The war on drugs failed. What now?
Public-health approaches to addiction share a compelling goal: to avoid making things worse.
Every day in Vancouver, Canada, anywhere from 600 to 1,000 drug addicts enter a nondescript building where they can—under medical supervision—inject themselves with illegal drugs they have brought with them, usually heroin, cocaine, or methamphetamine. They know that while at the site they will be neither arrested nor judged, and as long as they are in the building they will be safe.
The program, called Insite, is the only legal supervised injection site in North America. It’s located in the Downtown Eastside section of the city, a ten-block area full of single-room occupancy hotels. Drug users are visible on the street all day and often sleep in dumpsters and alleys. Business activity in the area reflects this population: there are lots of fast-food outlets and low-end shops and an open market where street vendors can obtain quick cash.
Once inside the center, first-time clients are interviewed by staff, who ask for identification and about the nature of their drug use. They are supplied with clean needles and syringes and enter one of 12 stalls surrounded by mirrors on three sides, which allow clients to be observed by nurses, who are available to minimize risk of injury. Clients then enter a lounge area. The second floor of the facility houses a detox unit and the third floor has an 18-bed long-term recovery unit. Individuals are not required to ask for these services, however.
