Supervised injection sites—like the one in Vancouver, Canada—offer people a safer place to use, often helping those with a long history of addiction who don’t respond to oral treatments like methadone and Suboxone.
Canada’s Bold Steps to Reduce Opioid Overdoses
Published: November 1, 2018
Onscreen: In 2017, the Vancouver, Canada Fire Department responded to a record 6000 overdoses in the Downtown Eastside.
Darwin Fisher: We have a situation in North America right now where's it's never been more unsafe to inject drugs. That doesn't seem to be stopping people from injecting drugs. And it makes me think that what enables addiction is our shunning and stigmatizing and isolating of people who use drugs. We need a new approach.
Onscreen: In 2003, Vancouver opened the first legal site in North America where drug users can inject illegal drugs under medical supervision. Called Incite, the program provides clean needles to prevent the spread of infectious diseases, drugs to reverse overdoses, and help accessing services like medicallymedication-assisted treatment.
Fisher: When people come to Insite, often the first thing that they're thinking is, "I need a safer place to use. I don't want to die in the alley. I'm tired of living in, essentially, what are Third World conditions." So, what we're doing is we're saying, "Come on in to first world healthcare.” And in the years since Insite opened, overdoses in the area have gone down and our HIV rate in Vancouver has plummeted dramatically.
Onscreen: Incite’s success bolstered other efforts. At the Overdose Prevention Society, Sarah Blyth helps people test their drugs for fentanyl. But that’s not the only contaminant she’s worried about.
Sarah Blyth: Because we've seen everything from cement filler to comet to pig de-wormer, like you name it. Anything that they can put in there they do, and it's dangerous.
Onscreen: A pink stripe indicates the presence of Fentanyl. It’s now found in 88% of illegal opioids here. Like many longtime users, Daniel knows he’s injecting fentanyl, but the fear of dying isn’t as powerful as his cravings. He first took opioids in prison to calm his anxiety.
Daniel: There’s always a fear that something bad is going to happen. There’s going to be somebody getting stabbed, or a fight’s going to break out. So, when I did that first hit, it was the first time I felt like I could relax and not have to worry.
Fisher: To my mind obviously the most important things about supervised injection sites is that it implicitly says that these lives are worth saving, these people are valuable to us. What’s really important about it as well is that it’s a space of connection—where people are treated like human beings, and that’s the space that people are going to ask for help from.
Onscreen: Today, Vancouver is going even farther to keep drug users safe. At the Crosstown Clinic, a select group of patients can now get daily injections of safe, medical grade heroin. For ten years, Coral had tried Methadone, but it couldn’t stop her cravings or keep her from relapsing.
Coral: I know it sounds stupid to like give drug users drugs, but it works. Because it's taken away all the criminal aspects of my life. It's made it so I can be honest with everybody. It's made it so, I'm safe. One of the big milestones for me was going through my first pay day, and not buying drugs. That was huge. I'd never made it past the pay day in 12 years.
Dr. Christy Sutherland: It seems like such a no brainer to sort of approach someone who's iving in those circumstances and say, "Hey. You know, I have something here you can take instead, uh, and that you won't feel withdrawal and you will feel safe. You won't have to do, uh, crime anymore. You won't have to do sex work. Uh. And that you won't have this constant fear of death."
Dr. Scott MacDonald: We need the full continuum of treatments. Yes, we have good treatments in Suboxone and in methadone- the standard oral treatments. And those work very well for most people, but not all the time, and not for everyone.
Sutherland: And once people have stabilized on the program, sort of, they can relax for the first time in many years and that they look for work and they get hobbies again and they reconnect with family. So, you're really just sort of breaking the cycle of that horrific intoxication and withdrawal and uncertainty that people have been living for many years.
Onscreen: Daniel is now working at supervised injection site, providing peer support. He is also taking legally prescribed morphine. Daniel, who is addicted to Fentanyl, is also taking legally prescribed morphine.
Daniel: My hopes are that getting up to a dose that's high enough, I may, you know, be willing or strong enough to start tapering my use or stopping using fentanyl. I want to get off Fentanyl. And I led a life of crime and I see myself giving back for all those years of my misspent youth getting into trouble and going to jail.
Sutherland: We know that making people uncomfortable does not decrease drug use. If it did, we wouldn't have addiction. If being uncomfortable and suffering and feeling shamed made you stop using drugs, people wouldn't use drugs. We know that that doesn't work. Then, in fact, treating people like humans, who are ... We care about. Giving them safety and giving them connection, is what makes people better.
Written, Produced, and Directed by: Sarah Holt
Director of Photography: Rob Lyall
Fixer/Field Producer: Robin Nielsen
Assistant Camera: Kevin Rigney
Sound: Jordan Sy
Digital Producer: Ana Aceves
Music: Sheldon Mirowitz
© WGBH Educational Foundation 2018