By Alex Richards
It is almost universally accepted that drug addiction is a serious global issue. Not only does addiction wreak pitiless destruction on the health and personal life of the addict, it is also a major cause of other crime, as a result of both gangs’ and drug cartels’ attempts to control the lucrative trade of illicit drugs and addicts’ attempts to appease addiction’s physiological extortion.
But despite decades of harsh prohibition and countless billions spent on the policing and incarceration of narcotics growers, processors, dealers and users, abuse of hard drugs is still entrenched in contemporary society. As such, many people have come to doubt traditional methods of dealing with this social ill due to their high financial cost and perceived ineffectiveness, as well as ethical concerns over the ostracism and incarceration of addicts.
Safe injection sites, sometimes called supervised injection sites or drug consumption rooms, were devised as an alternative to the strictly prohibitionist measures which compose the vast majority of drug policy across the globe. Following the harm reduction philosophy, safe injection sites aim to reduce the negative impact of drug abuse while making it easier for addicts to quit drugs. Safe injection sites are a designated space (usually indoors) where addicts can use drugs more safely and without fear of legal reprisal. The sites provide clean needles to addicts to help prevent the spread of serious blood-borne diseases such as AIDS and hepatitis, have medical staffs to treat overdoses, and offer access to medical and rehabilitation services that would otherwise not reach many addicts who are often homeless, impoverished or mentally ill [1,2,3].
The first government-sanctioned safe injection site opened in Berne, Switzerland in 1986, and sites can now be found in Europe, Australia and Canada [2,4,5]. The first safe injection site in North America opened in Vancouver’s Downtown Eastside in 2003. The Downtown Eastside is a poverty-stricken [1,6,7] area of Vancouver which is experiencing what has been described as an “injection drug epidemic”. It is estimated that in 2000, there were approximately 4,700 injection drug users living there. It also estimated that 17 to 31 percent of intravenous drug users are HIV-positive and that the total medical costs of HIV in IDUs in Vancouver’s Downtown Eastside is upwards of $215 million [8]. The safe injection site, known as Insite and operated primarily by Vancouver Coastal Health, was created to help salve the dire effects of the crisis on the area’s social and medical well-being.
Vancouver’s safe injection site has certainly been busy, running at near capacity almost since its opening [1]. In the two year period between April 1, 2005 and March 31, 2007, 7648 different individuals were registered at the site, and there were an average of 645 users per day. Many would argue that Insite has accomplished its intended goals; During that same 2 year period, more than 2,500 referrals were made for addiction counseling and although there were 696 overdoses, there was not a single fatality at the site [9].
Despite the relative success of Insite, vehement criticism of safe injection sites is still plentiful. Federal Health Minister Tony Clement is a noted critic of safe injection sites, as is the Conservative government in general, citing them as unethical [10,11,12]. Opponents argue that it is wrong to let people use drugs with impunity and that safe injection sites are a dangerous legal double standard [6,13,14]. The International Narcotics Control Board, an independent UN organization, has expressed concerns that Insite violates international drug treaties [15,16,17]. Some people have also argued that injection sites increase crime in the local area and lead to increased drug use [6,18,19]. However, a report completed by two BC criminologists and commissioned by the RCMP refuted these fears (at least in the Vancouver context), finding that Insite neither increased crime nor drug use in the surrounding area [6,20,21].
Even now that Canadians have been able to observe the effects and results of a safe injection site, public opinion remains very divided.
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