P: Should the Government Sponsor Safe Injection Sites?

Substance abuse sucks. It’s probably one of the worst ways to degrade and disrespect your body. But it’s misleading to immediately connect “substance abuse” with “illegal drugs.” Look at all the other forms of substance abuse around us: people get addicted to sleeping pills, painkillers (a Tylenol a day keeps the doctor away), and hey, how about those caffeine-crazed university students? The only difference is that the government has decided that it’s okay to be addicted to these “harmless” drugs; therefore, providing safe ways to access and ingest these drugs is essential. However, the moment you turn to an illegal drug, you forfeit any chance of safety the government could offer.

Semantics aside, substance abuse is not a problem that will go away by banishing addicted users to the streets; such under-the-rug attitudes only exacerbate this critical issue.  In Vancouver’s Downtown Eastside, illegal drug abuse causes over 500 deaths per year. Downtown Eastside is trying to combat these problems with the start of Insite, a safe injection site.

Insite is a facility which allows drug users access to a safe environment to inject their drugs. Although Insite does not provide the drugs itself, it does provide drug users with a sterile drug-injection kit, including clean needles and water. Users also inject drugs under the supervision of a qualified nurse. Despite contravening federal law, Insite was granted an exemption in 2003 by Chretien’s government because it served a “medical or scientific purpose or (that) is otherwise in the public interest.” However, the exemption was not renewed in 2008.

Safe injection sites can decrease substance abuse problems and improve public well-being in a number of ways. First, it keeps drug users off the streets. With more safe injection sites, there would be fewer addicts congregating in back alleyways. As a result, a safe injection site also decreases the amount of infections and transmitted diseases from drug abuse. The most desperate of the drug addicts have been reported to search for drugs off the ground, use filthy and contaminated water from drains, and recover used needles from the streets to inject drugs. Over a third of users in the Downtown Eastside area are HIV positive due to this type of unofficial needle-sharing. With Insite’s sterile drug-injection kits, many of the associated problems with drug abuse can be drastically reduced.

Furthermore, studies have shown that Insite does, in fact, reduce the number of drug-related deaths in the Downtown Eastside area — the chance of overdosing on drugs is much less under the supervision of a nurse. In 2009, the site received over 702 visits per day and over 484 overdoses were treated before they became fatalities.

One of the main concerns about government-funded safe injection sites is the cost associated with such a facility. Many people are against the idea of the government spending public dollars to help out drug users who are clearly violating federal law. However, the cost of treating these drug users at a later time — when they are wounded or bleeding from unsafe drug practices — is much higher. For instance, the cost of running Insite is approximately $2,000,000 a year. Benefits include a large decrease in the amount of overdose deaths, and a reduction in transmitted diseases such as HIV/AIDS or Hepatitis C. Drug users could also have wounds from unsanitary injections that can be left untreated for over a year. When these users eventually do seek treatment, they often have to receive skin grafts, a form of plastic surgery, to heal their wound. If the skin grafts don’t work, the only remaining option is amputation. Considering Insite has been used by over 5,000 unique users per year, the combined cost of plastic and/or orthopaedic surgery for each user would be much higher than the $2,000,000 needed to run the facility.

The government already funds other forms of assistance to drug users such as the successful needle-sharing program in Vancouver, BC. Thus, programs supporting drug users, like safe injection sites, are already precedented by other effective government initiatives. Although Insite is the first safe injection site in North America, many other sites exist around the world. There are over 17 safe injection sites in Switzerland, 21 in Germany, and 16 in the Netherlands — all of which have proven to be successful in reducing the frequency of drug abuse.

Insite also has many auxiliary benefits: Not only are these drug users spared from infectious diseases and death, they also have a greater chance of going into rehabilitation programs and recovering from substance abuse. Once drug users have finished their hit, they have the opportunity to go to a “chill out” room and talk to other users in a safe and welcoming environment. The facility also provides a number of counsellors and mental-health personnel who are willing to help users recover from their addiction.

However, at the end of the day, safe injection sites are not a matter of cost or increased economic benefits — they are a matter of life-and-death. “The reason people should care,” says Dr. John Blatherwick of Vancouver Coastal Health, “is because people are dying. If people were dying in other parts of the … province in as great numbers as they are concentrated in the Downtown Eastside, we would do something.”    If the government is spending billions of dollars on “tough-on-crime” programs that don’t stop crime and don’t prevent death, then it’s time to look for a new option. “Universal” healthcare in Canada doesn’t mean “universal for everyone but the drug users.”