- © 2007 Canadian Medical Association
In response to Federal Health Minister Tony Clement's demand for proof of the efficacy of safe injection sites, Health Canada has issued a call for research proposals to determine whether there is any validity to the proposition that such sites help to lower drug use and fight addiction.
The findings will be used to help Clement decide whether to extend an exemption from federal drug law that allows the Vancouver-based InSite safe injection site to continue operations (CMAJ 2006;175:859). Clement has deferred that decision on the extension until Dec. 31, 2007.
InSite is a legally run health facility where addicts who have purchased illegal drugs can go to inject under the supervision of trained medical staff. North America's first and only safe injection facility opened its doors in 2003 in Vancouver's Downtown Eastside, an impoverished neighbourhood heavily populated by sex-trade workers, drug users and dealers, and those with high rates of HIV and hepatitis C. At InSite, clients are given clean needles, as well as access to health care, and to detox and drug treatment programs.
Nearly 700 addicts visit InSite every day. Evaluations by the BC Centre for Excellence in HIV/AIDS indicate that the program results in harm reduction to users and other members of the community, reduces drug-trade litter and increases intake into intervention and addiction treatment programs (CMAJ 2006:175:1399-404).
But a spokesman for Clement says the health minister wants more proof. The call for research proposals “doesn't mean the exemption is being extended or that the InSite program is continuing. We are calling for more research on safe injection sites,” says Erik Waddell.
Waddell says the minister “has been very clear” that he needs to see more evidence on safe injection sites, before deciding whether the InSite program can continue, or whether others can open.
The call for research proposals specified 6 areas of study on the impact of safe injection sites: service utilization, treatment uptake and influence on risky behaviour; morbidity and mortality; public order and safety issues; implementation and operational issues; local contextual issues; and, the similarities and differences between Vancouver and other Canadian cities concerning patterns and trends with respect to injection drug use.
The research questions were developed by an expert advisory committee with public health, criminology, addictions and evaluation expertise. The call for proposals closed May 11, 2007.