Pubdate: Sun, 28 Sep 2008 Source: Province, The (CN BC) Copyright: 2008 Canwest Publishing Inc. Contact: http://www.canada.com/theprovince/letters.html Website: http://www.canada.com/theprovince/ Details: http://www.mapinc.org/media/476 Author: Dr. David Marsh Note: Dr. David Marsh is medical director of addiction, HIV and aboriginal health for Vancouver Coastal Health. Bookmark: http://www.mapinc.org/find?142 (Supervised Injection Sites) THE FACTS SHOW INSITE SAVES LIVES AND DIRECTS ADDICTS TO TREATMENT It is disappointing to read another editorial in which the facts about Vancouver Coastal Health's supervised injection site (SIS) are again ignored. Over 30 independent peer-reviewed studies confirm Insite is saving lives in the Downtown Eastside. The New England Journal of Medicine, The Lancet and the Canadian Medical Association Journal are hardly places where you'd expect to find "flawed research," as The Province states. Insite serves an extremely marginalized population, disconnected to many things most of us take for granted, including health care. Last year, Insite nurses intervened in 222 overdoses; half were full respiratory arrest. They were not breathing. Had Insite staff not intervened, many likely would have died or been permanently injured. An Insite user takes a conscious step, albeit a small one, to improve their health. Once in Insite, injection drug users are shown how to reduce the likelihood of contracting or spreading HIV and Hepatitis C. Our work in alleviating the spread of HIV has paid off. In 2006 there were just 30 new cases of HIV in the Downtown Eastside, compared with 2,100 new cases a decade earlier. Harm reduction and education measures at Insite, the expanded needle exchange program, methadone maintenance and other areas in our addiction strategy contributed dramatically to reducing the spread of HIV in the Downtown Eastside. Estimates are that a person with HIV incurs $350,000 worth of health-care costs during their lifetime -- setting aside the shortened life expectancy and tremendous life challenges that come with this infection. Making a significant dent in stopping the spread of HIV saves countless health dollars. It also saves lives. Once in Insite, injection drug users connect with health-care staff who help them get housing and social services they can't obtain because of how they lead their lives. Insite helped people connect to social services over 2,260 times last year. Insite nurses provided first aid and medical care on 4,000 occasions last year. Insite users who want to withdraw from drugs have quick access to Onsite, a detox centre located above the SIS. This works well for people who have chaotic lives and extreme challenges attending appointments. Our stats show clients who use Insite are twice as likely to engage in addiction treatment such as detox than an injection drug user who doesn't. Your editorial suggests we direct services toward treatment and prevention of addiction. We already do, as 80 per cent of our addiction services budget of $114 million is devoted to treatment. Lastly, we have never called Insite a "safe" injection site. It is never safe to inject illicit drugs. Insite is a supervised injection site, set up to reduce harm and provide care to a concentrated population of long-term and seriously addicted individuals living in the Downtown Eastside. Dr. David Marsh is medical director of addiction, HIV and aboriginal health for Vancouver Coastal Health. - --- MAP posted-by: Larry Seguin