Earlier this month, there were 36 overdoses in Surrey over the course of a single weekend. Despite the public health emergency, in an interview with the CBC, Surrey’s Mayor presented some shocking arguments against setting up supervised injection sites in B.C’s second largest municipality. The Mayor’s position is based on several underlying misconceptions about safe injection facilities that need to be put to rest once and for all. 

Listen to the CBC’s July 25 interview with Mayor Hepner here

Misconception #1: There needs to be more evidence that lives are changed by injection sites before City Council can endorse them.

First and foremost, the purpose of supervised injection sites is to reduce the harms associated with injection drug use. Harm reduction as a philosophy aims to meet people who are struggling with addiction where they are at. There is no expectation that they must change their behaviour in order to access healthcare – that is not reasonable to ask any group of people. Health care is a human right that should be accessible, full-stop. 

Furthermore, there is a multitude of research that shows Insite and other safe injections sites are highly effective in improving the lives of not just injection drug users but the community at large. Safe injections sites have been proven to reduce transmission of HIV, [1] Hep C [2] and other diseases, they provide an access point to primary health, mental health services, [3] detox and treatment, [4] they reduce discarded needles in neighbourhoods, [5] and they are a place where some of the most extremely marginalized people find support, safety and community.

The beautiful thing about safe injection sites is that along with preventing harms, they provide a space where healthcare providers can begin building respectful relationships first. Then, once those relationships are established, those who are ready may feel safe enough to ask for help. Respect is an incredibly powerful tool, particularly with a population that is used to being stigmatized, excluded and ignored by society. Change begins by providing non-judgmental access to the care that people need.

Over the years that Insite has been operating, there have been nearly 5,000 overdose interventions. Thousands more of lives have been impacted. The numbers clearly show that there are hundreds of detox admissions every year directly from Insite, and thousands of other service referrals and health treatments that take place on top of overdose interventions.[6] But the numbers miss one of the most significant ways that people’s lives are changed: Insite treats people with respect and dignity, often when they are struggling in the lowest moments of their lives. This kind of compassion and human connection is one of the most important positive impacts that a safe injection site can provide.

Misconception #2: Fatal overdoses are being effectively prevented without injection sites.

It is very lucky that there were no deaths in Surrey the July weekend when overdoses spiked. But luck is not a plan. Luck is not leadership. And there have already been dozens of preventable overdose deaths in Surrey this year.[7]

Leaving overdose response to first responders who must get to the scene after the overdose has occurred not only puts lives at risk, it is a misuse of emergency response resources, and is depriving Surrey’s drug users the opportunity to connect with health care providers, and maybe eventually the treatment services that everyone acknowledges are so important

Misconception #3: There needs to be other services in place for drug users in Surrey before considering supervised injection services.

Yes! There absolutely does need to be more services for Surrey's drug users! But that is not a reason to reject safe injection sites. There do not need to be treatment beds available for safe injection sites to be beneficial from a public health perspective. They are one, extremely important, piece of a larger network of health care services that needs to be provided to citizens who are struggling with drug use. And as we have seen with Onsite, the detox management and treatment centre attached to Insite, sometimes the best way to connect safe injection sites to treatment is to build them together and integrate their services. 

Safe injection sites have been studied extensively and the data shows that they are a powerful and positive addition to the continuum of services needed for drug users. Especially at a time when drug overdoses have spiked to epidemic levels, we need our leaders to embrace the evidence that these are services that will save lives, and improve the health and wellbeing of drug users in their communities.

With all major cities across Canada moving towards opening safe injection sites, it is indefensible that Surrey is moving in the opposite direction.