The evidence says safe injection sites needed in Winnipeg

published on May 22, 2018 by M-J Milloy and Brandon Marshall in Winnipeg Free Press

In the midst of an unprecedented crisis claiming thousands of lives every year, politics continues to stand in the way of evidence-based health policy.

Last week, political leaders in Manitoba expressed their opposition to a health service that could save people from dying of an accidental overdose. A recommendation to establish a supervised injection facility — where individuals can inject drugs under the supervision of a trained health care provider — was excised from a landmark government report on addressing the province’s mental health and addictions needs (the recommendation appeared in a preliminary version of the report that was mistakenly released by Manitoba Health; the report’s lead author said he removed it from the final report because he “didn’t have the data” to support it).

The provincial health minister claimed that the evidence doesn’t exist to support a facility in Winnipeg, while the premier downplayed the risk of overdose compared to other jurisdictions in the country.

Both are wrong. The scientific evidence on supervised injection sites and overdose is clear: these facilities save lives.

As scientists who worked on the evaluation of Insite — North America’s first legal supervised injection facility, located in Vancouver’s Downtown Eastside neighbourhood — we assessed its possible impact on overdose in a number of different ways.

During the first four years of its operation, there were 1,004 overdoses recorded — none resulted in death. In a statistical model, we estimated that between eight and 51 of these overdoses would have been fatal had they occurred outside of the facility. In fact, no overdose death has ever been reported at any of the approximately 100 supervised injection facilities worldwide.

We also reviewed the case files of the local coroner on all accidental drug overdose deaths in the city of Vancouver between 2001 and 2005, a period both before and after Insite opened. Rates of overdose in the area around Insite declined by 35 per cent — but only decreased by nine per cent in the rest of the city.