Insite

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Insite is the first legal supervised injection site in North America, located at 139 East Hastings Street, in the Downtown Eastside (DTES) neighborhood of Vancouver, British Columbia. DTES had 4700 drug addicts in 2000 and has been considered to be the center of an "injection drug epidemic".^[1] The site provides a clean, safe location for injection drug use, primarily heroin, cocaine, and morphine. Medical staff are present to provide addiction treatment, mental health assistance, and first aid in the event of an overdose or wound. Over a two year period ending March 31, 2006, the site recorded an average of 607 visits per day and 453 overdoses total, with none resulting in a fatality.^[2] Health Canada has provided $500,000 per year to operate the site, and the BC Ministry of Health contributed $1,200,000 to renovate the site and cover operating costs.

Contents 1 Operation 2 Research 3 Support and criticism 3.1 JGDPP article 4 Government 5 References 6 External links

[edit] Operation

Insite has been operated since 2003 by Vancouver Coastal Health, under a special exemption of Section 56 of the Controlled Drugs and Substances Act, granted by the Liberal government via Health Canada.^{[citation needed]} The site was slated to close on September 12, 2006, as the exemption was for a three year pilot project.^{[citation needed]} The new Conservative government granted a temporary extension, then added a six month extension that ends mid-2008.^{[citation needed]}

[edit] Research

Since opening, the site has been the focus of numerous scientific studies, in peer-reviewed journals such as the New England Journal of Medicine, The Lancet, the British Medical Journal, and the Canadian Medical Association Journal.^[specify] Findings have shown that the site has led to a reduction of public injections, neighbourhood litter, and needle sharing.^[3] It has also led to an increase in detoxification and addiction treatment,^[4] and has not been shown to increase crime or rates of relapse in former drug users.^[2]

[edit] Support and criticism

Partners of Insite include the City of Vancouver, the Vancouver Police Department, and the PHS Community Services Society.^[5] The site has the support of Vancouver's mayor Sam Sullivan,^[6] Premier of British Columbia Gordon Campbell,^[7] and former high-profile Vancouver mayors Larry Campbell, Mike Harcourt, and Philip Owen.^[8] The International AIDS Society and the B.C. Centre for Excellence in HIV-AIDS,^[9] and the Canadian Union of Public and General Employees^[10] also support Insite. Though originally opposed to the safe injection site, Chinatown and Gastown merchants associations now support it.^[8] International supporters include the UK-based think tank Senlis Council^[11] and the Australian Parliamentary Group for Drug Law Reform.^[6]

The site has drawn criticism from the Bush administration; the director of the White House Office of National Drug Control Policy called it "state-sponsored suicide" at the time of its opening.^[6] Though it is not within their jurisdiction, individual members of the Royal Canadian Mounted Police (RCMP, Canada's national police force), have spoken out against Insite. This is despite the fact that a report commissioned by the RCMP (conducted by two criminologists) concluded in favour of the injection site.^[12]

[edit] JGDPP article

The most significant published criticism has been an article by Colin Mangham, the director of research for the Drug Prevention Network of Canada, in the non-peer-reviewed Journal of Global Drug Policy and Practice (JGDPP). In the article Mangham claimed that, “the published evaluations and especially reports in the popular media overstate findings, downplay or ignore negative findings, report meaningless findings and overall, give an impression the facility is successful, when in fact the research clearly shows a lack of program impact and success.”^[13] Based on this article, Tony Clement told an August 2007 meeting of the Canadian Medical Association his belief that Insite should close was reaffirmed. Clement stated that "there has been more research done, and some of it has been questioning of the research that has already taken place and questioning of the methodology of those associated with Insite."^[14]

However, Clement's use of Mangham's article as justification in criticizing Insite has been called into question because of the fact that Mangham's article completely dismisses over 20 peer-reviewed studies from journals such as The Lancet, the New England Journal of Medicine, the British Medical Journal, all of which indicate that Insite has a positive effect.^[15] The JGDPP article, which was commissioned and financed by RCMP, has drawn further criticism for being "fraught with a host of outright factual inaccuracies and unsubstantiated claims."^[16] The JGDPP was itself created by two divisions of the Drug Free America Foundation,^[17] and partly funded by the U.S. Department of Justice.^[18]

[edit] Government

While the Liberal government allowed Insite to open, since 2006 its fate has been the responsibility of the new Conservative government, which has not been as supportive of it. Conservative Prime Minister Stephen Harper has voiced opposition to the injection site in the past, saying that "We as a government will not use taxpayers' money to fund drug use."^[19] In mid-July 2006, Conservative Member of Parliament David Fletcher stated that the their government would let Insite's special exemption lapse before deciding whether to continue the project.^{[citation needed]} The following week a spokesman for Tony Clement, the Minister of Health, refuted that, saying that a decision had not been made yet.^[20] During the XVI International AIDS Conference, held in Toronto, two high-ranking Liberal MPs (Bill Graham and Keith Martin) put their support behind the centre, and criticized the Conservative government for delaying their decision.^{[citation needed]} Insite supporters also demonstrated in Toronto during the conference, prompting the government to further delay any announcement, citing the week's 'politicized' nature.^[19]

On September 1, 2006, Health Minister Tony Clement deferred the decision of whether to extend the exemption for the site, citing a need for more research.^[12] However, on the same day the government cut all funding for future research, amounting to $1.5 million in lost research money.^[21] On August 13, 2007, the Portland Hotel Society and two drug addicts filed suit in the BC Supreme Court to keep the centre open, arguing that its closure would be a violation of the Charter right of Insite users to "security of the person."^[22]

On October 4, 2007, during the announcement of its $64-million drug strategy, the Conservative government announced that Insite will be granted another six month extension, allowing it to operate until June 30, 2008.^[7]

The future of Insite continues to be in limbo. In May 2008, the B.C. Supreme Court struck down sections of the Canadian Criminal Code prohibiting drug trafficking and possession, ruling that they contravened the Canadian Charter of Rights and Freedoms. This decision would give the site legal grounds to continue operating. However, the federal government has announced plans to appeal that decision to the Supreme Court of Canada.^[23]

[edit] References

[edit] External links

• Insite website
• Vancouver Coastal Health website

Coordinates: 49°16′52″N 123°06′04″W / 49.28111°N 123.10111°W / 49.28111; -123.10111