Landmark study: Overdose deaths down 35 percent after the opening of Insite

published on April 17, 2011

Scientific evidence demands that federal Conservatives drop their opposition to Vancouver’s supervised injection site

Vancouver, British Columbia (April 18, 2011) – Illicit drug overdose deaths in Vancouver’s Downtown Eastside declined dramatically after the establishment of Insite, North America’s first supervised injection facility, according to the findings of a groundbreaking new study published today in The Lancet, a leading medical journal.

In the first peer-reviewed study to assess the impact of supervised injection sites on overdose mortality, researchers at the Urban Health Research Initiative (UHRI), a program of the BC Centre for Excellence in HIV/AIDS (BC-CfE), observed a 35 per cent reduction in overdose deaths in the immediate vicinity of Insite following its opening in September 2003. By contrast, overdose deaths in the rest of Vancouver declined only nine per cent over the same period. No overdose deaths have been recorded at Insite since the facility’s opening.

“This study clearly demonstrates that supervised injection facilities such as Insite are saving lives and playing a vital role in reducing the harms associated with illicit drug use,” said co-author Dr. Julio Montaner, director of the BC-CfE and Chair in AIDS Research in the Faculty of Medicine at the University of British Columbia (UBC). “It’s time for the federal government to recognize the overwhelming scientific evidence in support of supervised injection sites, halt its legal maneuvering to close Insite, and allow facilities such as Insite to open in other Canadian cities.”

The researchers reviewed nearly 300 case reports from the British Columbia Coroners Service documenting all illicit drug overdose deaths in Vancouver between January 1, 2001 and December 31, 2005. Deaths were sorted geographically into two categories: those occurring within 500 metres of Insite and those occurring elsewhere in the city. Overdose mortality rates were then calculated for each category in the periods before and after Insite’s opening.

“There is no question in my mind that the study results provide further proof that harm reduction initiatives such as supervised injection facilities save lives, and have a key role to play in delivering safe and effective public health programs,” said Dr. Perry Kendall, B.C’s provincial health officer.

Despite public support in British Columbia and Canada and backing from the City of Vancouver and B.C’s provincial government, the Conservative federal government has consistently opposed Insite and continues to try to shut down the facility.

“Research results clearly show facilities such as Insite could literally be the difference between life and death for many people,” said Dr. Thomas Kerr, co-director of UHRI, associate professor at UBC and a senior author of the study. “The reality is that if the Conservatives fail to change their approach to harm reduction and do not adopt evidence-based policies to public health, more people will die needlessly.”

The researchers noted that Insite operates at capacity, supervising over 500 injections on an average day. Larger reductions in overdose deaths will require an expansion of the facility. Currently, Insite is a pilot facility with only 12 injection seats in a neighbourhood with an estimated 5000 injection drug users.

Established in 2003 in response to an HIV epidemic and escalating overdose death rates in Vancouver’s Downtown Eastside, Insite enables injection drug users to consume pre-obtained drugs under the supervision of nurses. Counsellors are also available onsite to provide support and referrals to programs, including addiction treatment. An extensive scientific evaluation by UHRI researchers has previously demonstrated the facility’s ability to reduce HIV risk behaviour, increase access to addiction treatment and primary health care services and reduce healthcare costs in the long term.

On January 15, 2010, the BC Court of Appeal upheld a decision by the BC Supreme Court, and clearly ruled that Insite, a health care facility, is under provincial, not federal, jurisdiction. The earlier BC Supreme Court decision also ruled that Insite helped ensure the constitutional right to health by providing an essential health service. These decisions allowed Insite to continue to operate based on its demonstrated health benefits.

Despite losing these two previous court cases, the federal government has submitted an appeal to the Supreme Court of Canada. The case is scheduled to be heard on May 12, 2011. Several groups and organizations, including the Canadian Medical Association, the Canadian Public Health Association, and the Canadian Nurses Association have obtained intervener status in the upcoming Supreme Court of Canada case, and will be calling for the continued operation of Insite.

The Lancet study abstract is available at


About the British Columbia Centre for Excellence in HIV/AIDS:

The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada’s largest HIV/AIDS research, treatment and education facility. The BC-CfE is a program at St Paul’s Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. Located in Vancouver, Canada, the BC-CfE is dedicated to improving the health of British Columbians with HIV through the development, monitoring and dissemination of comprehensive research and treatment programs for HIV and related diseases.

About the Urban Health Research Initiative:

The Urban Health Research Initiative (UHRI), established in 2007, is a program of the BC-CfE. UHRI’s mission is to improve the health of individuals and communities through research to inform policy. UHRI research programs are based on a network of studies that have been developed to help identify and understand the many factors that affect the health of urban populations, with a focus on substance use, infectious diseases, the urban environment and homelessness.

For additional information or to request an interview, please contact:

Mahafrine Petigara
Edelman (for BC-CfE)
604-623-3007 ext. 297
[email protected]

Graham Pollock
B.C. Centre for Excellence in HIV/AIDS
[email protected]