Chris Buchner manages the HIV/AIDS and Harm Reduction programs for Vancouver Coastal Health (VCH); as such he is familiar with the demographics of the population that uses Insite, Vancouver's Safe Injection Site (the only service of this type in North America). Insite is located at 137 East Hastings Street, just West of Main and Hastings, in the heart of the Downtown East Side (DES).

The location borders Vancouver’s Chinatown, a very active area of the city. Just beyond Chinatown, the DES is home to a variety of store-front retail outlets, poverty action groups, walk-in health clinics, food shops, porn shops, and especially inexpensive hotels filled with poverty stricken folks of all stripes. East Hastings itself is a through-fare that turns into the TransCanada Highway.

Insite safe injection site Injection Room in Vancouver, BC, sees approximately
700 clients per day and is the only service of its kind in North America.

Buchner said the Insite program is conscious of the people they serve, "We don't have an explicit quota as such but we make an effort to hire Aboriginals as well as women. We have a number of professionals on staff who are Aboriginal. We are lucky," said Buchner, "because we have the jobs staffed whereas there is such a huge demand for personnel in Aboriginal programs," and qualified staff are in short supply right across the country.

He said, "We see a lot of Aboriginal people in the Insite program, about 25 percent of the clientele is Aboriginal. They are amongst the most marginalized people of all, in all addictions. These are the people most likely to be homeless, likely using the most drugs. This place reveals the gaps in our system for Aboriginals, who have become way over-represented in this population." Buchner noted that Vancouver contains about 10 percent (or less) Aboriginal people but Insite contains a 25 percent Aboriginal clientele.

Insite's Injection Kit.

To address the fundamental issues behind this abnormal disparity, VCH opened a clinic called the Vancouver Aboriginal Healing Centre in East Vancouver. "We have 12 clinics around the city but there is a big barrier to culture accessibility and identity, so we opened an Aboriginal Healing Centre last year. We are trying to improve services with the traditional healing and cultural approaches that address First Nation issues and attitudes. We need more culturally specific approaches to fill the gaps."

The DES remains a magnet for despair. With First Nations people Buchner has seen a lot of back and forth between the DES and their home communities in remote locations. "When they come down to the city they leave homes due to hard times and hit the city with nothing, which leads them right into the temptations found in the DES."

Clay Adams is Communication Officer for Vancouver Coastal Health that operates Insite, "People either support it or they don't since it began three years ago," said Adams, "The debate continues, but clearly since (the opening) we have seen support increase." Studies are being conducted into the effectiveness of the safe injection site at the federal level and with the Vancouver-based Centre for Excellence for HIV/AIDS at St Paul's Hospital.

"Our clientele is not necessarily from the DES. It comes from right across the province and from out of province. There are no residency requirements," said Adams, "We are seeing 700 clients a day." The site is used by people whose identification is confirmed by assigned password. The Insite Safe Injection Site is open "18 hours a day, 10 A.M. to 4 A.M., seven days a week."

Adams said, "We are about at capacity. We don't run 24 hours a day because we cannot afford it." Drug addicts bring in their own 'stuff', "The drugs used are usually heroin and cocaine, but other drugs are used, including methamphetimines and others. "The 'stash' is their own, and they bring in enough for one sitting, one injection, and there are no assisting persons," to accompany the drug user.

Insite staff provide medical supervision and monitoring, and many staff members are Registered Nurses, as well as professional non-clinical counselors. They have a 12-person staff. The place is set-up with open area injection booths, not private at all. "That is the point, the activity is supervised." For more information about the Aboriginal Health Services contact 1-604-714-3475.

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