1. SAFE PLACES GAME

2. With safe injection sites would there be an increased use of addiction treatment? The SIF's opening was associated independently with a 30% increase in detoxification service use, and this behaviour was associated with increased rates of long-term addiction treatment initiation and reduced injecting at the SIF. Evan Wood, Mark W. Tyndall, Ruth Zhang, Julio S. G. Montaner & Thomas Kerr, et al. 2007. Rate of detoxification service use and its impact among a cohort of supervised injecting facility users Society for the Study of Addiction

3. Impact on Drug-Use Patterns in a Community Reports that the opening of InSite did not adversely affect community drug use, including relapse into injected drug use, stopping injected drug use, and seeking treatment. InSite appears to have improved public order and reduced syringe sharing. Kerr T, Stoltz J, Tyndall M, Li K, Zhang R, et al. 2006. Impact of a Medically Supervised Safer Injection Facility on Community Drug Use Patterns: A Before and After Study. British Medical Journal 332:220-2

4. Would there be an Impact on Drug Related Crime? It was examined, and crime rates in the neighborhood surrounding InSite (Vancouver) during the year before versus the year after InSite opened. It has found no increases in drug trafficking or assaults/robbery, and a decline in vehicle break-ins/vehicle theft. Wood E, Tyndall MW, Lai C, Montaner JSG, Kerr T. 2006a. Impact of a Medically Supervised Safer Injecting Facility on Drug Dealing and Other Drug- Related Crime. Substance Abuse Treatment, Prevention and Policy 1:1-4

5. Would it Attract Higher-Risk Drug Users? Reports that InSite did attracted injection drug users (IDUs) with elevated risks of blood-borne disease infection and overdose, and IDUs who were contributing to public drug use and unsafe syringe disposal problems stemming from public injection drug use. Wood E, Tyndall MW, Li K, Lloyd-Smith E, Small W, et al. 2005a. Do Supervised Injecting Facilities Attract Higher-Risk Injection Drug Users? American Journal of Preventive Medicine 29:126-30

6. Would an Injection Site Cost Money? InSite saves $6 million per year Through the use of conservative estimates, InSite prevents on average 35 new cases of HIV and 3 deaths each year. After program costs are taken into account, this prevention method is generating a societal benefit in excess of $6 million per year and is an effective and efficient use of public health care resources. Anderson, Boyd, 2006 International Journal of Drug Policy

7. What Would the Community Impact Be? This report explored the impact of InSite on public order in the surrounding neighbourhood. By detailing various kinds of property crime and violent crime the researchers found that no change in the rate of crime can be traced to the establishment of the InSite. Furthermore, 60% of those living/working in the area reported feeling that the site had a positive impact on public order; and more than 80% indicated that InSite should be either expanded, retained or modified. Boyd et al 2008 Vancouver: Health Canada

8. Would There be Overdoses Within a Safe Injection Site? This study attempted to estimate the number of overdose deaths potentially averted by the implementation of InSite. Based on a conservative estimate of the local ratio of non- fatal to fatal overdoses, the potentially fatal overdoses in the supervised injection facility during the study period could have resulted in between 8 and 51 deaths had they occurred outside the facility. The authors found that potentially fatal overdoses at InSite during this period prevented between 6 and 37% of the total overdose deaths in the community. Milloy et al 2008 PLoS

9. LETHBRIDGE FACTS When up to 40 per cent of patients using emergency room services are there because of addiction to pain pills, having a methadone clinic in the city makes perfect sense to Bill Leslie director of the Central Alberta Methadone Program. Four months later, there’s little doubt Lethbridge needed a methadone clinic. Nearly 150 patients have taken part in the substance abuse program. Mabell, D. (2009). Methadone clinic makes an impact. Lethbridge Herald.