“The fear is definitely out there,” says Neil Arao, Mental Health and Substance Use Manager, Inner City Health Services. “People who are coming to Insite are looking for safety, even more so with the risks that have been presented by fentanyl.”
The recent increase in drug-related overdoses and deaths has resulted in heightened risk in vulnerable populations, particularly in the Downtown Eastside (DTES).
Insite has been operating in the DTES since 2003. Clients access the service anonymously and inject drugs themselves. Individual booths are monitored by staff through mirrored windows. After exiting their booth, clients can spend time in the supervised “chill-out room” until they’re ready to leave. The constant supervision allows for immediate assistance in case of an overdose. In the full 13 years of operation, Insite has never had one onsite death due to drug overdose.
“The service is busy from the time the doors open to close. We also have the statistics now available to show high periods of use. In November, the facility started opening one hour earlier from 10 a.m. to 9 a.m. to help ease the initial line-up each morning. Insite is also really busy for the couple days following delivery of social assistance cheques,” says Arao, noting that even a short wait time can result in the predominantly male clientele leaving and going back to the street to inject themselves.
“Our statistics show that people are also staying longer (at Insite), which can increase wait times,” says Arao, in agreement with the opportunity to connect clients to other programs. “The private booths provide a safe and quiet space for a few minutes, in contrast to the constant noise on the streets.”
Health Canada staff visited Insite this month and were impressed with the holistic approach to care and capacity to provide services to approximately 1,500 unique users. They also noted the comprehensive services offered in the same facility: onsite detox and transitional housing.
Opening more supervised injection services has been identified as part of VCH’s overdose response efforts. Staff are working on preliminary plans to create several supervised injection services integrated into facilities where harm reduction services are already offered to injection drug users. These new services will offer clients an improved connection to other services and programs including primary care.