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  • Supervised injection sites come to Montreal

    Posted on January 16th, 2014 TimB No comments

    Montreal will soon be home to four supervised injection sites. The sites, announced in December 2013, will include three permanent locations in already existing clinics across the city, as well as one mobile clinic to serve the Montreal area.

    The news comes after a decade-long struggle between the Canadian federal government and the Quebec-based organizations that have been advocating for supervised injection sites (SIS) in Montreal ever since the first site, Insite Vancouver, was established in 2003.

    SISs are places where injection-drug users can go to obtain clean needles and dispose of used ones. Additionally, social workers and on-site emergency medical attention are available to users if needed. These sites are part of an approach known as harm reduction, which involves programs that provide safe spaces and medical services for drug users in a nonjudgmental and non-coercive manner.

    Since its inception, Insite has operated under an exemption to the Controlled Drug and Substances Act, allowing it to legally provide help to drug users.

    Inspired by Insite, Montreal-based organizations, such as Association pour la Défense des Droits et l’Inclusion des personnes qui Consomment des drogues du Québec (ADDICQ) and CACTUS Montreal, began campaigning for SISs in 2003. However, they were unable to obtain the same exemption that Insite was given, and thus had little hope of creating the sites. In 2011, the Supreme Court ruled that Insite was a necessary service, said Sylvain Côté of ADDICQ, a community-based organization that provides support for injection drug users.

    Read More

  • The Case for Heroin-Assisted Treatment in Canada

    Posted on November 1st, 2013 TimB No comments



    Heroin-Assisted Treatment, or HAT, is a medical intervention that provides prescription, pharmaceutical-grade diacetylmorphine (heroin) to people with long-term opioid dependency who have not responded to traditional treatments.  It is cost-effective, reduces crime, and promotes individual and public health.  Learn more about why HAT is good for Canada in this booklet PIVOT  produced for the  public forum on October 30, 2013.


  • A cost-benefit/cost-effectiveness analysis of proposed supervised injection facilities in Montreal, Canada

    Posted on July 12th, 2013 TimB No comments

    This paper will determine whether expanding Insite (North America’s first and only supervised injection facility) to more locations in Canada such as Montreal, cost less than the health care consequences of not having such expanded programs for injection drug users.

    With very conservative estimates, it is predicted that the addition of each supervised injection facility (up-to a maximum of three) in Montreal will on average prevent 11 cases of HIV and 65 cases of HCV each year. As a result, there is a net cost saving of CDN$0.686 million (HIV) and CDN$0.8 million (HCV) for each additional supervised injection site each year. This translates into a net average benefit-cost ratio of 1.21: 1 for both HIV and HCV.

    The research concluded that  funding supervised injection facilities in Montreal appears to be an efficient and effective use
    of financial resources in the public health domain.


  • Article – Opening of the first Drug Consumption Room in Paris

    Posted on February 24th, 2013 TimB No comments

    On 5 February 2013, French Prime Minister has agreed to experiment with a Drug Consumption Room (DCR) in Paris. It took four years of debate and determination associations to finally see this come to fruition harm reduction tool.

    On 19 May 2009, a fictitious DCR was installed in the premises of the association of self-support for drug users ASUD, by a collective of associations composed of : Fédération addiction, ASUD, Act-up Paris, Sos Hépatites, Safe, Gaïa Paris and salledeconsommation.fr for expertise. The collective “May 19″ had even filed a pre-project in the administration of the Ministry of Health. The time suggested the possibility of an experiment because the Minister of Health at the time, though a Conservative Government, ruled in his favor on the recommendations of the ‘INSERM’ (National Institute for Health and Medical Research) on harm reduction in France. But the Interministerial Mission for the fight against drugs and drug addiction and the Prime Minister at the time, quickly ended the debate by a non (“Neither useful, nor desirable”).

    2012 : Change of government and policy change. Actors in the field are finally heard. The pragmatic (based on science and the field) trumps ideology and morality.

    Why DCR?

    In recent years, the French situation on drugs has worsened due to a policy of “repressive of all”. Increased incarceration, 50% increase in the number of overdose (since 2003), a prevalence of Hepatitis C 60% among drug users…

    Paris is so far the only city chosen for this experiment (A feasibility study is underway for the city of Strasbourg. The mayor of Marseille, who was favorable, is now opposite -for political reasons- and despite the work of two years, an expert committee set up by the municipality itself.

    Paris: It is estimated that about 4 000 to 5 000 people who use the streets, parkings, building lobbies, toilets public. These people have health problems, social problems and are in great mental suffering.

    The public wanted by the DCR:

    Drug users who have little or no contact with health care facilities and/or harm reduction. Many young people under 30 years old, wandering, often accompanied by dogs, homeless, penniless, without family support, without social protection, without without without… They inject Skénan (based drug morphine), morphine, cocaine, consuming crack, alcohol. A very poor state of health despite their young age and are far removed from the care system. They are also drug users 30 to 50 years, very rooted in insecurity, polydrug often infected with hepatitis C, without medical supervision and with advanced disease. And finally, they are drug users of foreign origin, mostly Eastern European countries, Skénan injectors, heroin, methadone, without a residence permit without social rights open, and also with a high prevalence of the hépaite C.

    The area of the “Gare du Nord” (railway station) is particularly concerned: place of consumption and deal. In this area, it was also found a significant increase in the activity of two automata (distributors-exchangers syringes). The DCR should be installed in this area of Paris.

    Today, a steering committee will be created to work on the evaluation objectives, find the location in the neighborhood, the residents together… The association Gaia Paris should open the DCR in a few months.

    Bernard BERTRAND

    Expert DCR

    Member of the executive committee of the French Network Harm Reduction

  • Supervised Injecting Facilities: What the literature tells us

    Posted on January 20th, 2013 TimB No comments

    Supervised Injecting Facilities (SIFs) are a  well-known, and at times controversial  public policy measure to reduce the harms
    associated with injecting drug use A substantial amount of literature has been  published on SIFs The Drug Policy Modelling Program located 134 papers and reports that  provided reviews, outcome studies,  economic evaluations, policy analyses and  descriptions of SIF from across the globe The annotated bibliography provides the  details of these papers.


  • Australian Medical Association gets behind safer injecting rooms

    Posted on October 1st, 2012 TimB No comments

    The  Australian Medical Association has called for the trial of a supervised injecting facility in Victoria to prevent overdoses and help control the spread of blood-borne diseases including hepatitis C.

    The government has repeatedly ruled out making the necessary legislative change for a safe-injecting facility, and did so again last night.

    The Labor party would not say whether it would support the establishment of a supervised injecting facility if it won office, but the Greens said it should be considered.

    AMA Victoria president Stephen Parnis said such facilities had worked to reduce harm in other areas including Sydney’s Kings Cross “and we’re hopeful they can do the same in Melbourne’s drug hotspots”.

    Dr Parnis did not nominate a particular location for a proposed trial but noted that heroin-related ambulance attendances were particularly high in the City of Yarra.

    Read the rest of this entry »

  • Editorial – Mobile safe injecting facilities in Barcelona and Berlin

    Posted on October 1st, 2012 TimB No comments

    In spite of the evidence of the positive public health effects of SIFs, they remain controversial in some jurisdictions. Much of the controversy centres on perceived public amenity impacts of the facilities. However, there is no published research demonstrating any negative impacts of SIFs on measures of public amenity. In contrast, research has shown that the public amenity impacts of SIFs are either neutral or positive across a range of amenity measures such as those pertaining to drug related crime.


  • Safer injecting facilities in Ireland

    Posted on September 30th, 2012 TimB No comments


    This presentation was presented at University College Cork on Wednesday 26th September. All the documents highlighted in the presentation are hyperlinked to assist in the accessing further resources


  • DÁIL QUESTIONS addressed to the Minister of State at the Department of Health (Ms. Shortall) by Deputies for WRITTEN ANSWER on 18/09/2012 – Needle exchange and supervised injecting facilities

    Posted on September 18th, 2012 TimB No comments

    DÁIL QUESTIONS addressed to the Minister of State at the Department of Health (Ms. Shortall) by Deputies  for WRITTEN ANSWER on 18/09/2012

    * To ask the Minister for Health if he will support this issue on syringes (details supplied) in County Limerick..
    - Finian McGrath T.D.

    For WRITTEN answer on Tuesday, 18th September, 2012.

    * To ask the Minister for Health his plans to roll out supervised injection sites across the country, if he will provide an update as to the whereabouts and timeframe associated with this, if he will comment on the progress to date; and if he will make a statement on the matter.
    - Ciara Conway T.D.

    For WRITTEN answer on Tuesday, 18th September, 2012.

    * To ask the Minister for Health the efforts he is making to support the Anna Liffey drug Project in Dublin; his position on supervised injection sites in this State; and if he will make a statement on the matter.
    - Caoimhghín Ó Caoláin T.D.

    For WRITTEN answer on Tuesday, 18th September, 2012.

    * To ask the Minister for Health his views on the calls for the provision of supervised injections sites; and if he will make a statement on the matter.
    - Billy Kelleher T.D.

    For WRITTEN answer on Tuesday, 18th September, 2012.

    Read the rest of this entry »

  • Insite Safer Injecting Site: lessons for the UK?

    Posted on August 14th, 2012 TimB No comments

    Danny Morris in conversation with Dan Small from the Insite safer injecting site in Vancouver Canada. Dan talks about the people who use Insite and how it improves outcomes for treatment, detox and employment for many.

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