‘THERE WASN’T THIS ESCALATION IN CRIME’
Calgary’s police chief is backing calls for a local site where drug users could consume substances under medical supervision. Roger Chaffin said preliminary discussions are underway about what a supervised consumption site in the city will look like. He added that police will work to ensure that community members feel safe.
Dr. Thomas Kerr is the codirector of the Addiction and Urban Health Research Initiative at the British Columbia Centre for Excellence in HIV/AIDS and the principal investigator of several large cohort studies involving people who inject drugs and people living with HIV/AIDS. He spoke to Postmedia about community concerns when supervised injection facility Insite was established in Vancouver’s Downtown Eastside in 2003.
Q: What were the community fears when Insite was initially proposed?
A I think there were people who had a number of fears that this would make public order worse by either attracting drug users to the area or creating a bit of a honeypot effect where everybody kind of gathers in one area. There were some people who felt that it would undermine efforts to get people into abstinence-based treatment and some, although not many, who also were concerned that it would send the wrong message to youth and it might make injection drug use fashionable.
Q: How were those fears addressed?
A I think a lot of the fears simply went away once the site opened and people saw that it didn’t actually create this chaos, that there wasn’t this escalation in crime or people congregating in the Downtown Eastside. In fact, the Chinese merchants’ association, which initially opposed the supervised injecting site but did agree to the three-year evaluation experiment, actually wrote a letter at the end of three years in support of the site, saying that they’d noticed improvements in public order.
Our independent scientific evaluation of Insite specifically targeted potential negative effects as well as potential benefits. We were able to publish those results in peer review journals, and we released them publicly through the media and through the creation of summary documents and briefing notes. And that included a study that used the Vancouver police department’s own crime statistics for the Downtown Eastside, which showed that there was no impact on crime. We showed that it didn’t make drug use patterns in the community worse and, in fact, we showed also in a paper … that people were going to abstinence-based programs at a higher rate than before Insite opened, and that contact with the counsellor within Insite was something that strongly predicted people going into a detoxification program.
My sense is that when people imagine these facilities, they picture the worst, all chaos breaking out. Then when you actually see it open, it just looks like any other health clinic.
Q On the impact that Insite has had:
A Supervised injecting sites are one of the only tools we have to deal with overdoses when they occur, and there’s never been a death due to overdose in a supervised injecting site anywhere in the world, despite the fact that there’s over 90 of them and millions of injections have occurred.
We also published work showing a 35 per cent reduction in overdose deaths in the area immediately around Insite, and we know that there’s been literally thousands and thousands of overdoses there and nobody’s ever died. So while supervised injecting sites don’t necessarily prevent the overdoses from happening in the first place, they minimize the harmful effects, including potential fatalities.
Also right now in Vancouver, Insite is offering a drug testing service where people can test their drugs for fentanyl, which in turn could affect behaviour.
Q Does the success of a facility like Insite depend on a concentration of drug users, or can it still be successful if users are more distributed across a larger area?
A They do work best if it’s an area where not necessarily just people live, but where they acquire and use drugs. I know that a number of cities in Canada have been looking at a more distributed model where you have a number of smaller sites spread out over a bigger area to accommodate a more distributed population.
I think in that case, if that’s the nature of the population, more geographically dispersed, then that’s a sensible approach to go with.