VANCOUVER - A report to federal Health Minister Tony Clement indicates drug injections at a safe-injection facility in Vancouver's Downtown Eastside account for less than five per cent of all injections in the notorious neighbourhood.
"This limits the likelihood of significant direct impact from Insite in the Downtown Eastside," the report by an expert advisory committee says.
"However, more than 220,000 clean injections have taken place at Insite and for a population with these characteristics this is a significant achievement."
The expert committee report, released Friday in Ottawa, makes 17 conclusions that cite advantages and disadvantages to the controversial facility.
The committee, set up by Health Canada, also says more than 8,000 people have visited the facility since it opened as a pilot project in 2003. But only 18 per cent of those account for 86 per cent of the visits and less than 10 per cent used Insite for all their injections.
The drugs being injected are illegal but Insite operates with the blessing of the federal government, which twice has provided an exemption to a section of the federal Controlled Substances and Drugs Act.
Thomas Kerr, a research scientist at the B.C. Centre for Excellence in HIV/AIDS and an assistant professor of medicine at the University of B.C., has conducted or overseen many studies of the injection site.
He said the five per cent finding of people injecting at the site may mislead the public.
"If you count the number of injections that occur every day in the neighbourhood the site only covers five per cent," said Kerr.
"But that's obvious. It's a small pilot facility and it's running at capacity."
But Kerr said the report overall was very positive.
"It confirms a lot of our findings which show the site is producing many benefits and not causing any harm," he said.
The committee acknowledged the site had made a contribution to improving public disorder, helped get people into treatment and reduced HIV risk behaviour, he said.
The expert committee also says the general public has positive views of Insite and that users rate the facility as highly satisfactory.
The committee also said Insite staff have successfully intervened in more than 336 overdose events since 2006 and no overdose deaths have occurred at the service. Mathematical modeling suggests Insite saves about one life a year as a result of intervening in overdose deaths.
Letters of support and surveys indicate health professionals, local police, the local community and general public have either positive or neutral views of Insite, the report notes.
The annual operating cost of Insite is $3 million or $14 per visit in the year ended August 2007. The 500 most frequent users went more than 400 times at an average cost per person of $13,100.
Kerr said the $3 million figure was incorrect and that the site costs half that to operate annually.
The report says there seemed to be no increase in drug-related loitering, drug dealing or petty crimes in areas around Insite.
It also says the facility encourages users to seek counselling, detoxification and treatment. Such activities have contributed to an increased use of detox services and "increased engagement in treatment."
Health Canada spokeswoman Rita Smith in Ottawa said the minister would carefully review the committee's report, but she declined to speculate on how Clement viewed the findings.
The reports says "self-reports" from users suggest a decrease in needle-sharing but it also says there is no evidence the site helps reduce HIV infection.
Tom Stamatakis, president of Vancouver police union, said that unlike the executive of the police department, which has indicated support for Insite, the rank-and-file does not like the facility.
"We have a significant problem with drug addiction in the Downtown Eastside ... and I would like to see (Insite's operating costs) plowed into treatment programs.
"I'm concerned that some of the proponents will focus on some of the positives - and there are positives - and overstate what impact Insite has had."
He said Insite is a "well-intended" project, but it isn't making the difference that people envisioned "so let's re-evaluate on focus on treatment."
Stamatakis said front-line officers on the street "don't support the continuation of Insite and don't agree with the position the executive of the police department have taken."
