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These findings suggest that SIF can play a role in managing overdoses. Harm Reduction Journal Reducing Harms Associated With Drug-Related Overdose Conventional drug overdose prevention strategies have been criticised for failing to address the macro- and micro-environmental factors that shape drug injecting practices and compromise individual ability to reduce the risks associated with drug-related overdose. After program costs are taken into account, this prevention method is generating a societal benefit in excess of million per year and is an effective and efficient use of public health care resources. International Journal of Drug Policy Neighbourhood residents and businesses view In Site as making a positive contribution to public order This report explored the impact of In Site on public order in the surrounding neighbourhood. Wood 2008 Estimated Drug Overdose Deaths Averted by North America's First medically Supervised Safer Injection Facility. The study also considered the health effect of increased use of safe injection practices, the incremental net savings increased to more than million and the number of life-years gained to 1070. Drug users who use In Site for 75% or more of their injections are less likely to overdose than those who use the site less often.

Safer injection facilities (SIFs) constitute one such intervention, although little is known about the impact of such facilities on factors that mediate risk for overdose. 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 In Site. PLo S One Vancouver police officers support the efforts of In Site and work in tandem with the facility to improve public order Study examined the role of police in referring injection drug users to In Site and found that the supervised injection site provides an opportunity to coordinate policing and public health efforts in a positive manner thereby improving both health and public order.

Wood E, Tyndall MW, Stoltz J, Small W, Zhang R, et al. Safer Injecting Education for HIV Prevention Within a Medically Supervised Safer Injecting Facility. Mark W Tyndall, Evan Wood, Ruth Zhang, Calvin Lai, Julio SG Montaner, Thomas Kerr, 2006. Tyndalla, 2005 The Royal Institute of Public Health. In Site was found to decrease needle sharing which alone saves million and 920 life-years over 10 years.

International Journal of Drug Policy 1-4 Preventing Overdose Deaths Reports that there have been a large number of overdoses within the SIF, and that none of these overdoses resulted in a fatality. HIV seroprevalence among participants at a medically supervised injection facility in Vancouver, Canada: Implications for prevention, care and treatment. In Site saves over million per year Through the use of conservative estimates, In Site prevents on average 35 new cases of HIV and 3 deaths each year. Boyd, 2009 A cost-benefit and cost-effectiveness analysis of Vancouver's supervised injection facility. Increased knowledge of safe injection practices and referral to methadone maintenance through In Site saves million and 1175 life years over 10 years. Zaric 2008 Cost-effectiveness of the Vancouver Safe Injection Facility Canadian Medical Association Journal In Site does not increase rates of overdose These findings show that the proportion of individuals reporting recent non-fatal overdoses did not change as a result of access to In Site.

Wood E, Tyndall MW, Stoltz J, Small W, Lloyd-Smith E, et al. Factors Associated with Syringe Sharing Among Users of a Medically Supervised Injecting Facility. Drug-related overdoses within a medically supervised safer injection facility. Kerr 2008 Police and Public Health Partnerships: Evidence from the evaluation of Vancouver's supervised injection facility.

American Journal of Infectious Diseases -4 HIV Education Reports that individuals requiring help injecting - a risk factor previously associated with HIV incidence - are receiving safer injecting education at In Site. International Journal of Drug Policy Preventing HIV/AIDS The purpose of this analysis is to measure the prevalence and correlates of baseline HIV among those who are using the SIF, to determine if In Site could be used as a site for HIV related care and treatment. Substance Abuse Treatment, Prevention and Policy In Site saves the city, government and health care system money This study examines the cost-effectiveness of Vancouver's supervised injection site.

American Journal of Preventive Medicine 6-30 Service Uptake Reports that Wood E, Tyndall MW, Qui Z, Zhang R, Montaner JS, Kerr T. Service Uptake and Characteristics of Injection Drug Users Utilizing North America's First Medically Supervised Safer Injection Facility. Wood 2008 Non-fatal overdose among a cohort of active injection drug users recruited from a supervised injection facility American Journal of Drug and Alcohol Abuse In Site does not promote drug use Responding to concerns that In Site promotes initiation into injection drug use, this study found that In Site users have been injecting for an average of 16 years, and that only 1 participant reported having first injected at the site.

American Journal of Public Health 0-3 Syringe Sharing Factors Reports that the use of In Site by injection drug users is associated with reduced syringe sharing. The report concludes that the benefits of In Site have not been offset by a rise in drug use.

Tyndall MW, Kerr T, Zhang R, King E, Montaner JG, Wood E. Attendance, Drug Use Patterns, and Referrals Made From North America's First Supervised Injection Facility. Evaluation Methodology Lays out the method by which the health and community impacts of In Site will be measured and evaluated. These findings should be useful to other cities considering supervised injecting facilities and to governments considering regulating their use. Kerr 2007 Factors Associated with Public Injecting Among Users of Vancouver's Supervised Injection Facility. AIDS Care In Site provides a variety of integrated health care services This study examined the factors associated with receiving care for cutnaeous injection-related infections among In Site users. Journal of Public Health SIS Evaluation Review In many cities, infectious disease and overdose epidemics are occurring among illicit injection drug users. Summary of findings from the evaluation of a pilot medically supervised safer injecting facility. Wainberg, Mc Gill University AIDS Centre, Jewish General Hospital, 2006 Canadian Medical Association Journal Drug Users' Perceptions Regarding In Site This study was undertaken to explore injection drug users' experiences and opinions regarding North America's first SIF in Vancouver, Canada.

Vancouver's safer injecting facility has been associated with an array of community and public health benefits without evidence of adverse impacts. Canadian Medical Association Journal Commentary: The need to promote public health in the field of illicit drug use. Rate of detoxification service use and its impact among a cohort of supervised injecting facility users Society for the Study of Addiction Attendance and Detoxification Reports that weekly use of In Site and any contact with the facility's addictions counselor were both independently associated with more quicker entry into a detoxification program. In Site appears to have improved public order and reduced syringe sharing. British Medical Journal 30-2 Culture Change Case Study Highlights the ideas, processes and historical events that contributed to a cultural transformation that was critical to opening the In Site in Vancouver. International Journal of Drug Policy -82 Attendance, drug use patterns, and referrals Reports that In Site has successfully been integrated into the community, has attracted a wide cross section of community injection drug users, has intervened in overdoses and initiated over 2000 referrals to counseling and other support services.

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