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


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

Ministers to write to

The Hon. Tony Clement, P.C., M.P.
Why him? Sounds like the decision is up to him now (see previous post).
Minister of Health (and Minister for the Federal Economic Development Initiative for Northern Ontario)

Parliament Hill:
House of Commons
Ottawa, Ontario
K1A 0A6
Telephone: (613) 944-7740
Fax: (613) 992-5092

Constituency Offices
202 Main Street West (Main Office
Huntsville, Ontario
P1H 1X9
Telephone: (705) 789-4640
Fax: (705) 789-8857

Health Canada
0916A Brooke Claxton Building, 16th Floor Tunney's Pasture
Ottawa, Ontario
K1A 0K9
Telephone: (613) 957-0200
Fax: (613) 952-1154

The Right Hon. Stephen Joseph Harper, P.C., M.P.
Prime Minister
Why him? He's the one in charge.
Parliament Hill:
House of Commons
Ottawa, Ontario
K1A 0A6
Telephone: (613) 992-4211
Fax: (613) 941-6900

Constituency Offices:
1600 - 90th Avenue SW, Suite A-203
Calgary, Alberta
T2V 5A8
Telephone: (403) 253-7990
Fax: (403) 253-8203

Prime Minister of Canada
Langevin Building
80 Wellington Street
Ottawa, Ontario
K1A 0A2
Telephone: (613) 992-4211
Fax: (613) 941-6900

The Hon. Jim Prentice, P.C., M.P.
Minister of Indian Affairs and Northern Development and Federal Interlocutor for Metis and Non-Status Indians
Why him? 18% of InSite users are Native Canadian

Parliament Hill:
House of Commons
Ottawa, Ontario
K1A 0A6
Telephone: (613) 992-4275
Fax: (613) 947-9475

Constituency Offices
105-1318 Centre St NE
Calgary, Alberta
T2E 2R7

Telephone: (403) 216-7777
Fax: (403) 230-4368

Indian Affairs and Northern Development
Terrasses de la Chaudière,
North Tower, Suite 2100
10 Wellington Street
Gatineau, Quebec
K1A 0H4
Telephone: (819) 997-0002
Fax: (819) 953-4941

The Hon. Beverley J. (Bev) Oda, P.C., M.P.
Minister of Canadian Heritage and Status of Women
Why her? 29% of Insite users are women.

Parliament Hill:
House of Commons
Ottawa, Ontario
K1A 0A6
Telephone: (613) 992-2792
Fax: (613) 992-2794

Constituency Offices
68 King Street East
Bowmanville, Ontario
L1C 3X2
Telephone: (905) 697-1699
Fax: (905) 697-1678

Canadian Heritage
Les Terrasses de la Chaudière, 12th Floor
15 Eddy Street
Gatineau, Quebec
K1A 0M5
Telephone: (819) 997-7788
Fax: (819) 994-1267

The Hon. David Emerson, P.C., M.P.
Minister for International Trade and Minister for the Pacific Gateway and the Vancouver-Whistler Olympics
Why him? Insite is located just blocks from the proposed location of the Athletes" Village for the Vancouver 2010 Olympics. The entire area around False Creek, Main Street Station and Gastown are undergoing major gentrification. There is concern that a "clean-up" effort of the Downtown East side will push injection drug users and other marginalized members of the community on to other jurisdiction s like New Westminster and away from established resources like Insite, funded housing, food banks and detox programs.

Parliament Hill:
House of Commons
Ottawa, Ontario
K1A 0A6
Telephone: (613) 943-0267
Fax: (613) 943-0219

Constituency Offices
2148 Kingsway
Vancouver, British Columbia
V5N 2T5
Telephone: (604) 775-6263
Fax: (604) 775-6284

International Trade
Lester B. Pearson Building, Tower B, 5th Floor
125 Sussex Drive
Ottawa, Ontario
K1A 0G2
Telephone: (613) 992-7332
Fax: (613) 996-8924

The Hon. Diane Finley, P.C., M.P.
Minister of Human Resources and Social Development
Why her? InSite is the enrty point for many injection drug users not only to health care, but also to other social services.
Parliament Hill:
House of Commons
Ottawa, Ontario
K1A 0A6
Telephone: (613) 996-4974
Fax: (613) 996-9749

Constituency Offices
70 Queensway West
Simcoe, Ontario
Telephone: (519) 426-3400
Fax: (519) 426-0003

Human Resources and Social Development
Place du Portage, Phase IV,
14th Floor 140 Promenade du Portage
Gatineau, Quebec
K1A 0J9
Telephone: (819) 994-2482
Fax: (819) 994-0448

The Hon. Lawrence Cannon, P.C., M.P.
Minister of Transport, Infrastructure and Communities
Why him? See below for the role of this office in the minister's own words. Remind him we're not only interested in public transportation. Make him aware that addiction is one of the "realities around us". 7278 members of the downtown Eastside community are registered at Insite.

Parliament Hill:
House of Commons
Ottawa, Ontario
K1A 0A6
Telephone: (613) 992-5516
Fax: (613) 992-6802

Constituency Offices
127 Joseph Street (Main Office)
Gatineau, Québec
J8L 1G1
Telephone: (819) 281-2626
Fax: (819) 281-2755

143-B Principale Street South
Maniwaki, Québec
J9E 1Z8
Telephone: (819) 441-2510
Fax: (819) 441-2680

Transport, Infrastructure and Communities
Place de Ville, Tower C, 29th Floor
330 Sparks StreetOttawa, Ontario
K1A 0N5
Telephone: (613) 991-0700
Fax: (613) 995-0327

Notes for an address by the Honourable Lawrence Cannon Minister of Transport, Infrastructure and Communitesto the Federation of Canadian MunicipalitiesMontréal, Quebec June 4, 2006
(from: --accessed Aug 30, 2006)

[On the role of his office]: …Our goal is to build on the vitality of our cities and communities, and use our transportation system to make Canada more competitive in the global economy.

To do this, we need to be clear about how the pieces fit together. My approach has three main elements: understanding the world we live in, developing strategies to deal with this, and turning this into action.

First, we need to recognize that our challenges are rooted in the realities of the world around us. Consider dynamics like globalization, the rise of China and India, and the importance of our partnership with the United States.
Second, how do we respond to these challenges? We have to choose the strategic priorities on which action is required, a federal role is justified, and for which my portfolio is entrusted with practical tools.
There are four:
Economic competitiveness;
Quality of life;
The environment; and
Accountability to Canadians.

These four strategic priorities represent challenges of national scope, and important federal responsibilities. Those responsibilities include legislation, policies and investments that underpin the national transportation system, particularly its efficiency, safety, security and sustainability; the management of our borders; and investments in strategic and community infrastructure.

While each of these are legitimate areas for concrete federal actions, they will also demand strong partnerships with provincial and territorial governments, and our partners in Canada’s municipalities.
They will also require transparency and accountability on the part of all governments, and a renewed emphasis on results.

And finally, the third and most important of three main elements of this portfolio strategy – action. Over the coming months, I will be advancing practical, specific measures in four inter-related areas:
Sustainable infrastructure, which I will expand on shortly;
Transportation Gateways and Trade Corridors, starting with the Asia-Pacific Gateway Initiative to prepare for expanding trade with Asia;
Transportation security, including public transit; and
Building strong communities that offer a healthy environment and a good quality of life. (emphasis added)

Canada has been one of the great political and economic success stories of the 20th century. Together, we can ensure that Canada remains a model for the world, admired and even envied for its respect for diversity, the rule of law, and for the quality of life it offers its citizens. By building stronger communities, safer and more prosperous cities, by modernizing and developing our infrastructure and by cleaning up the environment, we are building a better Canada for future generations.

Recent update

From the Globe and Mail, Aug. 31, 2006
Safe-injection-site supporters demand answers from Ottawa
With deadline looming, Ottawa says fate of Insite facility to be announced 'shortly'

VANCOUVER -- The federal government was urged yesterday to stop delaying its decision about whether to permit a safe-injection facility in Vancouver to continue operating after Sept. 12.

"It is getting kind of late in the game," said Thomas Kerr, a scientist at the B.C. Centre of Excellence in HIV/AIDS, who has conducted a number of scientific studies about the impact and effectiveness of the Insite facility.

"We have a community that is waiting to find out what is going to happen. We have a large research staff that is wondering whether they are going to continue gathering data in two weeks," Dr. Kerr said. "What we need is an answer."

Prime Minister Stephen Harper was a few blocks from the news conference held by supporters of Insite and declined to provide that answer, even though the facility's exemption from the country's drug laws expires in less than two weeks.

"The safe-injection site decision is the Health Minister's decision," Mr. Harper said after announcing a federal funding commitment for the 2010 Winter Olympics.

"I won't be announcing anything myself on that, on this trip. I anticipate he [Health Minister Tony Clement] will be making an announcement on that very shortly."

The Health Minister travelled to Sweden last week and is believed to have spoken to drug policy officials in that country about the merits of safe-injection sites.

"It is kind of a curious choice because Sweden has no experience with these facilities," Dr. Kerr said. "We don't need to go to Sweden to look for these answers. We have the Vancouver Police Department, Vancouver Coastal Health and many community organizations doing some of the most innovative work in the world."

The pilot project, which has operated for the past three years, permits addicts to inject their drugs in clean surroundings, supervised by trained staff.

The continued operation of the Insite facility has been endorsed by the chief of police in Vancouver, Mayor Sam Sullivan, community leaders and four former mayors.

With the deadline looming for the federal government to make a decision about the site, the RCMP issued a news release this week that said it had concerns and called for more scientific research.

Dr. Kerr explained that there have been 15 scientific studies about the impact of the site and many have been published in prestigious journals such as The Lancet and the New England Journal of Medicine.

"My great disappointment is that the RCMP has failed to acknowledge scientific evidence that the international scientific community has endorsed and accepted," he said.

He noted that the RCMP commissioned two reports from criminologists about the community impact of the safe-injection facility, which were favourable. "Yet we are not hearing about those reports," Dr. Kerr said. "I think it's time to acknowledge that this is a simple medical intervention. A sterile injection is better than an unsterile injection."

Susie Ruttan, a teacher whose son is recovering from drug addiction, also praised the Insite facility. "It just comes down to saving lives. What can possibly be argued against that?"