Supervised Injection Sites

Researcher: Alex Reurink

What it is:

Supervised injection sites (SIS) are legally sanctioned facilitates where drug users can come to safely inject illicit drugs, primarily opioids and cocaine. SIS’ are a step up from methadone clinics, the main difference between the two being that SIS have medical staff that supervise the injections. The focus for the SIS is harm reduction, not merely through the use of clean needles like dispensary programs, but to ensure that intake itself is not lethal to the individuals who are addicted to said drug. They all have programs in place to help individuals wean themselves off the drugs, have access to sterile needles, and various other programs to get these people back on their feet again.

Where can SIS be found in Canada:

SIS can be found only in Vancouver, however several other large cities (Toronto, Montreal and Ottawa) are well on their way to creating SIS, with city councils approving multiple sites. Smaller cities have been in the works of putting in SIS as well, one of them being London, Ontario.

How does this affect London?

This past February a research study was conducted by the Ontario HIV Treatment Network involving 199 interviews in order to assess the willingness of drug users to use SIS. Along with this they also interviewed 20 representatives from various related fields (such as health care and government) to get their feedback as well. In London, HIV has been on the rise, along with Hepatitis C due to the increased use of dirty needles and not having proper care when dealing with drugs.  The study found that 86% of the people interviewed would use SIS. The Ontario HIV Treatment Network concluded their study expressing their opinion that SIS should be located either downtown or in the Old East Village.  

The Study:

Supervised injection sites

Pros:

  • Creates what is called the “community order” concept: by focusing on a harm reduction approach to drugs it has lead (in Vancouver) to an overall reduction in drug-related health issues and other harmful activity in the area, since neighbourhoods with high populations of drug users usually have greater issues with property damage, dirty needles, and overdosing deaths.
  • There is no disruption of public order, SIS emphasize efficient operation and discretion
  • Better access for medical aid (through the nurses and medical staff there), as well as greater access to rehab programs
  • There is an economic advantage, since SIS helps prevent HIV/AIDS it saves time and money on having to run those tests at hospitals on a more frequent basis
    • Example: A study of a prospective SIS in Montreal found that 11 cases of HIV and 65 cases of HCV could be prevented each year in that city (ohtn.on.ca)

Challenges:

  • The waits can be very long, especially when these people receive their welfare cheques (it can be up to 30 mins). This is problematic because these people are experiencing withdrawal symptoms and may not be willing or able to wait for that long
  • The relationships can become quite strong between the medical staff and the users, which has created a problem of the users feeling like they are letting the staff down by being there, and thus avoiding the sites altogether
  • Very few of them are open 24/7
  • Most places do not allow for assisted injection (having someone inject it for them, or having some help while they do it themselves). Many people who use drugs require assistance due to various factors (such as being disabled, intoxicated, or are in withdrawal).
  • SIS does not allow for people to split drugs while on the premises, even though many drug users buy in bulk together to reduce costs.  

 

Bibliography:

http://www.lfpress.com/2017/02/08/londons-safe-injection-site-should-be-in-old-east-village-or-downtown-survey-finds

http://www.lfpress.com/2017/02/06/study-about-safe-injection-site-in-london-to-be-released-wednesday

http://ipolitics.ca/2017/01/18/where-canadian-cities-stand-on-supervised-injection-sites-poll/

http://www.ohtn.on.ca/Pages/Knowledge-Exchange/Rapid-Responses/Documents/RR83-Supervised-Injection-Effectiveness.pdf

http://cscsottawa.ca/news/supervised-injection-sites-and-needle-exchanges-why-harm-reduction-matters-for-public-health

http://www.torontosun.com/2016/07/03/pros-and-cons-of-safe-injection-sites

http://www.ohtn.on.ca/wp-content/uploads/2016/11/SIS-FAQ.pdf

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