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Supporting a Safer Vancouver

About InSite

Who does InSite serve?

Injection drug users based in Vancouver's Downtown Eastside suffer from addiction, often to more than one drug. They are frequently also mentally ill; homeless; of Aboriginal descent; or have a history of trauma. Many also have HIV/AIDS, or hepatitis C.

How did InSite get its start?

Injection drug use continues to be a critical problem in Vancouver BC. Health Canada, recognizing the harms associated with injection drugs for both users and the community, developed guidelines to apply for a supervised injection site scientific research pilot project. The location was selected in accordance with pre-established criteria that included accessibility to active injection drug users, costs development, operating permits and community impact.

In June 2003, Health Canada granted Vancouver Coastal Health and PHS Community Services Society an exemption under Section 56 of the Controlled Drugs and Substances Act (CDSA) to establish a supervised injection site scientific research pilot project at 139 East Hastings Street in Vancouver's Downtown Eastside.

InSite had its first injection on September 21, 2003.

How does InSite work?

Participants using the supervised injection site are checked into a database by codenames before injecting, which allows InSite staff to track usage with compromising participants' anonymity.

InSite participants then have access to a 12 seat injection room where they can inject their own drugs under the supervision of nurses and trained staff. They have access to clean injection equipment, including syringes, sterile cookers, filters, water and tourniquets. The use of this equipment has been shown to reduce the spread of infectious diseases as well as reduce the number of serious soft-tissue infections, which intravenous drug users are susceptible to.

After injecting, participants move to a post injection room, where they can have a glass of water and rest until they feel ready to leave the premises. Staff are on-hand to help connect participants to other services including primary care for treatment of wounds, abscesses and other infections, addiction counseling and peer support and referral to treatment services such as withdrawal management, opiate replacement and other services. Staff can also refer participants directly to OnSite, a 30-bed detox and treatment program that is co-managed by the PHS Community Services Society and Vancouver Coastal Health, located right above the supervised injection site.

What are the benefits of InSite?

Insite is a harm reduction program that is meant to be part of a continuum of care for people with addiction, mental illness and HIV/AIDS. For many injection users, InSite is the first step in the recovery process, the goal being to move participants towards health and addiction services that will keep them alive, and eventually improve their health. Some of the ways that InSite benefits participants and the community:

  • Connecting participants to programs: InSite engages a marginalized population that is hard to reach through conventional methods, mainly due to their struggles with homelessness, one or more mental illnesses, injection dug addictions and trauma. The non-judgemental environment at Insite helps participants to develop trusting relationships with the staff, which in turn helps the staff connect them to key services and programs that they might not otherwise access.

  • Limiting the spread of disease: InSite participants have access to clean equipment and education on safe-injection practices, which helps limit the spread of diseases such as HIV/Aids and hepatitis C.

  • Overdose prevention: Participants injecting at InSite are supervised by nurses, who ensure that medical help is immediate should an overdose occur. To date, well over 2400 overdoses have occurred at InSite, with no fatalities.

  • Increased public order: InSite contributes to increased public order by helping to limit public injections and discarded syringes.

  • Cost-effective health care: Preventative health measures provided by InSite (by limiting overdose deaths and the spread of diseases such as HIV/AIDS and hepatitis C) saves the health care system over $6 million annually.


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