Supervised injection site accelerating initiation into detox

published on June 8, 2006

(Vancouver) – Vancouver’s pilot supervised injection site is leading to increased uptake into detoxification programs and addiction treatment, reveal new findings from the B.C. Centre for Excellence in HIV/AIDS.

The findings, published in the New England Journal of Medicine, show that more regular use of the facility, known as Insite, and any contact with the facility’s addictions counsellor, were both strongly tied to quicker initiation into detoxification.

The findings demonstrate the facility is bringing drug users off the street and into the first steps of addiction-treatment services, says Dr. Thomas Kerr, one of the study’s senior authors.

“The detoxification service rates are particularly significant considering Insite is reaching a class of injection drug users who are least likely to access care,” says Kerr.

Among a total of 1,031 randomly selected repeat attendees of Insite, 185 injection drug users (18 per cent) began a detoxification program during follow-up. Contact with Insite’s addictions counsellor was among the strongest independent predictors of more rapid initiation.

Importantly, the data underlines that Insite is a proven entry-point for the Downtown Eastside’s highest-risk injection drug users, says Dr. David Marsh, Physician Leader, Addiction Medicine, Vancouver Coastal Health.

“Insite is providing a means for marginalized individuals to access the health-care system, including addiction treatment," says Marsh.

Another recent Centre study highlights that Insite has not led to an increase in drug-related crime. The study, published last month in Substance Abuse Treatment, Prevention, and Policy, compared annual periods before and after the opening of Insite. Rates of arrest for drug trafficking, assaults and robbery were similar after the facility’s opening, although rates of vehicle break-ins/theft declined significantly. The results are consistent with a recent study of the impact of Australia’s first supervised which concluded that the Sydney facility was not associated with an increase in the proportion of drug use or supply offences.

The recent findings follow several similarly positive studies published in leading medical journals over the past two years.

Past Insite-related studies have revealed:

Insite has reduced the number of people injecting in public and the amount of injection-related litter in the Downtown Eastside, both notable improvements for people who live and work in the neighbourhood. (Canadian Medical Association Journal)
Insite is attracting the highest-risk users – those more likely to be vulnerable to HIV infection and overdose, and who were contributing to problems of public drug use and unsafe syringe disposal. (American Journal of Preventive Medicine)
Insite has reduced overall rates of needle sharing in the community, and among those who used the supervised injection site for some, most or all of their injections, 70% were less likely to report syringe sharing. (The Lancet).
Nearly one-third of Insite users received information relating to safer injecting practices. Those who received help injecting from fellow injection drug users on the streets were more than twice as likely to have received safer injecting education at Insite (The International Journal of Drug Policy).
Insite is not increasing rates of relapse among former drug users, nor is it a negative influence on those seeking to stop drug use. (British Medical Journal)

BC Centre for Excellence in HIV/AIDS

Search form

Supervised injection site accelerating initiation into detox

Search form