‘A little heaven in hell’: The role of a supervised injection facility in transforming place and its future

While numerous studies on InSite (North America’s first and only supervised injection facility (SIF)) have been published in leading international journals, little attention has been given to the potential role that InSite has played in transforming the landscape and culture of drug use in the Downtown Eastside (DTES) of Vancouver, British Columbia (BC). The present research was conducted on the premise of assessing the transformative role of InSite in the lives of injection drug users (IDUs) who are caught in a vicious cycle of substance abuse, poverty and homelessness. Semi-structured qualitative interviews were conducted with a purposively chosen sample of IDUs in Vancouver, Surrey, and Victoria, BC. Audio recorded interviews were transcribed verbatim and analyzed thematically using NVivo 8 software. Findings suggest attending InSite has numerous positive effects on the lives of IDUs. Furthermore, attending InSite has contributed to landscape and drug use transformation in the DTES. There is also an urgent need to expand the current facility to cities where injection drug use is prevalent. Cost-benefit and cost-effectiveness analysis conducted for this thesis suggests that funding additional SIFs in Vancouver would be an efficient and effective use of financial resources in the public health domain. Furthermore, there is a need for supervised inhalation rooms (SIRs) in Canada. Implementing a SIR could be based on the goals of prevention of infectious disease, reducing HIV and Hepatitis C risk behaviour, harm reduction education, reducing violence and improving safety.