Vancouver Safe Injection Site --- A 10 Year Success Story

[G Huxley]

After a decade of being open, there still hasn't been one single fatal overdose at the Vancouver Safe Injection Site. HIV transmission via needles have also decreased significantly in the area.

http://www.vancouversun.com/news/Insite+anniversary+Vancouver+safe+injection+site+celebrates/8939148/story.html

In fact the program has been so successful Health Canada has actually recommended that addicts receive free prescription heroin drawing the irk of the Conservative Hypocrite Government.

http://www.cbc.ca/news/politics/health-canada-heroin-decision-draws-minister-s-rebuke-1.1862601

[Shady]

Free everything for everybody!!!!

Edited September 22, 2013 by Charles Anthony
deleted re-copied Opening Post

[The_Squid]

Free everything for everybody!!!!

You do know that they don't supply drugs, right? Or do you? Or would it even matter to your silly rhetoric?

[Guest]

The only way to win the "war on drugs" is to ensure that people cannot profit by supplying drugs illegally. The only way to do that is to supply them legally.

An addict is going to get drugs. I would far rather (s)he got them from a safe source administered by a competent professional at a cost (s)he can afford, than (s)he gets them by coldcocking some granny for her pension, then giving that to some scumbag for a product that is, in all likelihood, so diluted with crap that the process repeats far more often than would a visit to the clinic.

[cybercoma]

Free everything for everybody!!!!

What's free? InSite has been around for a decade and it sounds like you still have no idea what they do there. It's a safe injection site. That's not rhetoric. It's literally a place where people are supervised for their safety, while they inject their own drugs. Drugs that they bring to the site themselves. It's not some bar that people go to and get free drugs.

[cybercoma]

The only way to win the "war on drugs" is to ensure that people cannot profit by supplying drugs illegally. The only way to do that is to supply them legally.

An addict is going to get drugs. I would far rather (s)he got them from a safe source administered by a competent professional at a cost (s)he can afford, than (s)he gets them by coldcocking some granny for her pension, then giving that to some scumbag for a product that is, in all likelihood, so diluted with crap that the process repeats far more often than would a visit to the clinic.

That's not what InSite does. They don't provide drugs at all. Or are you talking about some hypothetical situation that you would like to see?

[Bonam]

After a decade of being open, there still hasn't been one single fatal overdose at the Vancouver Safe Injection Site. HIV transmission via needles have also decreased significantly in the area.

I would say that the greatest measure of success of a program intended to address the drug addiction issue (which InSite definitely is, being one of the "pillars" of Vancouver's drug strategy) would be the number (per capita) of addicted people within the area/jurisdiction of that program, and how that number changes over time. Has the number of drug addicts in Vancouver gone up or down?

Edited September 22, 2013 by Bonam

[cybercoma]

I would say that the greatest measure of success of a program intended to address the drug addiction issue (which InSite definitely is, being one of the "pillars" of Vancouver's drug strategy) would be the number (per capita) of addicted people within the area/jurisdiction of that program, and how that number changes over time. Has the number of drug addicts in Vancouver gone up or down?

The number of deaths related to drug use have gone down. Is that not important too?

[Guest]

That's not what InSite does. They don't provide drugs at all. Or are you talking about some hypothetical situation that you would like to see?

Hypothetical situation. I lived in Vancouver for many years and I know what InSite does. I would like to see the concept carried much further.

I know it won't be. Not for a while, anyway.

Edit> I wondered why I didn't make that clear in my post. I think it was because I was responding more to Squid's comment about supplying drugs in the post preceding mine.

Edited September 22, 2013 by bcsapper

[Bonam]

The number of deaths related to drug use have gone down. Is that not important too?

Sure, it's also important. Although, the OP does not make that claim. It says the number of deaths at InSite is zero, it doesn't say what the number of deaths due to drugs in Vancouver as a whole has done (that may be in the links, I will admit I did not read the links, just the thread).

That being said, even if it does lower deaths, that still should be balanced against the prevalence of drug addiction. If, for example, 10 deaths were prevented, but at the same time, 100 more people are addicted to drugs that ruin their lives than otherwise would have been... is that a net improvement? Hard to say, in my opinion.

However, if drug addiction levels in Vancouver are down, and deaths are also down, then clearly they are doing things right. Do the stats show that?

Edited September 22, 2013 by Bonam

[G Huxley]

The stats show HIV transmission is down so that would be a considerable decrease in deaths.

but at the same time, 100 more people are addicted to drugs that ruin their lives than otherwise would have been... is that a net improvement

I don't think any more people are going to have gotten addicted, because of there being a safe place for addicts to shoot up.

[Bonam]

I don't think any more people are going to have gotten addicted, because of there being a safe place for addicts to shoot up.

Perhaps, perhaps not. Are there any stats on addiction rates in Vancouver over, say, the past 20 years, that would show how the trend in addiction rates changed (or didn't change) after the opening of InSite?

[cybercoma]

It's hard to see how InSite would create more addiction when they're not distributing the drugs. They're just making sure the people who take them don't die. So the numbers you're looking for might be disingenuous anyway. In theory, when someone addicted to drugs dies, that's one less person to count. If they stay alive, then they add to the number of people on drugs. So the numbers you're asking about could be interpreted in very different ways. What we do know is that InSite has provided addiction treatment to many people by referring them to the appropriate places for help (ie, OnSite, their affiliated treatment clinic) and InSite has stopped people from dying by providing a medically supervised safe place to inject. This has also cleaned up the streets of discarded drug paraphenelia, such as discarded and possibly infected sharps. It has demonstrable reduced the HIV transmission rates due to needle sharing and other high-risk behaviours.

So I would say the number you're seeking is a red herring. There are a great many positive things InSite has done, regardless of the addiction rate. Let's say the rate has increased. The implication is that InSite is causing more people to do drugs. How do you prove that? How do you show InSite is the cause of addiction without some sort of longitudinal analysis that controls for other factors that may contribute to an increase in drug use in the area? It would be extremely difficult. In any case, it would be irrelevant and no argument against all of the harm reduction that they've demonstrably provided to the community.

[Bonam]

It's hard to see how InSite would create more addiction when they're not distributing the drugs. They're just making sure the people who take them don't die. So the numbers you're looking for might be disingenuous anyway. In theory, when someone addicted to drugs dies, that's one less person to count. If they stay alive, then they add to the number of people on drugs. So the numbers you're asking about could be interpreted in very different ways. What we do know is that InSite has provided addiction treatment to many people by referring them to the appropriate places for help (ie, OnSite, their affiliated treatment clinic) and InSite has stopped people from dying by providing a medically supervised safe place to inject. This has also cleaned up the streets of discarded drug paraphenelia, such as discarded and possibly infected sharps. It has demonstrable reduced the HIV transmission rates due to needle sharing and other high-risk behaviours.

So I would say the number you're seeking is a red herring. There are a great many positive things InSite has done, regardless of the addiction rate. Let's say the rate has increased. The implication is that InSite is causing more people to do drugs. How do you prove that? How do you show InSite is the cause of addiction without some sort of longitudinal analysis that controls for other factors that may contribute to an increase in drug use in the area? It would be extremely difficult. In any case, it would be irrelevant and no argument against all of the harm reduction that they've demonstrably provided to the community.

Indeed, it is difficult to separate the factors, and controlled studies are not feasible when we are talking about something like the drug addiction rate in a city. Nevertheless, if stats could show that both the death rate and the addiction rate declined, then that would speak to the success of Vancouver's overall strategy, of which InSite is a part. Without the statistics showing an improvement in all relevant metrics, it is difficult to do anything but speculate, as you do above.

How could Insite potentially cause more addiction in the area? There are many hypothetical possibilities about which we might speculate. For example, perhaps some drug addicts or potential drug addicts are smart enough to realize the danger they place themselves in by injecting unsafely, and this danger deters some of them from using drugs. Without that deterrance, since the danger is reduced at InSite, perhaps some of them continue to use drugs. Or, perhaps drug addicts from other areas move to the vicinity of InSite, since it seems to them like a there is a support infrastructure there from which they might benefit. Or, perhaps some addicts are less afraid of running up against the law, if they only inject in an area where it is officially allowed. But those are just speculative possibilities, which may or may not happen.

I am not against InSite. Perhaps InSite really does only have a positive impact and no negative effects, who knows? But that's kind of the point; I would simply like some definitive stats showing comprehensive improvement in a thread titled "a 10 year success story". So long as hard drugs are outlawed, the overall goal of a comprehensive strategy to deal with them is to reduce the number of users, hopefully eventually reducing it to zero. If the current strategy seems to be doing that, then that's great. If the stats don't show that, then one can hardly boast of its success.

[CPCFTW]

What's free? InSite has been around for a decade and it sounds like you still have no idea what they do there. It's a safe injection site. That's not rhetoric. It's literally a place where people are supervised for their safety, while they inject their own drugs. Drugs that they bring to the site themselves. It's not some bar that people go to and get free drugs.

You do realize that the op mentioned health canada recommending free heroin prescriptions right? Did it not occur to you that Shady might be referring to this?

Edited September 22, 2013 by CPCFTW

[G Huxley]

So long as hard drugs are outlawed, the overall goal of a comprehensive strategy to deal with them is to reduce the number of users, hopefully eventually reducing it to zero. If the current strategy seems to be doing that, then that's great. If the stats don't show that, then one can hardly boast of its success.

Here you go:

Ten Years After Decriminalization, Drug Abuse Down by Half in Portugal

http://www.forbes.com/sites/erikkain/2011/07/05/ten-years-after-decriminalization-drug-abuse-down-by-half-in-portugal/

[cybercoma]

Indeed, it is difficult to separate the factors, and controlled studies are not feasible when we are talking about something like the drug addiction rate in a city. Nevertheless, if stats could show that both the death rate and the addiction rate declined, then that would speak to the success of Vancouver's overall strategy, of which InSite is a part. Without the statistics showing an improvement in all relevant metrics, it is difficult to do anything but speculate, as you do above.

Econometric analysis is possible to determine the things we're discussing, but the problem is we don't have the data we would need to do the analysis. Longitudinal data is very expensive to collect and maintain. Collecting longitudinal data on people that may not have fixed addresses and will be difficult, if not impossible, to find from one cohort to the next makes it next to impossible. Which makes me think, that's another benefit to InSite. They allow us to observe drug addicts and gather information on them, potentially longitudinal data on the same individuals over time. This is practically impossible without a central spot where they will continue to go because it's safe for them to do so.

[cybercoma]

perhaps drug addicts from other areas move to the vicinity of InSite, since it seems to them like a there is a support infrastructure there from which they might benefit.

This has absolutely happened. And it has taken drug addicts out of residential alleyways, parks, and schoolyards where they would leave dirty needles and paraphernalia, endangering children and the rest of the public. That was one of the intentions of InSite: that addicts would go there instead of areas that would have a worse impact on society.

[eyeball]

This has absolutely happened. And it has taken drug addicts out of residential alleyways, parks, and schoolyards where they would leave dirty needles and paraphernalia, endangering children and the rest of the public. That was one of the intentions of InSite: that addicts would go there instead of areas that would have a worse impact on society.

It has also taken addicts away from other city's and smaller towns that should have their own InSites up and running. Many if not most of the real hard-core addicts in Vancouver likely originated from elsewhere - often with mental health issues that caused them to be driven away by stigmatization at home and drawn by the anonymity of the big city. How many of them only became addicts after they hit the city? Of course it would help if there were more mental health facilities available throughout the province/country but sadly they're often as shunned as InSites are.

It's not fair that big cities should bear the brunt of refugees from rural Canada's unwillingness to treat their own.

[Army Guy]

Do these INSITES treat addicts or is it just a free zone for addicts to shoot up with government provided drugs. I have a buddy who's sister is an addict, for the last 10 years, although she has substituted hard drugs for methodone she remains an addict...According to her methodone is become a currency in her world, it is often sold or traded for other drugs or money....and while it may be a start in the right direction, what is being done to get these people back into normal world....

[Moonlight Graham]

Do these INSITES treat addicts or is it just a free zone for addicts to shoot up with government provided drugs. I have a buddy who's sister is an addict, for the last 10 years, although she has substituted hard drugs for methodone she remains an addict...According to her methodone is become a currency in her world, it is often sold or traded for other drugs or money....and while it may be a start in the right direction, what is being done to get these people back into normal world....

The sites have an area for counselling and for people who want to enter rehab and get off the drugs, yes. To include something like that would seem a pretty obvious decision to me.

Edited September 23, 2013 by Moonlight Graham

[Army Guy]

It would seem obvious to me as well, but i had to ask, So what is the plan for addicts who don't want rehab or counselling, who take advantage of those free drugs for instance like my buddies sister who has been getting her free methadone for 10 years now...She is not alone this has been going on for sometime in fact methadone has become a currency in it self, it is sold, and traded...

[GostHacked]

You do realize that the op mentioned health canada recommending free heroin prescriptions right? Did it not occur to you that Shady might be referring to this?

It's kind of hard to know what Shady is referring to.

[The_Squid]

...or is it just a free zone for addicts to shoot up with government provided drugs.

The gov't does not provide drugs at Insite... if they are on methadone, then they are getting that from a doctor, likely in a treatment program.

Not sure how many times this has to be said before people stop repeating that fallacy.

Edited September 23, 2013 by The_Squid

[cybercoma]

It would seem obvious to me as well, but i had to ask, So what is the plan for addicts who don't want rehab or counselling, who take advantage of those free drugs for instance like my buddies sister who has been getting her free methadone for 10 years now...She is not alone this has been going on for sometime in fact methadone has become a currency in it self, it is sold, and traded...

The plan is to make sure they don't spread HIV, aren't littering the street with needles, and hopefully live long enough that they eventually choose to enter rehab.