For the past 20 years, supervised-consumption services (SCS) have been part of a wider range of harm reduction programs in many places across the globe, including Canada. The focus of supervised consumption services is to allow for people who use drugs to use their drugs safely and securely in the presence of health-care professionals, without the fear of arrest or accidental overdose. In Canada these services came into effect in response to an HIV epidemic among injection drug users and an opioid overdose epidemic in Vancouver and British Columbia in the 1990’s. It reflected a growing understanding by both policy makers and the public that drug use was not a moral failing, but rather a public health issue that needed to be addressed through evidence-based health and social interventions.
Vancouver is home to two supervised-consumption sites. The first, an injection site, opened in 2002 as an ancillary service within the Dr. Peter Centre a multi-service HIV service that includes a Day Health Program, Specialized Nursing Care Residence Program and Enhanced Supportive Housing for people living with HIV. The injection site is an integrated part of their overall program and is available to people within the Dr. Peter Centre programs.
Insite, a high volume and street level injection room opened in 2003. At Insite people who inject drugs can access a range of medical services including access to detox services and transitional housing support. Over 40 peer-reviewed articles have been published from the Insite evaluation that show the service has had a significant positive effect on those who use the site and the surrounding community. Some of the findings include:
- Between the years 2003 and 2011, overdose deaths within a 500-metre vicinity of Insite decreased by 35% compared to a decrease of 9% in the rest of Vancouver.
- Those who use Insite are more likely to enroll in drug treatment programs and other health services than those who don’t use the site
- Those who use Insite are less likely to share syringes
- Insite has postiviely effected public order in the vicinity
- Drug related crime in the area as not increased
Supervised consumption services send a powerful message to the community – that the health and safety of community members who use drugs is of critical importance.
Supervised-consumption services have proven to be cost effective, life saving and create a safer environment for people who use drugs and the broader public. There is increasing interest in opening supervised consumption services for marginalized people who use drugs in a number of cities in Canada.
Priorities for action:
- Federal and provincial governments to facilitate and support health regions to implement supervised consumption services where needed in Canada.
Resources on Supervised Consumption Services
The Urban Health Research Initiative
Vancouver Coastal Health
Toronto Drug Strategy Supervised Consumption Services Toolkit
European Monitoring Centre for Drugs and Addiction