Handing out harm reduction supplies including take-home naloxone kits.

When Insite opened in 2003, people who used illicit drugs could walk into a welcoming space with trained staff and nurses on hand to respond to overdoses, deal with immediate health issues and provide referrals to addiction treatment. 

The impact was profound: overdose deaths were averted, the rates of HIV and hepatitis C due to shared needles went down and the number of people connected to health care and recovery services went up.

VCH Clinical Coordinator Kyle Yrjola prepares harm reduction supplies at the Insite nurses’ station; VCH Nurse Educator Dar Michaleski is in the background.

VCH Clinical Coordinator Kyle Yrjola prepares harm reduction supplies at the Insite nurses’ station; VCH Nurse Educator Dar Michaleski is in the background.

In April 2016, B.C.’s provincial health officer declared the toxic drug crisis a public health emergency. Today, the unregulated, illegal drug supply is the leading cause of death in the province for people aged 10 to 59, accounting for more deaths than homicides, suicides, accidents and natural disease combined. More than 14,000 people have lost their lives to overdoses in B.C. since the declaration.

“With the unregulated drug supply becoming more toxic, the risk to people in the community has grown exponentially worse in the years since 2003,” said Dr. Patricia Daly, Chief Medical Health Officer, VCH. “As a result, we’ve had to evolve the harm reduction services we’re offering at Insite and in the community because they are needed now more than ever.”

About Insite

Co-managed by VCH and PHS Community Services Society, Insite is a front-line, harm reduction service for people who use drugs and may be reluctant to access health-care services, as well as a hub for community connections. Insite offers drug checking; supervised consumption; immunizations, wound care, opiate agonist therapy and referral to specialists; support with basic health-care needs; case management; system navigation; access to supportive housing; medication support and connections to cultural services.

A supervised consumption room at Insite.

A supervised consumption room at Insite.

From left: Insite team members Carlo Campodonico, Doug Everett, Dar Michaleski, Adam Flood, Matt Wiley, Kyle Yrjola, Jeff West and Kelsey Rothwell.

From left: Insite team members Carlo Campodonico, Doug Everett, Dar Michaleski, Adam Flood, Matt Wiley, Kyle Yrjola, Jeff West and Kelsey Rothwell.

Preparing harm reduction supplies including take-home naloxone kits.

Preparing harm reduction supplies including take-home naloxone kits.

About Onsite

Located above Insite is Onsite. Every weekday, up to three people transition from supervised drug consumption at Insite to substance use stabilization at Onsite. It offers a 12-bed, medically supported substance-use stabilization floor and an 18-bed transitional housing floor that provides ongoing recovery support, and a modest temporary housing subsidies program that supports residents to transition back into the community.

“We now have more than 20 years of data that shows Insite saves lives. It does this directly, by reversing overdoses, and in less obvious ways, by providing access to health care and social supports,” said Micheal Vonn, CEO of PHS Community Services Society. “Insite brings stability to chaotic lives. It provides a pragmatic approach to a complex social and medical issue.”

Insite team member preparing harm reduction supplies.

Insite and other Overdose Prevention Sites also offer drug checking. Together with the British Columbia Centre on Substance Use (BCCSU) and the City of Vancouver, free, anonymous drug-checking services are available in Vancouver and other communities across VCH. Drug checking is a harm reduction service that allows people to determine what is in their substances and potentially take action to reduce the risk of any associated harms.