SAFE-INJECTION SITES: WHAT WE CAN LEARN FROM THE EXPERIENCE OF
OTHERS

Re: "Injection sites our moral imperative" (Gazette, Dec. 29).

Henry Aubin makes a very good suggestion in calling for a public
discussion in which both the benefits of supervised injection
programs and public concerns about these innovative programs can be
fully aired.

It is important that the discussion be informed by the considerable
experience in Canada and internationally with supervised injection sites.

These programs have been a part of addiction services in many
European countries since the mid-1980s; they were established in
response to conditions very similar to those that exist in Montreal:
drug-overdose deaths, HIV transmission among injection drug users,
public drug use and the desire to help those with addictions to get treatment.

The Vancouver supervised injection site, in operation since 2003,
saves lives by preventing drug-overdose deaths; reducing the
transmission of deadly blood-borne infections such as HIV and
hepatitis C; connecting street drug users with health services,
including drug-treatment programs and supportive housing; and
improving public order in streets and parks.

More than 30 peer-reviewed publications in leading medical journals
have demonstrated these outcomes.

Vancouver's supervised injection site has shown that this kind of
program can exist in a residential and commercial neighbourhood
without creating any of the feared negative outcomes.

The European injection sites also demonstrate this.

Aubin is right about the moral imperative. Refusing to implement
programs with such a solid body of scientific evidence behind them
would not be the moral choice in this situation.

As a physician who has worked in many parts of Montreal over the past
30 years, has had direct contact with injection-drug users in my
practice and lives in an area where injection-drug use is not
uncommon, I can only agree that we must get on with implementing
these important health interventions for some of our most
marginalized residents.

Gerald van Gurp, MD

Emergency Department, St. Mary's Hospital Centre

Faculty of Medicine, McGill University

Montreal