

“…Eight studies using data relating to British Columbia have been reviewed (Deering et al, 2011a;Janssen et al, 2009;Jozaghi & Andresen, 2013;Kurtz et al, 2008;Lazarus et al, 2012;Marshall et al, 2005;Salmon et al, 2009;Wardman, Clement, & Quantz, 2005). Four studies from Ontario were identified and included (Butters & Erickson, 2003;Daiski, 2005;Goodman, 2006;Woolhouse, Brown, & Lent, 2004).…”

“…Outreach services generally intend to provide an environment that fosters respect by staffmg it with individuals who are either trained or inclined to refrain from passing judgement. Studies show that marginalized populations are aware of the extent to which these centres minimize or remove some fundamental barriers to gaining access to primary health care services (Daiski, 2005;Deering et al, 201la;Islam & Conigrave, 2007;Islam et al, 2012;Janssen et al , 2009;Jozaghi & Andresen, 2013;Marshall et al, 2005). Studies looking at women's perspectives indicate a perception that outreach centre staff were more likely to listen, were more trustworthy (with respect to patient confidence), and more likely to believe what they were being told.…”

“…Islam et al (2012) specified that marginalized populations want their health care provided in outreach settings, given the emphasis on harm reduction and the increased likelihood of being treated without judgment, with greater respect, and less stigmatization. Jozaghi and Andresen (2013) showed that outreach facilities are also often seen as community centers, which foster a "sense of belonging ... we actually feel like we exist" (p. 7).…”