Hello

 

On May 2nd, City Council voted in support of the safe injection sites in Edmonton. The first step is to send a letter to the Federal Government in order to get an exemption for the sites to exist.

Currently, there are four locations with Council’s support: one in the Royal Alexandra Hospital, and three in community health and social service centres. The purpose behind these locations is so that the injection sites are located where those that need to use the service are. These sites cannot be in other areas because they won’t be accessible to those that need them, and so they will not help those in need. We need to be able to serve these people where they are. 

The city is also working on more affordable housing throughout the city.  Unfortunately, the cycle of addiction is often entwined with the cycle of poverty. Housing is key to all issues associated with poverty and addictions. Often, those who are struggling with addiction are also struggling with perpetual or periodic homelessness. Without a place to go, those recovering or going through detox are facing an uphill battle, and will often fall back into their addiction. By providing the ability to find permanent housing, this will give folks in poverty a place to go as they recover and when they are healthy. These affordable housing units are going to be throughout the city, and so will not be concentrated only in the city core. As these are developed, the need for these sites will spread out more, and therefore these safe injection sites will not be concentrated in one general area as they are right now.

Council is supportive of this initiative because safe injection sites work. It has been proven that these sites save lives, prevent infections amongst drug users, relationships can form between the staff on site and potentially marginalized clients, who can then encourage users to access healthcare and addiction services.1 It has also been shown to bring stability to the community because there is an alternative location than the streets for users to go and so do not disrupt the neighbourhoods nor leave needles and garbage in parks and on sidewalks.2 Safe injection sites have also been proven to increase linkages to addiction treatment.3

The purpose of these sites is mainly harm reduction. Particularly with the fentanyl crisis, these sites provide valuable resources and services to save lives and address a particularly marginalized population. Vancouver’s Insite has seen over 5000 overdoses since it opened in 2003, but these overdoses have not resulted in any deaths because there are trained medical professionals and equipment on site.

These safe injection sites do not supply drugs, but simply provide clean needles and a safe place for addicts to go that is supervised by medical professionals, rather than on the street or on someone’s front yard.

These sites are not the solution to the opioid problem, but they are an important part of dealing with it. Those who use opioid substances are dealing with addiction, often with mental health, sometimes poverty and homelessness, and stigma. These sites are vital to addressing an often-overlooked population and health care concern. These locations are not simply a place to do drugs, they have trained medical staff on site, and often will have counselors and professionals trained in dealing with addiction in the same building. In the Vancouver Insite injection site, users can check into detox which is in the same building. It also has transitional recovery programs and addiction counseling on site. Vancouver’s completion rate for the detox program was over 50%.4 And, those who use the Insite services in Vancouver are 30% more likely to enter addiction treatment than those who do not.5

Safe injection sites have been the target of some stigma, but this has not been shown in the realities of different sites. When Insite was brought before the Supreme Court of Canada in 2011 by the federal government, the court concluded that “Insite has been proven to save lives with no discernible negative impact on the public safety and health objectives of Canada”.6 Insite has had benefits for the area surrounding the facility as well. Its presence in Vancouver’s Downtown East side has resulted in reductions in public disorder in the area, reductions in violence against women, and “increased use of detox programs and addictions treatment”.7  Insite’s presence in the community has also not resulted in “adverse changes in community drug use patterns, no increase in initiation into injection drug use, and no increase in drug-related crime.”8 In 2007, four years after Insite was created in Vancouver, the Federal Government asked for a report on the impact Insite had on crime and on public order in the surrounding neighbourhood. The report was consistent with previous research that had been done, and showed that there was no evidence of negative impacts on the neighbourhood, and the majority of the citizens in the neighbourhood sampled viewed Insite as having a positive impact on public order, and wanted “to see the service expanded, retained, or modified”.9 It was found that the businesses it the area reported a reduction in crime while Incite was in operation.

Overall, the evidence before Council in regards to safe injection sites is that it is a positive program. It addresses a serious, chronic health issue that is suffered by many in marginalized populations. These programs save lives, and are important to helping those struggling with addiction to be safe from other diseases and health effects that can come from risky addictive behaviour, and can assist in battling addiction and recovering. I had the opportunity to go to Vancouver with REACH to discuss Incite and learn about the program and how it has benefitted Vancouver, and how to implement this knowledge in Edmonton. I am proud of Council for supporting this initiative, as it is a serious health issue, and safe injection sites are an important part of addressing substance abuse and addiction problems.

 

References:

1 Holly Hallbourg, “Canadian Municipal Network on Crime Prevention Vancouver-Edmonton Inter-municipal Exchange” 3 November 2016, REACH Edmonton.

2 David Staples, “Everyone loves safe injection sites, except their future neighbours” 2 May 2017, Edmonton Journal (link)

3 Sara E Wakeman, MD, “Another Senseless Death—The Case for Supervised Injection Facilities” 16 March 2017, The New England Journal of Medicine.

4 Holly Hallbourg, “Canadian Municipal Network on Crime Prevention Vancouver-Edmonton Inter-municipal Exchange” 3 November 2016, REACH Edmonton.

5 Ken MacQueen “The Science is in. And Insite works.”, 20 July 2015, Macleans. (link)

6 Ken MacQueen “The Science is in. And Insite works.”, 20 July 2015.

7 Simon Jones, BSC, MD, “Insite: A Harm Reduction Success Story”, March 2012, University of British Columbia Medical Journal.

8 Simon Jones, BSC, MD, “Insite: A Harm Reduction Success Story”, March 2012, University of British Columbia Medical Journal.

9 Neil Boyd, “Lessons from INSITE, Vancouver’s supervised injection facility: 2003-2012”June 2013, Drugs: education, prevention and policy.