Safe Houses and Harm Reduction

Safe houses provide many benefits in the form of different harm reductions.  Among the most important benefits are affection, normal social engagement, nutrition, regular sleep.
The primary goal of safe injection houses is to provide a hygienic environment in which drug users can take substances such as heroin and cocaine without being at risk of the dangers normally involved with these activities. Typically, these dangers include:
* The spread of blood-borne diseases, such as HIV and Hepatitis C * The chance of infection through contaminated needles * Risk of damage to the veins and arteries through improper injection techniques
Another study looking at the Vancouver site found that crime rates did not increase, despite a rise in the number of drug users in the area. Within the supervised grounds of the safe injection house, addicts were left to use in private without having to disturb the public outside. As well as this, it was also shown that these types of locations had the following benefits:
* Decrease in injection debris around the city
* A slowdown in the spread of Hepatitis C and HIV
* Less government expenses ($1 spent on-site saved $4 of the taxpayer’s money)
* An increase in patients entering rehab clinics through the house’s counseling services

Police corruption and street crime in the Kings Cross district of Sydney, prompted the Wood Royal Commission to recommend the opening of an injection facility in the area,[7] with the Sydney Medically Supervised Injecting Centre (MSIC) opening in May, 2001.[8] In Canada: problems with drug use, discarded needles and crime made Downtown Eastside of Vancouver the location for the first facility, when Insite commenced operation in 2003.[8]
Whereas injection facilities in Europe often evolved from something else, such as different social and medical out-reaches or perhaps a homeless shelter, the degree and quality of actual supervision varies. As many European centers also allow clients to consume drugs by other means then by injecting it on its premises, EMCDDA prefers call them “drug consumption facilities” instead of anything alluding to “injection”. The history of the European centers also mean that there have been no or little systematic collection of data needed to do a proper evaluation of effectiveness of the scheme.[3]
However, some of the very rationale for the projects in Sydney and Vancouver are specifically to gather data, as they are created as scientific pilot projects. The approach at the centers is also more clinical in nature, as they provide true supervision with a staff that is equipped and trained to administer Oxygen or Naloxone in the case of a heroin or other opioid overdose.[8]

Impact on community levels of overdose

Over a nine-year period the Sydney MSIC managed 3,426 overdose-related events with not one fatality[40] while Vancouver’s Insite had managed 336 overdose events in 2007 with not a single fatality.
The 2010 MSIC evaluators found that over 9 years of operation it had made no discernable impact on heroin overdoses at the community level with no improvement in overdose presentations at hospital emergency wards.[41]
Research by injecting room evaluators in 2007 presented statistical evidence that there had been later reductions in ambulance callouts during injecting room hours,[42][43][44] but failed to make any mention of the introduction of sniffer dog policing, introduced to the drug hot-spots around the injecting room a year after it opened.[45]

Cost effectiveness

The cost of running Insite per annum is $3 million Canadian. Mathematical modeling showed cost to benefit ratios of one dollar spent ranging from 1.5 to 4.02 in benefit. However, the Expert Advisory Committee expressed reservation about the certainty of Insite’s cost effectiveness until proper longitudinal studies had been undertaken. Mathematical models for HIV transmissions foregone had not been locally validated and mathematical modeling from lives saved by the facility had not been validated.[32] The Sydney MSIC cost upwards of $2.7 million Australian per annum in 2007.[78] Drug Free Australia has asserted that in 2003 the cost of running the Sydney MSIC equated to 400 NSW government-funded rehabilitation places[79] while the Health Minister for the Canadian Government, Tony Clements, has stated that the money for Insite would be better spent on treatment for clients.[80]

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