Inside Insite

The debate around supervised injection facilities (SIF) rages on more than a decade after the opening of Insite, Canada’s first supervised injection site in Vancouver. Recently, an article published in the journal Addiction reignited the discussion when it made a financial case for introducing facilities in Ottawa and Toronto. The model predicts that the introduction of two SIFs in Ottawa and three in Toronto would be a cost-savings measure to prevent the spread of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) among intravenous drug users (IVDUs). Over 600 total cases of HIV or HCV are projected to be averted in a 20-year period, saving over $40 million in healthcare costs in Toronto and over $30 million in Ottawa. Opponents deny the benefits of safe injection sites despite research conducted on Insite, which suggest that these facilities have tremendous utility and are economically viable. Insite targets and attracts high-risk IVDUs, fosters safer injection habits and prevents transmission of needle-sharing diseases. Insite’s facilities also offer complementary detoxification and rehabilitation services and encourage users to register for these programs. In contrast to arguments made by opponents, Insite has not been found to increase incidental overdoses, neighbourhood crime rates, or public disposal of needles. Given the outcomes of research conducted on Insite, the viability of similar facilities in Ontario should be further explored.

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French People’s positions on supervised injection facilities for drug users

Substance Abuse Treatment Prevention and Policy ◽

10.1186/s13011-020-00321-2 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Maria Teresa Munoz Sastre ◽

Lonzozou Kpanake ◽

Etienne Mullet

Keyword(s):

Health Professionals ◽

Drug Users ◽

Political Orientation ◽

Staff Members ◽

Rehabilitation Programs ◽

Supervised Injection ◽

Safe Injection ◽

Supervised Injection Facilities ◽

Set Up ◽

Unsafe Injection

Abstract Background Supervised injection facilities have been set-up in many countries to curb the health risks associated with unsafe injection practices. These facilities have, however, been met with vocal opposition, notably in France. As harm reduction policies can only succeed to the extent that people agree with them, this study mapped French people’s opinions regarding the setting-up of these facilities. Method A sample of 318 adults--among them health professionals--were presented with 48 vignettes depicting plans to create a supervised injection facility in their town. Each vignette contained three pieces of information: (a) the type of substance that would be injected in the facility (amphetamines only, amphetamines and cocaine only, or amphetamines, cocaine and heroin), (b) the type of staff who would be working in the facility (physicians and nurses, specially trained former drug users, specially trained current drug users, or trained volunteers recruited by the municipality), and (c) the staff members’ mission (to be present and observe only, technical counselling about safe injection, counselling about safe injection and hygiene, or counselling and encouragement to follow a detoxification program). Results Through cluster analysis, three qualitatively different positions were found: Not very acceptable (20%), Depends on staff and mission (49%), and Always acceptable (31%). These positions were associated with demographic characteristics--namely gender, age and political orientation. Conclusion French people’s positions regarding supervised injection facilities were extremely diverse. One type of facility would, however, be accepted by a large majority of people: supervised injection facilities run by health professionals whose mission would be, in addition to technical and hygienic counselling, to encourage patrons to enter detoxification or rehabilitation programs.

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