Injection drug users’ experiences with supervised injection sites

The injection of illicit drugs, such as heroin and cocaine, is associated with human suffering and high financial costs that harm individuals, families, communities, and society. Canada has approximately 125 000 injection drug users (IDUs), with approximately 5 000 living within 16 square blocks in Vancouver’s Downtown Eastside. In this area’s streets and alleys, illicit drugs are openly sold, bought and consumed. To address problems related to drug trafficking and consumption, the City of Vancouver adopted in 2001 a "Four Pillar" approach of 1) Prevention; 2) Enforcement; 3) Treatment; and 4) Harm Reduction. One component of the harm reduction pillar was the establishment and operation of two supervised injection sites (SISs) as research pilot projects. Although SlSs are operating in Europe and Australia, Vancouver has the only official sites in North America. The limited research on SlSs has focused on operational statistics, client demographics and health, and the effects on the community. Very little is known about the experiences of IDUs. I conducted a qualitative study, using interpretive description as a methodology, to explore IDUs’ experiences with SISs. The primary data was collected through audiotaped interviews with seven lDUs residing in single-room occupancy hotels and apartments located near an open drug scene. Findings revealed that while participants unanimously support SISs, because they believe the sites save lives, most use the sites only rarely or occasionally. Although SlSs are designed as a low-threshold service to meet the needs of high-risk IDUs, five barriers that limit access to the service have been identified: 1) Limited Hours of Operation; 2) Public Entrance--Lack of Anonymity; 3) Waiting Time; 4) Atmosphere; and 5) Prohibition of Assisted Injection. This research revealed some unexpected findings. First, many participants feel unsafe because they perceive that the degree of violence on the streets has increased and they blame this on younger crack smoking addicts. Second, participants expressed a concern for others and they have acted to make positive changes through advocacy, action, and acts of compassion. These findings highlight the importance of including IDUs’ perspectives regarding health interventions, such as SISs, that are specifically directed at them.Applied Science, Faculty ofNursing, School ofGraduat