Vancouver, Canada is the only city in North America that provides a legal facility for drug addicts to push heroin and cocaine and other types of substances into their veins. It's called InSite, and it's both government-sanctioned and government-funded.
Located in Vancouver's notorious Downtown Eastside—often called Canada's poorest postal code—the supervised injection site opened as a 3-year experiment back in 2003 to curb the neighborhood's high levels of disease spread through shared needles and death from overdose. Now, after nearly a decade of academic research, political debate, public scrutiny and a Canadian Supreme Court ruling last September that stated InSite should remain open indefinitely, Montreal, Toronto, Ottawa and other cities across the nation are contemplating opening their own injection facilities. According to InSite's own records, between 2004 and 2010 they had 1418 overdoses without a single one resulting in death. No one has ever died there.
I spoke with Tim Gauthier, InSite's current clinical coordinator and registered nurse, about the difficulty of maintaining order in a room where most people are high, the significance of whether addicts live or die, and what hope can look like in such an unusual place.
Paul Hiebert: So, how would you describe InSite to someone who's never heard of it?
Tim Gauthier: It's place where staff members and nurses supervise people's injections. The participants come in with their own drugs. In case a participant overdoses or has a heart attack, someone is there to help. If we can intervene timely and quick, there's no reason anyone should ever die. That's our primary function.
There was a big push to get a facility like this opened in the late '90s when overdose rates in British Columbia were reaching epidemic proportions. I think in 1997 we had something like over 450 overdose deaths in the province. Those are absolutely needless deaths.
Participants at InSite have their own booth, which is clean and sanitary. We offer them new needles, alcohol swabs, a sink to wash their hands and medical care. We can dress their wounds and address chronic health issues. We can also link them up with income assistance and housing.
At our front desk, people can pick up equipment such as condoms, lubrication, needles, cookers, filters and everything you need for injecting safely. We give out as much as people think they need. You could take hundreds of needles if you want. There's no limit. It's not a one-for-one needle exchange.
Also, we ask that participants maintain the confidentiality of others who use the site.
Most of the people using InSite are not casual, weekend users. Is that correct?
Typically, participants are people who have been addicted for two years or longer. They're usually heavily addicted middle-aged men from the neighborhood. We also have an overrepresentation of aboriginal users in comparison to general population rates.
We do have the odd time when a person comes in who's relatively new to their addiction. Maybe they're not even addicted at all. Either way, they're new to using. We used to have a blanket rule that we couldn't accept anybody who was brand new to drugs. But that's been revamped because we were turning away people who were using one needle several times or injecting alone. They were engaging in much higher-risk behavior.
by Paul Hiebert, The Awl | Read more:
Photo courtesy of Vancouver Coastal Health
