Drug overdose deaths in Vancouver's Downtown Eastside fell dramatically after a safe injection site opened there, according to a study published online Monday in the British medical journal The Lancet. Fatal drug overdoses declined 35% in the vicinity of the Insite safe injection site in the two years after it opened, compared to only a 9% decline in the rest of the city.

[image:1 align:left caption:true]"No one has ever been able to demonstrate a substantial reduction in overdose deaths due to the presence of a safe injection site, but we have done so," said Thomas Kerr of the Urban Health Research Initiative at St. Paul’s Hospital in Vancouver and one of the authors of the study.

The study examined 290 drug overdose deaths between 2001 and 2005, 89 of which occurred within 500 meters of the Insite location. Insite opened in 2003. After Insite opened, the overdose death rate within 500 meters dropped from 253.8 per 100,000 to 165.1 per 100,000, a 35% decrease. In the two years prior to Insite opening, 56 neighborhood drug users suffered fatal overdoses; in the two years after, only 33 did.

Previous research had shown that Insite reduced behaviors that could lead to blood-borne infections like Hepatitis C and HIV and contributed to public order by getting IV drug use off the streets and into a clinical setting.

It is not that drug overdoses do not occur at Insite; in fact, there have been 2,000 of them at the facility, but no deaths. In addition to providing injection booths and clean syringes, Insite has nurses on staff who can and do revive users who have overdosed.

Despite previously demonstrated benefits of Insite and the strong support of provincial health authorities, Canada's Conservative government has sought repeatedly to shut it down. The Canadian Supreme Court next month will hear the government's appeal of British Columbia courts' rulings that denying injection drug users such a service violates their rights under the Charter of Rights and Freedoms and that the province has jurisdiction in the case because Insite is providing a health care service, a provincial function.

For the study's authors, the conclusion was obvious: "Safe injection facilities should be considered where injection drug use is prevalent, particularly in areas with high density of overdose."