Supervised injection site
Supervised injection sites (SIS)[1][2][3] or drug consumption rooms (DCRs) are a health and social response to drug-related problems.
In 2022, there were over 100 DCRs operating globally, with services in Belgium, Denmark, France, Germany, Greece, Luxembourg, the Netherlands, Norway, Portugal and Spain, as well as in Switzerland, Australia, Canada, Mexico and the USA.
Primarily, DCRs aim to prevent drug-related overdose deaths, reduce the acute risks of disease transmission through unhygienic injecting, and connect people who use drugs with addiction treatment and other health and social services.
[4] Proponents say they save lives and connect users to services, while opponents believe they promote drug use and attract crime to the community around the site.
[14] After several years of community activism, Victoria agreed to open a supervised injection site in Melbourne's North Richmond neighbourhood in 2018 on a trial basis.
[16] However, as of 2024, the site has been rejected by Premier Jacinta Allan who cited disagreements over location, preferring to set up a new community health and pharmacotherapy centre instead.
[2] Whereas injection facilities in Europe often evolved from something else, such as different social and medical outreaches or perhaps a homeless shelter, the degree and quality of actual supervision varies.
[18] Ireland has legislation to permit the opening of a service (as of May 2017) in the Misuse of Drugs (Supervised Injecting Facilities) Bill 2017; however, it has been halted by planning concerns.
After discussions with the police and legislature, the café was turned into the first legally sanctioned drug consumption facility provided that no one under the age of 18 was admitted.
[25] In 2023, the Lord Advocate—Scotland's chief legal officer—announced that the Crown Office and Procurator Fiscal Service would institute a policy of not criminally prosecuting those using approved supervised drug consumption sites.
[34] In September 2020, a group in Lethbridge, Alberta led by an ARCHES employee started hosting an unauthorized SCS in public places in a tent.
[44] Local governments in Seattle, Boston, Vermont, Delaware, and Portland, Oregon have considered opening safe injection sites as well.
One problem brought up by the leadership of the Metropolitan Transportation Authority is how use migrates from the centers to nearby New York City Subway stations when the OPC's are closed.
"[57] An organization called Safehouse was hoping to open a safe consumption site in Philadelphia in February 2020 with the support of the city government.
[61] Safehouse said its proposed operation was "a legitimate medical intervention, not illicit drug dens" and claimed protection under the Free Exercise Clause because "religious beliefs compel them to save lives at the heart of one of the most devastating overdose crises in the country".
These programs use phone lines or smartphone apps to monitor clients while they use drugs, contacting emergency services if the caller becomes unresponsive.
The Vancouver Insite facility was evaluated during the first three years of its operation by researchers from the BC Center for Excellence in HIV/AIDS with published and some unpublished reports available.
[33]: 16 Philadelphia's WPVI-TV Action News team traveled to Toronto, Canada in 2018 to make first hand field observations of several safe consumption sites already in operation.
In the November 2016 Alberta Health report that resulted from that meeting, the introduction of supervised consumption services, along with numerous other responses to the crisis, was listed as a viable solution.
[80]: 1 The 2016 Alberta Health report stated that, SIS, "reduce overdose deaths, improve access to medical and social supports, and are not found to increase drug use and criminal activity.
[83] In May 2019, the Calgary Herald, said that Health Canada announced in February 2019 of approval for Siteworks to operate for another year, conditional to addressing neighborhood safety issues, drug debris and public disorder.
Acting Inspector Pete Christos stated that the initial auditors did not have the means to determine whether money was missing, and confirmed that, during police interviews with Arches staff, all spent funds had been accounted for.
The report's author, University of Lethbridge's Em M. Pijl, said that news media tended to the "personal experiences of business owners and residents who work and/or live near an SCS", which contrasts with "scholarly literature that demonstrates a lack of negative neighbourhood impacts related to SCSs.
[97] While overdoses are managed on-site at Vancouver, Sydney and the facility near Madrid, German consumption rooms are forced to call an ambulance due to naloxone being administered only by doctors.
[101] Commenting on the high overdose rates in the Sydney MSIC, the evaluators suggested that, The results of a research project undertaken at the Dr. Peter Centre (DPC), a 24-bed residential HIV/AIDS care facility located in Vancouver, were published in the Journal of the International AIDS Society in March 2014, stating that the provision of supervised injection services at the facility improved health outcomes for DPC residents.
There was no evidence that the facility influenced drug use in the community, but concerns that Insite ‘sends the wrong message’ to non-users could not be addressed from existing data.
[107] An audit of Lethbridge ARCHES SCS by accounting firm Deloitte, ordered by the Alberta provincial government, found the SCS had $1.6 million in unaccounted funds between 2017 and 2018; additionally they found that led[clarification needed] $342,943 of grant funds had been expended on senior executive compensation despite the grant agreement allowing only $80,000.
When asked why these funds had previously been reported as missing, LPS Acting Inspector Pete Christos stated that the initial auditors did not have the means to investigate the agency's finances, and that all spending had been accounted for during the criminal probe.
Premier Jason Kenney did not dispute the results of the investigation, but declined to reinstate funding, claiming that the site's management had lost the confidence of his government.
However, the Expert Advisory Committee expressed reservation about the certainty of Insite’s cost effectiveness until proper longitudinal studies had been undertaken.
