Vancouver’s Supervised Shooting Up Site: 2,000 ODs, 0 Deaths

It’s been a long, bitter battle, and it’s not over yet, but now the prestigious medical journal The Lancet has put its stamp of approval on what has become common knowledge to most Canadians: "InSite," Vancouver's—and North America's—first (and, so far, only) legal drug-injection center in Vancouver, where medical staff provide clean needles to heroin and cocaine users, has reduced drug overdose deaths by 35% in its notorious Downtown Eastside that houses the highest population of needle addicts in Canada. The study found that drug overdoses do occur at Insite—but among its recorded 2,000 ODs, there has not been a single fatality (doctors are on hand with a ready supply of the anti-OD drug Naloxone). Earlier studies have shown that injection centers offer other public health benefits, including steering addicts into treatment and reducing hepatitis C and HIV infections. The study authors conclude: “Safe injection facilities should be considered where injection drug use is prevalent, particularly in areas with high density of overdose.”

Advocates of InSite, which remains a pilot project with a mere 12 injection seats that operate at full capacity (500 consumers a day), have been pushing to expand the facility's services to meet the needs of the city's estimated 5,000 IV drug users. But Canada's Conservative Party has attempted to close down InSite ever since its launch, arguing that it encourages illegal drug use. The province of British Columbia has been involved in a long-running battle with the federal government, while the Canadian Supreme Court will rule next month on another government attempt to close the service. In an op-ed in the Globe and Mail, Dr. Julio Montaner, the former president of the International AIDS Society who runs the site, makes the case that InSite "should be hailed as an innovative advance in medical care—not a political football to be punted about by the government of the day."  

The Dutch city of Rotterdam pioneered safe-injecting sites in the 1970s, and many European cities now offer them as part of local health services. Australia has a pilot project like InSite that is mired in similar political controversy. In the U.S., San Francisco and New York have made periodic attempts to establish a program like InSite, but the concept remains a tough sell to the average American politician and taxpayer.