SAFE INJECTION SITE LEADS TO DETOX

Results Of Study Published In New England Journal Of Medicine

WHISTLER - The more a drug user visits Vancouver's experimental
supervised-injection site, the more likely that user is to go into
detox, according to a study published Wednesday in the New England
Journal of Medicine.

Those were the surprising findings that researchers studying the site
discovered.

"If you use the site at least weekly, you are two times as likely
than others to enter detox," said Dr. Thomas Kerr, a Centre for
Excellence in HIV/AIDS Research who co-wrote the journal paper. He
said that finding was not something researchers expected.

"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."

Of 1,031 randomly selected repeat users of Insite, which is near the
city's notorious Main and Hastings intersection, 185 people -- about
18 per cent -- went into a detox program in a 15-month period between
December 2003 and March 2005. Those who used the site weekly or saw
one of the site's addictions counsellors even once were twice as
likely as other site users to go into detox.

Kerr said the evidence appears to run counter to some people's fears
that having an injection site would promote drug use and encourage
people not to go into treatment.

"Our findings provide reassurance that supervised injection
facilities are unlikely to result in reduced use of
addiction-treatment services," the investigation says.

The study didn't rely on people's anecdotal evidence about whether
they had sought treatment or on the site's statistics about how many
people they had referred to detox.

Instead, it compared the names of people registered at the site with
names of those who had actually entered the city's three detox facilities.

The study does not indicate the rates at which drug users in other
cities or drug users who don't use the site in Vancouver go to detox.

However, other statistics collected by the centre indicate that,
among the 1,000-some users studied, people were almost twice as
likely to go to detox once they had started going to the site
compared to before the site was opened.

In a six-month period before Insite was opened, 8.5 per cent of that
group went to detox. In a six-month period after it opened, 14.5 per
cent went to detox.

Insite, the only supervised injecting facility for illegal drugs in
North America, was opened in September 2003 as a health initiative to
reduce the spread of HIV in the Downtown Eastside and prevent
overdose deaths. As well, some advocates argued that a "low
threshold" service for drug users would encourage people to get treatment.

David Marsh, the head of addiction services for Vancouver Coastal
Health, said detox referrals from Insite are given priority at detox
facilities, because most of the site's clients are homeless and it's
difficult for them to wait for a phone call back saying when there is
a spot open.

The site has one addictions counsellor and two nurses on during most
opening hours.

Those people will talk about options for treatment while they're
helping out with other issues that come up, like wound treatment or housing.

"The staff understand that's part of the role of the site," said Marsh.

The site saw an average of 611 daily visits in its second year of
operation. It tends to attract what health workers consider the
highest-risk drug users, people who are homeless or just out of jail.
Previous studies have indicated that people who use the site are less
likely to share needles.

The site has seen 197 overdoses in its second year of operation, but
no one has died.

The site is being operated as a research pilot, with its federal
exemption from narcotics laws due to expire this September.

Conservative Prime Minister Stephen Harper said during his election
campaign that he was not going to provide federal support for the site.

Since being elected, however, he has not made a definitive statement
and it is unclear whether the site will have its exemption extended
by Health Canada this September.