InSite,the first legal supervised injection site, was opened in 2003 in East Vancouver, British Columbia, where there is a significant drug problem.  Dr. Gabor Maté writes candidly about his work with the addicted population there in his book In The Realm Of Hungry Ghosts: Close Encounters With Addiction.

In addition to providing clean needles and other sterile drug paraphernalia, InSite has nurses standing by to intervene if an overdose occurs.  Further to that, staff are available to provide addiction counselling, mental health and peer support, and other medical services such as wound care.

InSite has been very controversial, to put it mildly.  Proposals for similar sites in Toronto are moving very slowly.  InSite “operates on a harm-reduction model, which means it strives to decrease the adverse health, social and economic consequences of drug use without requiring abstinence from drug use.”  According to the Harm Reduction Coalition (http://harmreduction.org) harm reduction “is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.  Harm reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.”

Harm reduction is itself quite controversial.  Many in the addiction and recovery community believe that total abstinence is the right and only answer for addicts, and that encouraging anything else is simply perpetuating the problem.  Harm reductionists counter that with the argument that for many users, abstinence simply won’t happen, and so it is more realistic, more compassionate, and safer from a public health perspective to protect these populations from the risks their usage poses to them, such as disease transmission and overdose.

I do not have a history with drug abuse, or even use.  I have inhaled about three puffs of marijuana in my lifetime, after which I giggled uncontrollably for fifteen minutes and then went home.  I do smoke occasionally when under stress, and drink when under stress, but I am entirely capable of being around alcohol and choosing to abstain, and to go long periods without it.  So I cannot speak to the difficulty of true physical addiction, or to withdrawal, or to losing important things and people to a habit I can’t part with.

I do believe that those who are addicted are in great pain.  If they didn’t begin their drug use because of pain, surely they are experiencing it now, as their health wears down and they acquire diseases and infections from dirty needles and long years of use, as they lose the relationships that keep all of us, any of us, on a straighter, healthier path.   After awhile, their brains become damaged by their drugs of choice, so they become hard-wired to make the decisions they are making, less likely and less capable of moving into recovery. They probably, if they are honest, at some point give up, and take their comforts where they can, even as those comforts costs them the very things that would make it easier to quit.

I read somewhere that the war on drugs has actually become a war on the drug users.  While it has taken me awhile to come to this belief, I see safe injection sites as tragically, sadly, necessary.  These sites are, quite literally, places to save addicts from themselves, and I think, in their utter brokenness, they deserve that.  Please visit http://supervisedinjection.vch.ca to learn more.