By: Ellen Albritton
This article and related video highlights a controversial clinic in Vancouver, Canada. This clinic, called Insite, was founded on the idea of helping drug users be as safe as possible when using drugs. But this isn’t just another needle-exchange program to ensure that users don’t share needles, a practice that increases the chance of contracting HIV. Insite goes a step further, by inviting addicts in, allowing them to use in their facility, with clean needles and other equipment, and even having nursing and medical staff on-hand to not only help a user find a vein, but also to help prevent and treat overdoses.
Insite is located in an area of Vancouver that used to be home to the fastest growing AIDS epidemic in all of North America. In addition to providing clean needles, the clinic also aggressively tests their patients for HIV, as well as other sexually transmitted diseases, provides gynecological exams, and tries to encourage people to enroll in detox programs. Many officials in the program argue that Insite has helped lower the rate of HIV/AIDS through providing clean needles, helping people learn their HIV status, and enrolling those who are positive in ARV therapy. Those involved with Insite even claim that their program has helped reduce crime in the area because less people are being robbed and attacked while trying to use out in the open on the streets.
There are some many different things to think about regarding this program, but below are a few that immediately came to my mind. How does this program fit into the idea of “First, Do No Harm.” Is the medical staff that is present doing harm to these individuals by aiding in their drug usage, or would it be more harmful to let them continue to use on the streets? In my social work classes, we have often discussed the current divide in social work concerned with substance abuse–is it better to take a hard-line with clients/patients, advocating for going “cold-turkey,” or is it better to advocate for harm reduction, hoping that eventually they will completely quit abusing substances. Would it be just to allow those who use drugs to do so in a more harmful manner (sharing needles, on the streets, etc) because we disagree with their personal decision to begin using drugs in the first place? Is it just to require others to pay for this service, hoping that it will pay off in the long-run by reducing the HIV/AIDS cases?