Deaths from drug overdose decline 35 percent after the opening of supervised injection site

Illicit drug overdose deaths declined dramatically after the establishment of North America's first supervised injection facility located in Vancouver, Canada, according to the findings of a groundbreaking new study published in The Lancet.

In the first peer-reviewed study to assess the impact of supervised injection sites on overdose mortality, researchers observed a 35% reduction in overdose deaths in the immediate vicinity of a pilot injection facility called Insite located in Vancouver, Canada, following its opening in September 2003. By contrast, overdose deaths in the rest of Vancouver declined only 9% over the same period. No overdose deaths have been recorded at Insite since the facility's opening.

Insite supervises over 500 injections on an average day with only 12 injection seats. It is estimated that the neighborhood in Vancouver has an estimated 5000 injection drug users.

"The results of the study clearly indicate that supervised injection facilities such as Insite are playing a key role in reducing mortality rates from illicit drug use," said the study's lead author Brandon Marshall, PhD, a postdoctoral research fellow in the Department of Epidemiology at Columbia University's Mailman School of Public Health and former graduate student at the Urban Health Research Initiative (UHRI), where the study was conducted.

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 approximately a third of a mile from the facility 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.

Established in 2003 in response to an HIV epidemic and escalating overdose death rates in this downtown Vancouver neighborhood, Insite enables injection drug users to consume pre-obtained drugs under the supervision of nurses. Counselors 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 behavior, increase access to addiction treatment and primary health care services, and reduce healthcare costs in the long term.

Despite its success, INSITE has come under legal attack from political opponents. On January 15, 2010, the British Columbia Court of Appeal upheld a decision by the BC Supreme Court, now under appeal to the Supreme Court of Canada, that allowed Insite to continue to operate based on its demonstrated health benefits. Several groups and organizations, including the Canadian Medical Association, the Canadian Public Health Association, and the Canadian Nurses Association are calling for the continued operation of Insite.

Access The Lancet study abstract.

Source: Mailman School of Public Health