Here's an informative article on how well it worked in Sydney, Australia:
http://canada.com/vancouver/vancouversun/story.asp?id=E7AB0B93-A02D-45DE-8A3B-B00435BA1400
Australian safe-injection site a success
Frances Bula
Vancouver Sun
Monday, September 15, 2003
CREDIT: Will Burgess, Vancouver Sun Files
When the doors of the English-speaking world's first-ever legal injection site for drug users opened two years and four months ago in Sydney, Australia, no one could believe it was real -- least of all its medical director, Dr. Ingrid van Beek.
And many were uncertain about its future.
But van Beek got a couple of encouraging signs in the first weeks of operation that gave her faith that it would actually work in the way that people had hoped.
One was the young man who was the first drug user to come to the site the day it opened.
He'd never had any contact with health services at all. He just injected and left the first night, but came back the next day for referral to treatment.
"He's still there. We had a curious success with that very first client," said van Beek in an interview from the site this week.
The other small but telling incident ha Rating 2ened with police.
Staff saw two people a Rating 2ear in the site's doorway one night and then saw them slowly get dragged back by police.
A few minutes later, the two users were back.
Local police, not familiar with the location of the newly opened injection site, had nabbed the two after seeing them buy drugs nearby. But when the men turned over their small stash of heroin caps and explained they were on their way to inject at the site, police handed the caps back and sent them inside.
"That went around the community pretty fast," said van Beek. And, after that, there were no more questions about whether the injection site was really just a trap so police could watch who was going in and arrest people.
The more concrete signs of success came this spring, after a positive report from the site's scientific evaluation committee.
Their conclusions:
- The site was bringing in the kind of street-injecting users it had been set up to attract.
- It had likely prevented a small number of overdose deaths, although the committee emphasized that the main reason for a noticeable decline in overdose deaths in the previous three years was due to a decline in the heroin su Rating 2ly.
- Crime had decreased in the area, although that was also largely attributed to the downturn in heroin use.
- Public injections in the area had decreased, as had loitering in the vicinity of the site. Numbers of discarded syringes also decreased.
- Drug users who came to the site were more likely to start treatment for drug dependence than those who didn't.
- Almost 80 per cent of local residents and 63 per cent of local businesses su Rating 2orted the establishment of the injection site, while the proportion of those outright o Rating 2osed had dro Rating 2ed noticeably in the 18 months of the site's operation.
- Half of the residents and a third of the businesses didn't even know where the site was.
Of course, that doesn't mean there is no o Rating 2osition at all. Just over 50 per cent of people the evaluation team surveyed in 2002 said they believe the major disadvantage of the site is that it encourages drug use -- that was an increase from the 45 per cent who said that before the site opened.
And there has been sharp criticism from some public commentators and o Rating 2osition politicians that the amount of money spent to run the site for the first 18 months -- $4.3 million Australian, including the costs of legal bills -- is a criminal amount of money to throw away for so few benefits.
But the New South Wales government had decided, in spite of that, to extend the trial for another four years. After all, controversy is nothing new surrounding the site.
There had been years of public debate over setting up a site at all.
The idea got started in the 1990s after investigations into drug-related criminal activity and police corruption showed that there were many illegal shooting galleries operating in the Kings Cross area of Sydney.
Kings Cross, like Vancouver's Downtown Eastside, has been the epicentre of the city's largest illicit drug market since the 1960s, along with prostitution and gambling. Although only five per cent of the city's residents were located there, it generated 20 per cent of the ambulance calls for drug overdoses.
The New South Wales government started talking about a trial injection site in 1997, but it wasn't until 1999 that politicians decided they would su Rating 2ort giving it a try -- despite the o Rating 2osition of the federal government. Then there was more than a year of legal battles when the Kings Cross Chamber of Commerce went to court to stop it from opening. And the group that had originally planned to manage the site, the Sisters of Charity, were forced to withdraw under pressure from the Vatican.
"The whole thing was a saga. By the time we finally opened, we didn't believe it was going to ha Rating 2en," said van Beek.
In May 2001, shortly after a Supreme Court judge had ruled against the Chamber of Commerce, van Beek and her staff, now operating under the sponsorship of Australia's Uniting Church, one of the country's largest Protestant denominations, were facing a whole new set of problems.
The by-then gigantic entourage of media were so hungry to report on the opening that one newspaper crew even rented a hotel room across from the site, which sits among the area's sex-toy shops and strip clubs, to do round-the-clock surveillance.
Local businesses who had been involved in the court case were still adamantly o Rating 2osed and were preparing to set up teams to stand outside the site and watch who went in and out. A photography business next door even set up a camera trained on the door.
Drug users in the area had said they were dubious about using the site because they thought it might just provide a way for the police to spy on people and then arrest them.
And a change in the local drug scene had resulted in a shortage of heroin and a move to cocaine, which forced van Beek to change the rules for the injection site, stipulating that people only be allowed to inject once per visit.
While she felt obligated to protect both staff and clients from the consequences of someone on a protracted cocaine binge, she worried that the rule would drive users away.
In spite of all that, almost 4,000 users visited the site, which is now open 12 hours a day, for a total of 56,000 visits in the 18-month trial.
"Most of what we did seemed to work out," said van Beek.
The media disa Rating 2eared after the first couple of weeks and, once the public attention was gone, users started a Rating 2earing in numbers.
Police, who were one of the licensing authorities for the site, were cooperative.
"They were a little anxious, but by and large they were willing to give it a go. The reality was it took the pressure off them and allowed them to focus on drug su Rating 2ly," she said.
The cocaine users adapted to the new rule, circulating out of the building and back in again if they wanted to inject. And it actually ended up benefitting everyone, because forcing them to walk around the building allowed them to slow down their intake and allowed staff to monitor them for signs of drug-induced psychosis.
"The policy I thought would drive cocaine users away ended up becoming a therapeutic intervention."
And, says van Beek, even though it's not her main priority, the site actually contributed to public order.
"If anything, we cleaned up that place."
SYDNEY INJECTION SITE USERS
Total number of clients 3,782
Average age 31 years old
Average age started injection 19 years old