The PHS Community Service Society operates North America’s first legal supervised injection site (Insite) in partnership with Vancouver Coastal Health (VCH). Insite provides a safe and clean environment where users can inject their own drugs under the supervision of clinical staff. Counsellors and nurses provide access and referral to drug treatment, health care, and mental health services, as well as first aid and wound care.
Since opening its doors in 2003, Insite has been a safe, health-focused place where people can go to inject drugs and connect to health care services – from primary care to treat disease and infection, to addiction counselling and treatment. Insite is an integral part of Vancouver Coastal Health’s continuum of care for people with addiction, mental illness and HIV/AIDS in the Vancouver community.
Insite was designed to be accessible to injection drug users who are not well connected to health care services, a population that includes: men and women who use more than one drug; people who experience both addiction and mental illness; people with a history of trauma; people who are homeless, live in shelters or live in substandard housing; men and women of Aboriginal descent; and people who have tried unsuccessfully in the past to beat their drug addiction.
Insite currently operates under a constitutional exception to the Controlled Drugs and Substances Act. The BC Ministry of Health provides operational funding for Insite through Vancouver Coastal Health.
Insite has benefitted from a comprehensive peer-reviewed evaluation process – the first such evaluation of a supervised injection facility worldwide. As such, the information available on patterns of use and outcomes is both comprehensive and reliable. And the results speak for themselves.
• 750 – 800 visits per day
• 257,575 visits per year
• Average of 11 visits per month, per person
• More than 10,000 unique individuals registered at Insite to date
• 27% of clients are women
• 19% of clients are Aboriginal
• 17% of clients are homeless
• 68% of clients live in the Downtown Eastside (DTES)
• 80% of clients have a history of incarceration
• 73% of users have injected in public before
• Heroin was used in 42% of injections
• Cocaine was used in 26% of injections
• Morphine was used in 11% of injections
• 3 in 10 injection drug users in the DTES are HIV positive
• 18% of Insite clients are HIV positive
• 30 new HIV cases in the DTES in 2006 compared to 2,100 cases in 1996
• Lifetime costs for a new HIV infection are close to $500,000 USD
• 9 in 10 injection drug users in the DTES have Hepatitis C
Harm Reduction At Insite
• Number of overdose interventions: 2395. Number of deaths: 0
• 3,862 first aid and medical care interventions
• 2,269 referrals to social and health services (40% made to addiction counselling)
• Insite users are twice as likely to engage in addiction treatment than non-Insite users
Benefits to the Health Care System
• Benefit of prevented HIV infections deaths is calculated to be between $1.50 and $4.02, depending on model used, for every dollar spent. These calculations are based upon an underestimate of the full range of benefits and an overestimate of the annual costs of operation of the facility.