Supervised Injection, or SIF, became legal in Canada in 2003. More than a dozen cities in the United States are considering operating supervised injection sites to help them deal with their ever-growing drug-related death issues.
This has been a controversial subject in Canada for nearly 20 years. Critics claim that offering these sites only encourages drug use since drug users know they will not be arrested and do not need to hide. There are also claims that drug users bring more crime to neighbourhoods where SIF centers are.
Others claim that supervised injections save lives, overall. Drug addicts are people who deserve care and compassion, they argue, not jail time. You will never stop people from taking drugs, all you can do is make it illegal, they argue.
When you consider that, even after rehab, relapse rates among alcoholics are between 50 and 90 percent, while drug addicts are between 40 and 60 percent, it appears that the compassionate group has something to back up at least part of their claims.
Do Supervised Injection Sites Really Save Lives?
While SIF has been studied for years, many questions remain unanswered. There are approximately 100 sites around the world, many of them in European countries, Australia, and, of course, Canada.
Drug users often bring their supplies to a SIF and given clean needles, along with a clean, safe environment to use them. These facilities have staff with naloxone (an overdose antidote) and breathing masks. There is also information about drug treatment centers, but it is unknown if anyone takes advantage of this information.
Much of the information we have about these sites come from our own 25 facilities, including the first, called Insite, in Vancouver, along with one in Sydney, Australia.
One study published in the respected Lancet found that fatality rates due to overdose sharply decreased in the immediate area surrounding the clinic.
These studies seem to indicate that supervised injection sites can and do save lives. There is evidence from around the globe that these programs do help those who need them.
Still, some in Canada, such as Health Minister Christine Elliott, want to see these programs shut down.
According to one registered nurse, who began working for SIF after her brother died of an overdose, alone in an alley, bodies would be found all over the city if this program were to close. “We’ve seen thousands of people,” Leigh Chapman, a founder of the Moss Park Overdose Prevention site, told CBC Radio’s Metro Morning show.
Beyond Saving Lives
Ask those who work with the drug-addicted, and they will tell you that the importance of these sites goes far beyond saving lives; they offer something most drug addicts can’t get anywhere else- a safe place where they are not judged. Treated like human beings with feelings, SIF sites offer a welcome respite from the outside world and show addicts what their lives could be like if they went into a treatment center.
Supervised injection sites also offer a place that takes addicts off the streets, even if only for a short time.
Studying supervised injection, however, presents quite a few problems. To operate a truly randomized trial, drug users would need to be separated into two groups, with one group having access to SIF, and the other group denied entry. This involves the opposite of the goal set by SIF personnel. This could also mean choosing who would live and who might die.
For that reason, observational framework studies would have to be performed.
Critics Still Remain Skeptical
Critics and skeptics maintain that, even if SIF saves lives, governments should not be encouraging or facilitating drug use.
Some argue that if using illegal drugs is OK if you do it in a government-approved site, what’s to stop gambling, sex addicts, or pedophiles from creating “safe spaces”?
Others will argue that the money spent on supervised injection is better spent on true services for addicts, such as treatment centers, and not encouraging drug use.
While some individuals have argued that drug laws restrict their personal freedom, governments in Canada and Australia have stated that they do not see these laws as “restrictions”, but rather, individuals always have the choice to use illegal drugs. It’s whether they feel that the risk is worth the high.
SIF May Save Lives, but Don’t They Increase Crime in the Area?
In Australia, police records looked at the crime rates in 2003 of theft, robbery, and other crimes in the area of the clinic about 27 months before it opened, this rate was then compared to the 16 months afterwards.
This comparison found that:
- There was an increase in loitering near the rear of the SIF location soon after it opened, but in general, loitering had become rare.
- There was no increase or decrease in loitering in the front
- While there was a temporary increase in crime in early 2001, but noted that crime increased everywhere at that time, probably due to a shortage of heroin.
An update in 2006 revealed that between 2002 and 2006, most crime had declined steadily, including theft and robbery, and that there was no clear trend in drug offences in the area surrounding the SIF.
Ideology vs Evidence
Some politicians, when asked directly about supervised injection sites, will tell you that they are dead set against them, or that they need “more information” before they can decide.
As we noted above, there is plenty of evidence for supervised injection sites and none against them, but some people insist on sticking to ideology and refute studies and evidence as “flawed.”
The Final Word
There isn’t any evidence that supervised injection is harmful in any way, however, there is plenty of evidence that shows that not only does this practice save lives, but it also helps to prevent infectious disease while bridging the gap for the drug-addicted to find the services they need.
Only those with a political agenda or an axe to grind could find fault with SIF programs, and they should be reminded that they are playing with people’s lives.
While SIF’s do save lives, they need to be part of an overall solution, used perhaps as a gateway for other services. If and how these SIF’s are used to meet that objective is unknown. Also, John, an illicit drug user for three years may use the SIF on a Tuesday, overdose and is revived fairly quickly.
On Saturday, John wanted his fix within a short time after getting his dope from the dealer. He did not want to make his way to the SIF, instead chose to use an alcove of a closed business. He overdosed again – this time no one was there to save him.
Does having a SIF really save lives? You decide. Should SIF’s be part of a continuum of care steering people into some type of treatment whether that be mental health, detox, or drug substitution?
In some communities, a community like Nanaimo for example, decision makers are afraid to have a concentrated system of care instead choosing to spread services across the city.
The purpose of the Centre One website is to educate people and to provide information on the services available at our Centre One location at 55 Victoria Road, Nanaimo, BC.