Canada: Safe Injection Site Leads to Detox
June 13, 2006
According to a new report, the more a drug user visits Insite, Vancouver's experimental supervised injection facility, the more likely he or she is to go into treatment.
"If you use the site at least weekly, you are two times as likely than others to enter detox," said Dr. Thomas Kerr, co-author of the study. "We weren't surprised that the site had resulted in less public disorder or syringe sharing. But we were kind of astounded actually that the more you use this facility, the more likely you are to enter treatment."
The researchers randomly selected 1,031 repeat users of Insite. They found that 185, about 18 percent, went into detox in a 15-month period between December 2003 and March 2005. Those who used the site weekly or saw one of its addiction counselors even once were twice as likely as other site users to go into detox.
"Our findings provide reassurance that supervised injection facilities are unlikely to result in reduced use of addiction-treatment services," the authors wrote. The investigators did not rely on anecdotal evidence or site statistics; rather, they compared the names of people registered at the site with names of people who had entered the city's three detox facilities. Other statistics collected in the study indicate that, among the users studied, people were nearly twice as likely to go into detox once they started going to the site, compared to before the site was opened. In the six months before Insite opened, 8.5 percent of the group went into detox. In six months after it opened, 14.5 entered detox.
Insite opened in September 2003 as a health initiative to reduce the spread of HIV in Vancouver's Downtown Eastside neighborhood and to prevent deaths from overdose. It is the only supervised injecting facility for illegal drugs in North America.
David Marsh of Vancouver Coastal Health said referrals from Insite are given priority at detox facilities because most Insite clients are homeless, so it would be hard for them to wait for a phone call saying space was available.
One addiction counselor and two nurses are on duty during most Insite hours, and they help with other issues such as wound treatment or housing in addition to discussing treatment options. The site had an average of 611 daily visits in its second year of operation. It tends to attract people whom health officials consider the highest-risk drug users: the homeless or those just released from jail. Previous studies indicated that people who use the site are less likely to share needles.
The report, "Attendance at Supervised Injecting Facilities and Use of Detoxification Services," appeared in the New England Journal of Medicine (2006;354(23):2512-2514).
06.08.06; Frances Bula
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.