Thursday, August 31, 2006

Insite Fact Sheet

Insite is the only Safe Injection site in North America.

How a Safe Injection Site works (pers. comm. from my tour and the Insite webpage).

  • -Clients in the waiting area sign in the first time and sign waiver
  • -12-seat injection room where they can inject their own drugs under the supervision of trained medical staff.
  • -Self report drugs and recieve equipment and instruction for proper use.
  • -Have access to clean injection equipment including spoons, tourniquets and sterile water, aimed at reducing the spread of infectious diseases. All equipment must be left in the injection room.
  • -Average time in injection room: 20 minutes.
  • -After injecting, they move to a post-injection room where, if appropriate, staff can connect clients with other on-site services. These include primary care for the treatment of wounds, abscesses and other infections; addiction counseling and peer support; and referral to treatment services such as withdrawal management, opiate replacement therapy and other services.

Why this is important and necessary

  • - Injection drug users have access to resources the rest of us take for granted: an interdisciplinary healthcare team, clean equipment, social services and outreach.
  • - There is access to injection site assessment for abcesses, infection, safe injection technique.
  • - All equipment is safely disposed of, not left in the streets, alleys, public trash.
  • - Common practice prior to the site opening included using any available water source for injecting, for example puddle water.
  • - Individuals are giving the dignity to shoot up in a private space and public order is improved as there is now less conflict between injection drug users and other members of the community (for example business owners, like the Chinatown Merchants Association, who, while initially sceptical or opposed to the site, are now overwhelmingly supportive)
  • - There is a reduction in crime in the community
  • - Individuals inject individually, and equipment can't leave Insite; so, there is no chance of shared needles

Staff

Along with the on-site coordinator, two registered nurses are present at all times with an addiction counsellor and physician support available on-call. Program assistants from our partner, the PHS Community Services Society, help greet and register people, as well as provide peer contact to encourage safe injection practices and orient drug users to use the site.



Facts and Figures (from Insite homepage and pers. comm from my tour)

  • -People using Insite are more likely to enter a detox program, with one in five regular visitors beginning a detox program
  • -Over a two year period 4,084 referrals were made with 40 per cent of them made to addiction counseling
  • -To date there have been over 500 overdoses at Insite. Thanks to prompt medical attention there have been no deaths.
  • -Daily average visits: 607
  • -Number of nursing care interventions: 6,227
  • -Number of nursing interventions for abscess care: 2,055
  • -Busiest day: May 25, 2005 (933 visits in 18 hours). So, nearly 1000 needles kept off of the street, nearly 1000 instances where a needle was not shared.1000 instances where an individual had the opportunity to access the healthcare system, not only for drug-related treatment but also for mental health, HIV/AIDS care, pregnancy testing and maternity care, social work services, counseling and peer-support.

Key Research Findings (thanks to S. Evans, VCH)

  • -Insite has attracted and retained a high risk population of injection drug users, including those at high risk for HIV, overdose, and involved in public disorder.
  • -The opening of Insite has been associated with improved public order, including reductions in public injecting and discarded syringes
  • -Insite is associated with reduced syringe sharing. Data obtained before Insite opened showed that the reduction in syringe sharing only emerged after the opening of Insite. These are the first ever published findings to demonstrate an impact of a Supervised Injecting Facility on syringe sharing among Intravenous Drug Users.
  • -The opening of Insite did not lead to negative changes in community drug use patterns. Therefore, the recently reported benefits of Insite on HIV risk behaviour and on public order have not been offset by negative community impacts.
  • -Use of Insite and any contact with the facility's addictions counselor were both independently associated with more rapid entry into a detoxification program.

Funding

Funding for Insite is from both the federal government (Health Canada) and from the BC Ministry of Health via Vancouver Coastal Health.

5 comments:

Jen said...

Although you say it's safer, cleaner, and provides more dignity to the addict, as an RN I would have to change professions if part of my job entailed me overseeing addicts inject their own street drugs "in a medical setting".

Amazing. I don't really know what else to say. I'm just glad this isn't happening in the USA.

Ron Hudson said...

I support this concept of accepting as reality that people aren't perfect and that we can take action to make their high-risk behaviors less threatening to their own and to public health. Sadly, if I am not mistaken, the Canadian government is closing down this site. There was a presentation about the facility in the Time to Deliver website from the AIDS Conference in Toronto. It should be featured in a few days in the International Carnival of Pozitivities, hosted by aids-write.org.

Jen said...

Hi all,

Thanks for responding to the site.

Jen: Well, supporting a safe injection site (or not) is your perogative. In creating the site I had no illusions that I'd see 100% support. Would your disinclination to working in the site be because it is supporting drug use or is it that the users are bringing their own drugs?

Ron: I have a more recent post on the site re: the status of Insite. The government has extended the exemption until Dec, 2007. This blog will stay active with updates.

Cheers, Jen

ceejayoz said...

Amazing. I don't really know what else to say. I'm just glad this isn't happening in the USA.

Yes, heaven forbid we see the same reduction in crime and increase in care for the addicted.

The statistics for this type of thing show benefits for everyone, and there don't seem to be any real downsides to it. Take a step back from your emotionally prompted responses and look at it logically.

richard kearns said...

your post has been linked to icpoz.three, the september issue of the international carnival of pozitivities, hosted at http://aids-write.org. an excellent article about a stigmatized and needed service.

http://aids-write.org/?p=231

thanks,
richard kearns