Pubdate: Thu, 08 Jun 2006
Source: Vancouver Sun (CN BC)
Copyright: 2006 The Vancouver Sun
Contact:  http://www.canada.com/vancouver/vancouversun/
Details: http://www.mapinc.org/media/477
Author: Frances Bula
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

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.
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MAP posted-by: Beth Wehrman