Supervised injection services: What has been demonstrated? A systematic literature review

There is growing attention across the social sciences to the mobility of people, products, and knowledge. This entails attempts to extend and/or rework existing understandings of global interconnections and is reflected in ongoing work on policy transfer—the process by which policy models are learned from one setting and deployed in others. This paper uses a case study of the development of an innovative approach to drug policy in Vancouver, British Columbia to deepen our understanding of what I call ‘urban policy mobilities.’ It details the often apparently mundane practices through which Vancouver's ‘four-pillar’ drug strategy—which combines prevention, treatment, enforcement, and harm reduction—was learned from cities outside North America and is now increasingly taught elsewhere. In doing so it draws on a neo-Foucauldian governmentality approach to emphasize the role of expertise (specialized knowledge held by many actors, not just credentialed professionals) and the deployment of certain powerful tru...

/pdf/expertise-truth-and-urban-policy-mobilities-global-circuits-32ygkpbdgx.pdf

Expertise, truth, and urban policy mobilities: global circuits of knowledge in the development of Vancouver, Canada's 'four pillar' drug strategy

In many cities, infectious disease and overdose epidemics are occurring among illicit injection drug users (IDUs). To reduce these concerns, Vancouver opened a supervised safer injecting facility in September 2003. Within the facility, people inject pre-obtained illicit drugs under the supervision of medical staff. The program was granted a legal exemption by the Canadian government on the condition that a 3-year scientific evaluation of its impacts be conducted. In this review, we summarize the findings from evaluations in those 3 years, including characteristics of IDUs at the facility, public injection drug use and publicly discarded syringes, HIV risk behaviour, use of addiction treatment services and other community resources, and drug-related crime rates. Vancouver's safer injecting facility has been associated with an array of community and public health benefits without evidence of adverse impacts. These findings should be useful to other cities considering supervised injecting facilities and to governments considering regulating their use.

/pdf/summary-of-findings-from-the-evaluation-of-a-pilot-medically-1d1dzywt7y.pdf

Summary of findings from the evaluation of a pilot medically supervised safer injecting facility

Expertise, Truth, and Urban Policy Mobilities: Global Circuits of Knowledge in the Development of Vancouver, Canada's ‘four Pillar’ Drug Strategy

To the Editor: In September 2003, the first safer injecting facility in North America opened in Vancouver, Canada. Here, injection-drug users can inject preobtained illicit drugs under medical supervision.1 A concern regarding such facilities is that they may lessen the likelihood that injection-drug users will seek addiction-treatment services.2,3 Randomized trials are lacking to address this concern. We assessed factors associated with time to entry into a detoxification program at one of the city's three detoxification centers. We used data collected by means of a questionnaire as part of a cohort study (supported by Health Canada) of persons who use . . .

Attendance at Supervised Injecting Facilities and Use of Detoxification Services

Vancouver's new safer injection site for addicts ( CMAJ 2003;169[8]:759,825) has many advocates, but none of them will be found in the White House.

Dr. Andrea Barthwell, deputy director of demand reduction for the White House Drug Policy Office, says the Canadian initiative will only serve to

/pdf/us-slams-canada-over-vancouver-s-new-drug-injection-site-4z5o11e17j.pdf

US slams Canada over Vancouver's new drug injection site

The advisory group appointed to assess lessons learned from Canada's recent SARS epidemic has handed federal Health Minister Anne McLellan a seemingly infinite list of problems.



![Figure][1] 

Figure. Registered respiratory therapist Jacob Krygier wears a protective suit at North York

/pdf/canada-s-approach-to-public-health-must-be-reinvented-sars-27qa6m4f82.pdf

Canada's approach to public health must be reinvented: SARS report

Medical students are interested in pursuing development of a common first year of postgraduate medical training, but only if it does not add to the overall training time required.

That message emerged clearly during the recent annual meeting of the Canadian Federation of Medical Students (CFMS) in

/pdf/failure-of-wto-talks-bleak-news-for-health-of-world-s-poor-1f8syagopl.pdf

Failure of WTO talks bleak news for health of world's poor.

Senator Michael Kirby is challenging the federal government to invest in health protection within the year “Three studies in 10 years have recommended this, yet nothing has happened Frankly, it's outrageous The time has come to stop studying and start taking action,” Kirby said

Kirby's

/pdf/kirby-outrageous-delay-in-health-protection-funding-pikrlnwvhp.pdf

Kirby: “Outrageous” delay in health protection funding

Later this month Health Canada will release new SARS recommendations to help health care workers and governments respond to the challenges posed by the impending influenza season.

Dr. Arlene King, director of Health Canada's Immunization and Respiratory Diseases Division, says they will provide

/pdf/new-sars-recommendations-to-be-released-this-month-48mzicqhl8.pdf

New SARS recommendations to be released this month

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