Who is involved?

The Addicts

                                                                              Residents of the Downtown Eastside


Over 12,000 unique people visit Insite annually. Half of these people are either homeless, living in shelters or have serious mental health issues. Also, about 17% of the 12,000 are aboriginal. These addicts have been using for a long time and tend to be older and usually Insite is the only way for them to connect to health care services.


The Health Care Providers

 At Insite, there are health care and social workers to provide assistance to their clients so as to develop close relationships with them and help them pursue detox and addiction treatment services. It is operated under Vancouver Coastal Health. By combining community and health services, they provide great support for users. 


The Federal Government

The Federal Government let Insite operate under a three year exemption from the Controlled Drugs and Substances Act for scientific and research purposes as a response to the absurd number of people afflicted by HIV/AIDS in the community. When the time for the exemption to end came, local supporters of Insite wanted it to be declared a provincial issue rather than federal. The federal government was against a permanent exemption for Insite due to the fact that the government should not fund the facilitating of drug use and it would be better spent on other services. Furthermore, the federal government should have the only power over drug regulations as provincial control would cause fragmented regulations across Canada. After many appeals from the Attorney General, the issue went to the Supreme Court. There, it was decided that Insite would operate under a permanent constitutional exemption ensuring that no more legal hassles would come towards Insite's way.

                                                                               Poster put up on Insite's facilities



The Taxpayers

Insite's operational budget was $2,969,440 in 2010-2011. With taxpayers concerned that their money is essentially going to the hands of drug users, the money issue is the biggest one against Insite. Yet, the health care costs of providing emergency care for drug users for when they may overdose or need major surgery or plastic surgery directly due to their drug use, Insite tackles these issues before they become a burden for taxpayers. Providing clean needles and supervision so that users may not harm themselves seriously, it becomes clear that what Insite does is cost beneficial. With the cost benefit ratio being 1:5.12, Insite is clearly a good thing. The only shame is that money was wasted on lawyers because of Insite's convulated legal issues when the money could have easily been used to provide care for their clients.

Brief History of the Downtown Eastside

                                                  Landscape of the Downtown Eastside

Just ten blocks long and five blocks wide, the Downtown Eastside is a place that has transformed over the years. Once a transportation hub with a Canadian Pacific Railway station and streetcars lining Hasting St, it wasn't always Skid Road. Though mainly populated with Japanese and Chinese immigrants and labourers wanting to work in saw mills or fisheries, it was still a family-oriented area where parents worked hard and children went to school. But then people stopped coming, the streetcars stopped running and the low-income housing was decreased. The banks, theatres and hotels that were once cultural staples of Vancouver would eventually blend in to the grime of the district and the once popular Carnegie Library reopened in the 80's as a community centre after years of abandonment. It opened up as a response to the increasing drug abuse and crime that the area was facing.

                                                                   Carnegie Library

                             Up & Down: Downtown Eastside Architecture - Arni Haraldsson
 
So why did this once fluorishing place become Skid Road?

The area had always been a place for beer parlours but since most weren't well regulated, many people drank too much too often and over time would become enslaved to their alcoholism. As years progressed, the area would become a hub for drinkers. However, in the 80's with the introduction of cheaper and more potent heroin, locals had a new drug to get their fix off. With heroin being very addictive, a new generation of addicts was spawned. As well as the fact that many patients at Riverview Hospital who still suffered from mental illnesses were essentially being dumped in the area since they could afford to live there, the Downtown Eastside we know off had been birthed.

Insite opened as a response to Vancouver having the highest rate of HIV/AIDS transmission in North America. Intended to combat the adverse health effects associated with drug abuse, it has done much more to help the people in the community by offering addicts simple health care and a second chance. The city had adopted a "four pillars" drug strategy (prevention, reduction, harm prevention, enforcement) but more focus was being put on prevention, reduction and enforcement. Insite became the harm reduction component of this strategy and has become a success story on how much it has done for the community.

 

 

                                                             Front door of Insite

For some historic photos of the Downtown Eastside, check out this gallery.



What is Insite?

Insite is a "supervised injection site" located in the downtown Eastside in Vancouver, BC. Though there are multiple sites like these in Europe, Insite is the first (and only) one in North America. Apart from providing addicts with clean injection equipment such as syringes, cookers, filters, water and tourniquets, Insite also supervises those injecting drugs to make sure that they do not overdose and if they do that they receive medical attention immediately. Insite also provides counselling, housing, community support and primary care to treat disease and infection for their users. Since most of these individuals would not have access to health care services, Insite connects them to nurses who can help them and even refer them to Onsite. Just upstairs from Insite, Onsite is where users can pursue detoxification and overcome their addiction.

By working on the "harm reduction model", Insite intends to decrease the negative health, social and economical consequences of drug abuse without requiring users to be drug free. It has been held in high regard by those in the community for multiple reasons:
-overdoses have decreased from 35% on site, and 9% in the city overall
-since opening, there has been a decrease in needle-sharing, public injections and publicly discarded syringes
-an increased number of people are seeking treatment services due to Insite.

Insite is a great benefit to the community in the downtown Eastside. Overcoming legal and political obstacles, it continues to provide services to those who need it.

If you want to continue reading about Insite, check out their official website!

Or, if reading isn't your thing, this video provides some excellent information.

Bibliography

A Look At Insite