The concept of supervised injection sites (SISs) – also referred to as safe injection sites or supervised consumption sites – has been controversial for the past 50 years. The reality is that addiction is widespread in today’s society, and the issue should be at the forefront of the Canadian government’s agenda. Whether it is at home, on the streets, at local parks, or within these controlled sites, drug use is inevitable. It is easy to turn a cold shoulder and take an individualistic stance, claiming that since drug addiction does not specifically affect me, I shouldn’t care. But this mentality overlooks the humanity of drug users and the socioeconomic conditions that can lead to drug abuse, as well as the harms that unaddressed drug use can have on society as a whole.
What are Supervised Injection Sites?
Supervised injection sites share common goals of reducing overdoses by ensuring users have access to controlled amounts of clean drugs, rather than drugs cut with other potentially more dangerous substances like fentanyl that are sold on the street. SISs also function to mitigate the spread of infectious diseases like HIV; making sure needles used for intravenous drug use are not shared and are disposed of properly can help guarantee diseases carried in the bloodstream are not transmitted to others.
Overall, SISs offer a safe and clean environment, life-saving resources, and take some responsibility off of healthcare systems. Furthermore, these sites provide people with employment and income support, medical and counseling services, referrals to housing and drug treatments, and education on safe consumption practices and the harms of drug use.
This topic is important to discuss because addiction is not a choice, but rather a disease that is highly stigmatized. As Dr. Jillian Hardee stated, “Addiction does not occur because of moral weakness, a lack of willpower or an unwillingness to stop.” Addiction alters the brain: drugs hijack the dopamine pathways in one’s brain, teaching it that drugs are needed to feel any sort of pleasure or euphoria, which then encourages the user to continue using drugs to chase that initial feeling. When substance use is consistent, the brain’s ability to produce dopamine is inhibited – it produces less which impacts the individual’s ability to experience feelings of pleasure.
Because of the misconception that addiction is a conscious decision or a sign of weakness, those suffering from addiction are often met with immense discrimination and judgement from other members of society. This, in turn, creates barriers for them to access the help they need. The government has a responsibility to its constituents and their well-being; through the facilitation of supervised injection sites, it can remind those struggling with addiction that they are not alone, help is available, and their substance use does not define who they are. This creates a bridge between people suffering from addiction and the government – it recognizes them and sees them as worthy of help.
The Dangers of Stigma at the Government Level
However, there has been anti-SIS legislation introduced over the years in Canada. In particular, Bill C-2, which was put forward in 2013 as an amendment to the 1997 Controlled Drugs and Substances Act, has created operational barriers to creating new clinics and has threatened the future of existing sites. This bill states that in order for organizations to operate a safe injection site, they must gain support from 26 different agencies, whether they be from the federal government, civil society groups, or provincial health departments. This makes it nearly impossible to get new sites approved. In response to this, business owners, service providers, and residents from Vancouver’s Downtown Eastside have come out stating the positive impact SISs have had on the health of their community as a whole.
Debunking the Myth that Supervised Injection Sites Encourage Addiction
It is important to address the common argument that states that taxpayer money should not be used towards funding these sites, as it would encourage “immoral” behaviour or even increased drug use and addiction. Prominent political figures like Ontario Premier Doug Ford have publicly voiced their support for decreasing the number of sites within the vicinity of each other – according to Ford they should not be too concentrated. He stated, “It’s okay to help ‘em, but not in my backyard” – a conservative talking point that has been echoed by many people across the province who support decreasing the funding of SISs.
Many believe that the establishment of SISs would make the problem of addiction worse, and instead believe those suffering from addiction should be cut off so they would be forced to become clean. But this is a very harmful way of approaching addiction. Someone suffering from addiction isn’t going to be able to stop their compulsion just because someone told them to – instead, cutting individuals with addiction off from any supply can have the effect of pushing them to use in dangerous and life-threatening ways.
SISs entail meeting people where they are on their own journeys, not forcing them onto a path that is detrimental to their own physical and mental health. But what about the larger social ramifications of SISs on public safety one might ask? Research on Insite, the first legal safe injection site in North America, showed that participation in safe injection sites did not encourage increased drug use. What’s more, many researchers have concluded that drug-related crimes like dealing or trafficking either decreased or stayed the same in areas with SISs. Ultimately, SISs contribute to both public health and safety as well as the individual well-being of those suffering from addiction.
Individuals struggling with addiction deserve help and SISs would offer a shame-free environment for them to access safe resources and social support. Turning a blind eye to addiction will not cause it to disappear, in fact, it would diminish the dignity of those who struggle with it. SISs have the potential to increase the quality of life for those who struggle with addiction and for other community members, thus they should not be met with disdain.
Edited by Barbara Amona Purdie