Injection Facilities

Introduction Many cities in the United States and Canada are dealing with an epidemic of infectious diseases and overdoses by intravenous drug users. Vancouver, Canada developed a plan to help reduce these numbers by opening a facility where drug users may inject previously purchased drugs under the close supervision of medical staff. The facility was granted legal exemption by the Canadian government so that an intensive three-year study could be conducted and the results may be helpful in determining if this pilot program could be implemented in other cities, including the United States. The facility offered sterile syringes, emergency care in the event of an overdose, primary care and referrals to addiction treatment programs.
Participants
That study points out to gain a better understanding as to if the injection facility was curbing publicly discarded syringes, drug related crimes, use of addiction treatment services and HIV risk behavior, the intravenous drug users should have been randomly assigned complete access and no access to the facility, this was deemed unethical. Also, the evaluators were completely external to the facility operations.
Methods
The Vancouver safer injection facility has twelve stalls where users may inject and is under the supervision of nurses. The nurses respond to overdoses and address other health needs, treating injection-site abscesses. There is also an addiction counselor and other support staff to help the users with community based needs such as housing and mental health treatment. While the evaluators were external from the facility operations they conducted surveys and interviews with the drug users who used the facility and those who did not.
It was discovered that heroin was used in 40% of the injections, cocaine was in 30% and other illicit drugs or combinations were used in the remaining 30%. While there were 1.3 overdoses per 1000 injections, only 40% required an ambulance and 60% were successfully managed by the medical staff. The police department reported that drug deals had not increased in the neighborhood around the facility and that public drug use had gone down after the first year that facility was in operation. There has also been an increase in drug users seeking addiction treatment and similarly with the new facility there has not been an increase in the relapse rates. While the study points out that the findings a mainly observational and to keep that in mind when making evaluations, overall, the facility has accomplished what it set out to