Controversial HIV Prevention Strategy for Intravenous Addicts

InSite, a safe injection programme in Vancouver, Canada has helped limit the spread of HIV, and has prevented over 1,000 drug overdoses since 2003 – yet it is still considered highly controversial. Why?

InSite, a safe injection programme in Vancouver, Canada is the sole programme of its kind in North America where intravenous addicts are invited in to safely inject the illegal drugs they just bought on the streets. It was created in order to reduce the spread of HIV by providing clean needles, HIV testing, and healthcare to Vancouver’s addicted. At InSite nurses may watch on and even assist addicts to find veins and “safely” inject the drugs they are addicted to. They also help care for and clean infected injection sites, and respond to overdoses. One thousand overdoses – but no deaths – have taken place at InSite since it opened in 2003. What if those overdoses happened on the street with no medical staff around?

Although InSite does not provide treatment to individuals suffering from addiction, it does prevent deaths due to overdose, offers advocacy and referrals for treatment, and aids in preventing the spread of HIV. Because InSite is exempt from federal narcotic laws, individuals who choose to shoot up at InSite also do not have to worry about being arrested while getting their fix.

InSite’s model brings up a whole host of questions:

– By taking away one of the negative consequences of illicit drug use – arrest – will addicts be less likely to seek out help to change or less often mandated to treatment by law enforcement?

– On the other hand, are people likely to recover unless it is something that they are 100% committed to? -Is Insite promoting the continuation of addictive behaviours, or is it better to permit people who are not willing or ready to address their addiction to use drugs more safely? -Should more be done to get people off drugs, rather than support people to “safely” inject them? The above are only a few of the issues related to the impact on individuals suffering from the disease of addiction resulting from a community safe-injection site.

Advocates for the programme report that research shows InSite not only saves lives and reduces the spread of HIV, but also reduces crime. Even so, over the past ten years InSite remains the only programme of its kind in North America.

InSite’s unique public health approach poses a controversial stance on the addiction epidemic. But supporters are strong in the belief that harm reduction, and health care for addicts is essential to improvement in overall community health. That may be – but what about the overall well-being of the addicts? Studies have long shown that treatment programmes based on total abstinence have a much higher recovery rate as there is a much lesser chance of relapse. Statistics aside, we at The Cabin believe in every human being’s fundamental right to “quality of life”. According to SAMHSA (Substance Abuse and Mental Health Services Administration) recovery from addiction is defined in the following way: “Recovery from mental disorders and substance use disorders is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential”. This, we argue is hard to achieve whilst still injecting, even though safe from the risk of Aids.