The Ministry of Health appointed an Expert Advisory Committee (EAC) to report to a Federal Coordinating Committee and the Minister of Health on research on the supervised injection site (INSITE) in the Downtown Eastside (DTE) of Vancouver. The EAC included experts on blood-borne diseases, substance abuse, program evaluation, and crime.
Supervised injection sites (SISs) are controlled health care settings where drug users can inject their own personally acquired illicit drugs under supervision and receive health care, counseling and referral to social, health and drug use treatment services. There are 70 SISs spread across 6 countries. However, the majority of the research reviewed and discussed in this report relates to INSITE and an SIS in Sydney, Australia.
INSITE was established as a pilot project in 2003, when permission was given to the Vancouver Coastal Health Authority (VCH) under section 56 of the Controlled Drugs and Substances Act. Health Canada provided the VCH with funds to evaluate the service, and VCH contracted with the BC Centre for Excellence on HIV/AIDS to undertake the evaluation. The Centre completed parts of the original evaluation, but indicated that they required more time to complete the evaluation in a second application for another exemption. While Health Canada granted the exemption for an additional period of time, it did not provide funding for the proposed evaluation. This funding was sought and received from alternative sources.
The EAC organized the available research into tables around key questions and the stated objectives of INSITE (see appendix B). Each table contains highlights from: (i) published and unpublished research on INSITE, data on use provided by (VCH), and three pieces of additional research requested by the EAC; (ii) research on the Sydney, Australia SIS; and (iii) research on other SISs in other countries.
The research reviewed relates to the formally stated objectives of INSITE, namely to: i) increase access to health and addiction care; ii) reduce overdose fatalities; iii) reduce transmission of blood-borne viral infections and other injection related infections; and iv) improve public order.