Thursday, August 13, 2009

Safe Injection Site (revised*)

Some of the Toronto and Ottawa papers have had stories about a proposed safe injection site. I was part of a focus group for that study. I was "representing" neighborhood citizens from the Dalhousie catchment area.

Most people who watch the news or read about current affairs will be familair with the distressful situation in Vancouver's downtown east side (DTE). There, hundreds if not thousands of drug addicts congreate and shoot up in public, buying the drugs openly. It is a miserable scenario. As part of government actions concerning this (I say concerning, because helping and other words are value laden) they set up a public safe injection site, a shooting gallery where addicts bring in their illegally bought illegal drugs and inject them under supervision. The presence of a nurse and social worker makes it "safe" or "harm reduction". About 5% of the addicts in the DTE use the facility.

There have been numerous reports and commentaries on the safe injection site in Vancouver. It doesn't take long on the net to discover that for every study there is a critic. I was alarmed to discover that 22/25 of the studies were done by the same two authors who are vocal proponents of the site. Like too many other issues in our society, the issue has become polarized and militants seem to rule the waves.

There is an ongoing study in Ontario to see if safe injection sites would be useful in Toronto and Ottawa. Focus groups were set up drawing from Hintonburg & Dalhousie areas, and the Market& Sandy Hill areas, as these areas are the likely home for any single site.

I do not think that there is an "open" or public shooting-up problem in either neighborhood, which was supported by data showing fewer and fewer pipes and needles being found. (Soft drugs is another matter, it seems every second house generates clouds of cannibis smoke, perhaps we should examine the second hand smoke effects of that !).

From several hours of discussion, guided by questions from the facilitators, I learned about the nature of the problem, that it is largely "indoors" in our neighborhood, that DTE solutions are not transferrable to here as our problem is very different. Difficulties with addicts buying their goods on street near the injection centre is apparently a real problem, with the police having to leave a 'safe zone' around the centre for drug deals, and I wondered if this would make a track or circle route of dealers driving the neighborhood to sell their goods as users make up to 5 buys a day, similar to the prostitution track that used to exist in the Market.

Addicts get their money from a variety of sources, including prostitution and petty theft, both of which are issues in this area. Would a harm reduction centre for addicts merely ensure we never get another grocery store? (Loeb on Booth closed in part because it had the highest shrinkage rate of any store in their system).

I also learned that there are other types of harm reduction sites, such as a "safe drinking site", eg in Toronto a site that dispenses a glass of wine every 90 minutes to alcoholics was kept open by management during the recent strike there.

There are a number of hard drug harm reduction / safe injection sites in the world. Some are comparable to Vancouver, some are much lower key and very small. While a number of cities have them, a number have had them and subsequently closed them in favour of other drug strategies.

I wonder whether a site "enabled" drug use; whether money was better spent on prevention (where is a copenhagen consensus type of ranking of drug measures?), impact on the image of a neighborhood (neither area needs more outflight of families to Barrhaven) and thus its longer term stability and continued presence of schools.

I ask myself whether a safe site would fly in more affluent neighborhoods or if it stigmatizes certain inner city neighborhoods. I am also acutely aware that our neighborhoods did not have the same problems as the Market and Sandy Hill.

I did not come to any one answer, because there is no one answer. This neighborhood is not at all like the DTE, and may need its own measures. I think the study should examine the idea of mini-safe-sites, perhaps integrated into existing community health centres, or even high schools or in the downtown office district. I am concerned about harm reduction to our neighborhoods collectively and its addicted inhabitants, and uncertain about the moral issues related to 'enabling'.

*this blog posting has been revised to make it read that these are my opinions and do not necessarily reflect the opinions of others participating in the focus group, in accordance with the non-disclosure agreement terms of the focus group.

(readers may wish to look back a few days to my blogs about the impact of homeless shelters on adjacent streets. They were prompted by my Insite experience.)


  1. My internet connection dropped when I tried to submit my comment a couple days ago. Here's what I commented on David Reevely's blog:

    Eric doesn't mention it, but the need for such a facility (i.e. the problem to be solved) is not public blight like in Vancouver, but that Ottawa has the highest rate of new HIV infections from injection drug use. It's an invisible epidemic.

    Also, the study managers were using the term "Supervised Consumption Site", not 'safe injection site', which is Eric's creation. They are not proposing that illegal drug consumption would be 'safe', just that much collateral harm is reduced if it is done in a supervised setting.

    Police Chief Vern White is trying to scare the community away from this by saying it will cost $6M to police the area around such a facility (as quoted in the Sun). He says that's what it costs Vancouver police to patrol around Insite. But Insite is in the middle of a big drug-infested neighbourhood, and the neighbourhood would be that way with or without Insite. White is playing a dishonest, political game with a serious health issue.

  2. Arcade/shooting games may seem violent but actually it enhances strategic concentration. A better way of venting without harming anyone but the computer screen.