The following statement is an executive summary of our recent study of the costs and benefits and cost-effectiveness of Vancouver’s Supervised Injection Site (SIS) (Andresen and Boyd, 2008). After a review of existing literature regarding both the efficacy of supervised injection sites generally, and Vancouver’s site more specifically, we engaged in two kinds of analysis to determine benefit to cost ratios for the Vancouver SIS, and cost effectiveness: linear trend analysis and mathematical modelling. We were particularly interested in Insite’s ability to impact HIV infections and overdose deaths, as we were able to obtain reliable temporal and spatial data for each of these two variables.

Linear trend analysis was hampered by the small number of observations that we could make post-Insite; the inability to demonstrate significant changes with a three year time line, post implementation, compromised the utility of trend analysis. Nonetheless, we did observe some positive changes post-Insite in rates of HIV infection within the three local health areas in Vancouver that are closest to Insite (a reduction in rates of HIV infection), and correspondingly negative changes in trends in the three local health areas of Vancouver most removed from Insite (an increase in rates of HIV infection). These changes in trends did not, however, reach the point of statistical significance, and we are left with the observation that little can be concluded from a linear trend analysis of overdose deaths or HIV infections. Additionally, we were required to assume that new cases of HIV amount to a proxy for new HIV infections, and to assume a regional stability in rates of HIV transmission and corresponding rates of detection. In these circumstances any results from our linear trend analysis should be interpreted cautiously.

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Executive Summary

The following statement is an executive summary of our recent report on the impact of Vancouver’s Supervised Injection Site (SIS) on public order in the downtown eastside neighbourhood in which it is located (Boyd, Kinney, McLean, Heidt and Otter, 2008). We have compiled two sources of data: a detailed spatial and temporal analysis of criminal offences in the affected neighbourhood and beyond; and an analysis of 80 responses from structured and semi-structured interviews with men and women who work and/or live in the downtown eastside neighbourhood: interviews with 20 residents, 20 police officers, 20 service providers, and 20 business operators.

In examining spatially generated data regarding criminal offences from 2000 to 2006, we have been able to test two competing hypotheses regarding the impact of the SIS on public order. The first hypothesis suggests that the site may have a negative impact on public order, achieved through what has been termed a “honey pot” effect; users and dealers throughout Vancouver, and possibly beyond, may be drawn to Insite — amplifying the kinds of disturbance that are typically associated with illicit drug use: drug dealing, property crime, prostitution and violent crime. The second hypothesis is one which suggests that the site has had no significant impact on the commission of criminal offences – that it has been constructed to respond to health concerns, and is unlikely to have an impact on the ongoing dynamic of illicit drug use and distribution.

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