The Scientific Evaluation of Vancouver s Supervised Injection Site: The Evidence and Future Directions

Size: px
Start display at page:

Download "The Scientific Evaluation of Vancouver s Supervised Injection Site: The Evidence and Future Directions"

Transcription

1 The Scientific Evaluation of Vancouver s Supervised Injection Site: The Evidence and Future Directions Thomas Kerr Director, Urban Health Research Initiative, BC Centre for Excellence in HIV/AIDS, St. Paul s Hospital Associate Professor, Department of Medicine, University of British Columbia

2

3

4

5

6

7

8

9

10

11 The Objectives Reduce public disorder Reduce transmission of infectious diseases Increase contact with health services Reduce risks associated with overdose

12 The Scientific Evaluation of Insite A Highly Politicized Environment Efforts taken to ensure scientific rigor and transparency Evaluation overseen by a provincial steering committee All data peer-reviewed and published prior to being shared

13 SIF Evaluation Structure SIF DATABASE Database tracking usage, overdose events, referrals, drug use, etc. SEOSI Prospective cohort of Insite users VIDUS LINKED DATA EXTERNAL ACTIVITIES Long-running prospective cohort with pre/post-sif data Data linkages provide info on drug treatment and other service use Various complimentary data including ethnographic interviews, community surveys, police data

14 Evaluating Insite

15 state-sponsored suicide

16 RESEARCH QUESTION: Is the SIF reaching the target population? Wood et al, American Journal of Preventative Medicine, 2005

17

18 RESEARCH QUESTION: Is the SIF having an impact on public disorder caused by injection drug use? Canadian Medical Association Journal. 2004

19 Wood et al., CMAJ 171:7, p.731

20

21 RESEARCH QUESTION: Is the SIF having an impact on HIV risk behaviour in the community? Kerr et al, The Lancet, 2005

22 Frequent Insite users were 70% less likely to report syringe sharing Kerr et al, The Lancet, 2005

23

24

25

26 Length of stay in hospital among those self-referring: 12 days [IQR: 5-33] Length of stay in hospital among those referred by a SIF nurse: 4 days [IQR: 2-7]

27 RESEARCH QUESTIONS: Is the SIF helping people quite drug use? Is the SIS enabling drug use? Wood et al, NEJM, 2006

28

29 Figure1: Cumulative incidence of detoxification program initiation during the periods before and after the SIF's opening Post-SIF Period 16 Probability of Detox Enrollment (%) Pre-SIF Period Time (months) pre-sif post-sif

30 Impact of SIF on Addiction Treatment The SIF s opening was associated with: >30% increase in detoxification service use increased rates of addiction treatment initiation reduced injecting at the SIF

31 RESEARCH QUESTION: Is the SIF having an impact on overdose deaths in the community? Marshall et al, Lancet, 2011

32 Methods Location of death estimated using six-digit postal code Geocoding: ArcGIS using the Statistics Canada Postal Code Conversion File Area of interest: all blocks within 500 metres of the SIF Quasi-control: blocks >500m from the SIF Outcome: rate difference in OD mortality between the pre-sif (Jan 1, 2001 Sep 20, 2003) and post-sif (Sep 21, 2003 Dec 31, 2005) periods

33 Results Fatal OD s in Vancouver between Jan 1, 2001 & Dec 31, 2005 SIF Population Size >500

34 Overdose deaths declined by 35% in the area around Insite Marshall et al, Lancet, 2011

35 Is Insite Cost-effective? If Insite closed: Annual number of incident HIV infections among Vancouver IDU increases from to These 83.5 preventable infections are associated with $17.6 million in life-time HIV-related medical care costs

36 Wood et al, SATPP, 2006

37 Kerr et al, American Journal of Public Health, 2007

38

39 Politicizing and Misrepresenting the Science Surrounding Insite

40 August 28, 2006

41 August 28, 2006 RCMP Funded Report on Insite Research Corrado (2006): In general, the initial assessment of outcomes has been consistently positive. There is, therefore, little to criticize or express caution over in the methodologies reported in the publications.

42 Sep 1, 2006

43 Sep 1, 2006 Minister Clement deferred the decision on the Vancouver application to December 31st, Minister Tony Clement: "Do safe injection sites contribute to lowering drug use and fighting addiction? Right now the only thing the research to date has proven is drug addicts need more help to get off drugs,

44 The institute supports efforts to vigorously oppose policies based on the concept of harm reduction. (see:

45 National Post, May 29, 2007

46

47

48 -Tony Clement, Federal Minister of Health at the Canadian Medical Association Conference on Aug 20, 2007 Aug 20, 2007

49 October, 2008

50

51 Insite & the RCMP there is an extensive body of Canadian and international peer-reviewed research reporting the benefits of supervised injection sites The RCMP commissioned reports to provide an alternative analysis of existing SIF research...these reports did not meet conventional academic standards.

52 IN THE SUPREME COURT OF BRITISH COLUMBIA Citation: PHS Community Services Society v. Attorney General of Canada, 2008 BCSC 661 Date: Docket: S Registry: Vancouver Between: PHS Community Services Society, Dean Edward Wilson and Shelly Tomic Plaintiffs And: Attorney General of Canada Defendant - and - Docket: S Justice Minister Pitfield Tony ruled: Clement: Registry: Vancouver Between: Vancouver Area Network of Drug Users (VANDU) Plaintiff I Insite think And: is it's a health quite care clear facility from my remarks that there exists Attorney General of Canada and Minister of Health for Canada Defendants today Closing a And: it significant would violate degree the of Charter uncertainty of Rights in the and research Freedoms British Columbia Civil Liberties Association Intervenor I can inform you today that I will be asking my colleague the Minister of Justice, to appeal Judge Pitfield's decision at the earliest possible opportunity. Before: The Honourable Mr. Justice Pitfield Reasons for Judgment Granted Insite a constitutional exemption to federal drug laws Counsel for the Plaintiff: PHS Community Services Society, Dean Edward Wilson and Shelly Tomic J.J. Arvay, Q.C. F.A. Schroeder M. Pongracic-Speier Counsel for the Plaintiff: VANDU Counsel for the Defendant: Attorney General of Canada J.W. Conroy, Q.C. J.J.L. Hunter, Q.C. K.M. Stephens

53

54 Sep 2011 The Minister s failure to grant [an exemption] to Insite contravened the principles of fundamental justice Insite has been proven to save lives with no discernable negative impact on the public safety and health objectives of Canada

55

56

57

58 The area of focus in the Lancet study The area of focus in the DFA/DPNC Report

59 The Complaint

60

61 Nature, 2008

62 What s next?

63 Exploring New Models of Supervised Consumption: The Dr. Peter Centre The Dr. Peter Centre The Harm Reduction Room (HRR) opened in April 2002 The HRR includes 3 spaces for injecting

64 Unaddressed Issue: Assisted injection

65 Time to HIV infection among Vancouver IDUs stratified by requiring help injecting Probability of Remaining HIV-Negative (%) Did not require help Required Help Time from Enrollment (months) Wood et al CJPH 2003

66 Unaddressed Issue: Crack Cocaine Use Rate of daily crack use among cohort of injection drug users in Vancouver Association between daily crack cocaine use and HIV seroconversion. Ave rate for = 11.6% Ave rate for = 27.2% Ave rate for = 39.7%

67 382 (61%) of Crack Cocaine Smokers Report 271 (71%) Crack Users Who Smoke in PublicinAreas were Smoking Public Areas Willingintothe UseL6M an 61% Inhalation Room 71% Willing use anin Public SmoketoCrack inhalation room Not NotWilling in Public

68

69

70 Conclusions Supervised injection sites are evidence-based interventions These programs remain controversial and under-utilized Efforts are now need to explore second-order questions Future directions might include expanding programming to include supervised inhalation programs

71 Acknowledgements Study participants InSite users UHRI staff Insite/PHS staff Vancouver Coastal Health/BC Ministry of Health

72 Further information

Drug Situation in Vancouver UHRI. Report prepared by the Urban Health Research Initiative of the British Columbia Centre for Excellence in HIV/AIDS

Drug Situation in Vancouver UHRI. Report prepared by the Urban Health Research Initiative of the British Columbia Centre for Excellence in HIV/AIDS Drug Situation in Vancouver Report prepared by the Urban Health Research Initiative of the British Columbia Centre for Excellence in HIV/AIDS Second edition June 2013 UHRI U R BAN H EALTH R ESEARCH I NITIATIVE

More information

IN THE SUPREME COURT OF BRITISH COLUMBIA

IN THE SUPREME COURT OF BRITISH COLUMBIA IN THE SUPREME COURT OF BRITISH COLUMBIA Citation: Merlo v. Canada (Attorney General), 2013 BCSC 1136 Date: 20130625 Docket: S122255 Registry: Vancouver Between: Brought under the Class Proceedings Act,

More information

GROUND UP. Insite was specifically designed to be accessible to

GROUND UP. Insite was specifically designed to be accessible to Vancouver s Supervised Injection Site s Role in Accessing Treatment and Care GROUND UP Canada has long been regarded as a global leader in health care delivery and innovation. Since September 2003, Insite,

More information

Introduction to Substance Abuse Issues in Canada: Pathways, Health Implications and Interventions

Introduction to Substance Abuse Issues in Canada: Pathways, Health Implications and Interventions Introduction to Substance Abuse Issues in Canada: Pathways, Health Implications and Interventions Maritt Kirst, PhD Centre for Research on Inner City Health, St. Michael s Hospital OTC Summer Institute

More information

Report of the Toronto and Ottawa Supervised Consumption Assessment Study. April 11, 2012

Report of the Toronto and Ottawa Supervised Consumption Assessment Study. April 11, 2012 Report of the Toronto and Ottawa Supervised Consumption Assessment Study April 11, 2012 www.toscastudy.ca Bayoumi AM and Strike C (co-principal investigators), Jairam J, Watson T, Enns E, Kolla G, Lee

More information

COMMUNITY SUPPORT FOR A SUPERVISED CONSUMPTION SITE IN OTTAWA

COMMUNITY SUPPORT FOR A SUPERVISED CONSUMPTION SITE IN OTTAWA COMMUNITY SUPPORT FOR A SUPERVISED CONSUMPTION SITE IN OTTAWA Table of Contents Acknowledgement... 2 Introduction... 3 Summary... 3 Why Advocate for Safer Consumption Sites in Ottawa?... 4 Residential

More information

Beyond Insite: Charter Protection of a Safe Smoking Facility. Jon Major

Beyond Insite: Charter Protection of a Safe Smoking Facility. Jon Major Beyond Insite: Charter Protection of a Safe Smoking Facility Jon Major I. Insite Since 2003, Insite, North America s first medically supervised injection facility, has provided drug-addicted residents

More information

STOP HIV TB: Special Populations, The Vancouver Experience

STOP HIV TB: Special Populations, The Vancouver Experience STOP HIV TB: Special Populations, The Vancouver Experience Rolando Barrios, MD Assistant Director BC Centre for Excellence in HIV/AIDS Senior Medical Director Vancouver Community Health Services, Vancouver

More information

Court of Appeal for British Columbia. Citation: Barbeau v. British Columbia (Attorney General), 2003 BCCA 406. Date: 20030708

Court of Appeal for British Columbia. Citation: Barbeau v. British Columbia (Attorney General), 2003 BCCA 406. Date: 20030708 Court of Appeal for British Columbia Citation: Barbeau v. British Columbia (Attorney General), 2003 BCCA 406 Date: 20030708 Docket: CA029017; CA029048 Docket: CA029017 Between: Dawn Barbeau and Elizabeth

More information

Case Comment: Canada (Attorney. General) v PHS Community Services Society. Rahool P. Agarwal* Introduction. Background

Case Comment: Canada (Attorney. General) v PHS Community Services Society. Rahool P. Agarwal* Introduction. Background Case Comment: Canada (Attorney General) v PHS Community Services Society Rahool P. Agarwal* Introduction In September of this year, the Supreme Court of Canada released its decision in Canada (Attorney

More information

Attendance, drug use patterns, and referrals made from North America s first supervised injection facility

Attendance, drug use patterns, and referrals made from North America s first supervised injection facility Drug and Alcohol Dependence xxx (2005) xxx xxx Attendance, drug use patterns, and referrals made from North America s first supervised injection facility Mark W. Tyndall a,b,, Thomas Kerr a,b, Ruth Zhang

More information

Feasibility Study on Supervised Drug Consumption Options in the City of Victoria

Feasibility Study on Supervised Drug Consumption Options in the City of Victoria Feasibility Study on Supervised Drug Consumption Options in the City of Victoria Benedikt Fischer, PhD Christiane Allard, HonBA Centre for Addictions Research of British Columbia (CARBC), University of

More information

Hospitals as Risk Environments: Patient Perspectives from People Who Inject Drugs Thomas Kerr, PhD

Hospitals as Risk Environments: Patient Perspectives from People Who Inject Drugs Thomas Kerr, PhD Hospitals as Risk Environments: Patient Perspectives from People Who Inject Drugs Thomas Kerr, PhD Director, Urban Health Research Initiative BC Centre for Excellence in HIV/AIDS St. Paul s Hospital, Providence

More information

SUPREME COURT OF CANADA

SUPREME COURT OF CANADA SUPREME COURT OF CANADA CITATION: Canada (Attorney General) v. PHS Community Services Society, 2011 SCC 44 DATE: 20110930 DOCKET: 33556 BETWEEN: Attorney General of Canada and Minister of Health for Canada

More information

OHRDP Communication and Information Toolkit for Needle Exchange Programs (NEPs)

OHRDP Communication and Information Toolkit for Needle Exchange Programs (NEPs) OHRDP Communication and Information Toolkit for Needle Exchange Programs (NEPs) Goals: The communications strategy must engage and support the broad network of Needle Exchange Programs and affiliated organizations.

More information

IN THE SUPREME COURT OF BRITISH COLUMBIA

IN THE SUPREME COURT OF BRITISH COLUMBIA IN THE SUPREME COURT OF BRITISH COLUMBIA Citation: Between: And Toor v. Harding, 2013 BCSC 1202 Amrit Toor and Intech Engineering Ltd. Date: 20130705 Docket: S125365 Registry: Vancouver Plaintiffs Thomas

More information

Findings from the Community HIV/HCV Evaluation and Reporting Tool (CHERT)

Findings from the Community HIV/HCV Evaluation and Reporting Tool (CHERT) Findings from the Community HIV/HCV Evaluation and Reporting Tool (CHERT) PAN Fall Conference October 22, 2014 Presented by: Elayne Vlahaki, President, Catalyst Consulting Inc. evlahaki@catalystresearchgroup.com

More information

IN THE SUPREME COURT OF BRITISH COLUMBIA NOTICE OF CIVIL CLAIM. This action has been started by the plaintiff for the relief set out in Part 2 below.

IN THE SUPREME COURT OF BRITISH COLUMBIA NOTICE OF CIVIL CLAIM. This action has been started by the plaintiff for the relief set out in Part 2 below. IN THE SUPREME COURT OF BRITISH COLUMBIA No. ----- Vancouver Registry BETWEEN: THE BRITISH COLUMBIA CIVIL LIBERTIES ASSOCIATION Plaintiff AND: THE ATTORNEY GENERAL OF CANADA Defendant Narne and address

More information

Implementation of a near real-time phylogenetic monitoring program for HIV transmission outbreaks

Implementation of a near real-time phylogenetic monitoring program for HIV transmission outbreaks Implementation of a near real-time phylogenetic monitoring program for HIV transmission outbreaks Art FY Poon 1,2, Conan K Woods 1, Susan Shurgold 1, Guillaume Colley 1, Robert S Hogg 1,3, Mel Krajden

More information

Highly active antiretroviral therapy and survival in HIV-infected Injection drug users: implications for the critical role of adherence

Highly active antiretroviral therapy and survival in HIV-infected Injection drug users: implications for the critical role of adherence Highly active antiretroviral therapy and survival in HIV-infected Injection drug users: implications for the critical role of adherence Robert Hogg, PhD BC Centre for Excellence in HIV/AIDS and Simon Fraser

More information

UNODC World Drug Report 2016:

UNODC World Drug Report 2016: UNODC World Drug Report 2016: Launch in Geneva on 23 June 2016 Briefing to the Member States and Civil Society Organizations Remarks by Aldo Lale-Demoz, Deputy Executive Director, UNODC UNODC is honoured

More information

Citation: Albion Bay v. Robertson Date: 20010316 2001 PESCTD 25 Docket: SCG-1414 Registry: Charlottetown

Citation: Albion Bay v. Robertson Date: 20010316 2001 PESCTD 25 Docket: SCG-1414 Registry: Charlottetown Citation: Albion Bay v. Robertson Date: 20010316 2001 PESCTD 25 Docket: SCG-1414 Registry: Charlottetown PROVINCE OF PRINCE EDWARD ISLAND IN THE SUPREME COURT - TRIAL DIVISION BETWEEN: ALBION BAY PLUMBING

More information

Report of the Toronto and Ottawa Supervised Consumption Assessment Study, 2012

Report of the Toronto and Ottawa Supervised Consumption Assessment Study, 2012 Report of the Toronto and Ottawa Supervised Consumption Assessment Study, 2012 APRIL 11, 2012 Ahmed M. Bayoumi and Carol Strike Margaret Brandeau Naushaba Degani Benedikt Fischer Richard Glazier Shaun

More information

MORTALITY AMONGST ILLICIT DRUG USERS

MORTALITY AMONGST ILLICIT DRUG USERS MORTALITY AMONGST ILLICIT DRUG USERS Over the past 40 years the rate of illicit drug use worldwide has risen dramatically, and with it the number of deaths reported among drug-using populations. What are

More information

STOP HIV/AIDS Update. Structured Learning Collaborative brings health care teams together to improve HIV care. We can do better.

STOP HIV/AIDS Update. Structured Learning Collaborative brings health care teams together to improve HIV care.  We can do better. STOP HIV/AIDS Update Seek and Treat for Optimal Prevention of HIV/AIDS No. 3, Spring/Summer 2011 In this issue: Structured Learning Collaborative 1 China adopts Treatment as Prevention 2 STOP HIV/AIDS

More information

Testimony of The New York City Department of Health and Mental Hygiene. before the

Testimony of The New York City Department of Health and Mental Hygiene. before the Testimony of The New York City Department of Health and Mental Hygiene before the New York City State Assembly Committee on Alcoholism and Drug Abuse on Programs and Services for the Treatment of Opioid

More information

IN THE SUPREME COURT OF BRITISH COLUMBIA NOTICE OF CIVIL CLAIM

IN THE SUPREME COURT OF BRITISH COLUMBIA NOTICE OF CIVIL CLAIM IN THE SUPREME COURT OF BRITISH COLUMBIA Noo Vancouver Registry BETWEEN: AN: PROVIENCE HEALTH CARE SOCIETY and EBORAH BARTOSCH, CHARLES ENGLISH, OUGLAS LISTROM, LARRY LOVE and AVI MURRAY on their own behalf

More information

Alcohol and drugs prevention, treatment and recovery: why invest?

Alcohol and drugs prevention, treatment and recovery: why invest? Alcohol and drugs prevention, treatment and recovery: why invest? 1 Alcohol problems are widespread 9 million adults drink at levels that increase the risk of harm to their health 1.6 million adults show

More information

Evidence based Prevention & Treatment Options for Emerging Heroin Use in a Public Health Framework

Evidence based Prevention & Treatment Options for Emerging Heroin Use in a Public Health Framework Evidence based Prevention & Treatment Options for Emerging Heroin Use in a Public Health Framework Benedikt Fischer, PhD Professor, CIHR/PHAC Chair in Applied Public Health & MSFHR Senior Scholar Faculty

More information

Drug use among 16 to 18 year old BC students

Drug use among 16 to 18 year old BC students Drug use among 16 to 18 year old BC students 2008 BC Adolescent Health Survey Bulletin The fourth BC Adolescent Health Survey (AHS) conducted by the was completed by over 29,000 grade 7 to 12 students

More information

1. To create a comprehensive Benchmark plan that will assure maximum tobacco cessation coverage to all populations in Rhode Island:

1. To create a comprehensive Benchmark plan that will assure maximum tobacco cessation coverage to all populations in Rhode Island: POSTION STATEMENT Submitted to the Rhode Island Health Benefits Exchange Submitted By the Public Policy Workgroup of the Statewide Tobacco Cessation Committee on Tobacco Cessation Treatment Benchmarks

More information

drug dependence treatment and care

drug dependence treatment and care UNODC-WHO Joint Programme on drug dependence treatment and care The vision Effective and humane treatment for all people with drug use disorders. Nothing less than would be expected for any other disease.

More information

Briefing Note Bill C-36: An Act to amend the Criminal Code in response to the SCC decision in AG Canada v Bedford

Briefing Note Bill C-36: An Act to amend the Criminal Code in response to the SCC decision in AG Canada v Bedford Briefing Note Bill C-36: An Act to amend the Criminal Code in response to the SCC decision in AG Canada v Bedford Background Providing Alternatives, is a Sex Workerled organization that has provided peer-driven

More information

Science addressing drugs and HIV: State of the Art. Vienna

Science addressing drugs and HIV: State of the Art. Vienna Science addressing drugs and HIV: State of the Art 2 nd Scientific Statement: March 2016 Vienna Context In March 2014, UNODC organized within the frame of the High-level Review of the 57 th session of

More information

IN THE SUPREME COURT OF BRITISH COLUMBIA

IN THE SUPREME COURT OF BRITISH COLUMBIA IN THE SUPREME COURT OF BRITISH COLUMBIA Citation: 410727 B.C. Ltd. et al. v. Dayhu Investments Ltd. et al., 2003 BCSC 1142 Between: 410727 B.C. Ltd., Walline Ltd., Minoru Investments Ltd., and Y.H. Canadian

More information

IN THE SUPREME COURT OF BRITISH COLUMBIA

IN THE SUPREME COURT OF BRITISH COLUMBIA IN THE SUPREME COURT OF BRITISH COLUMBIA Citation: Between: Bagasbas v. Atwal, 2009 BCSC 512 Myla Bagasbas Date: 20090416 Docket: M081193 Registry: Vancouver Plaintiff And Gursimran Atwal and Sarbjit Atwal

More information

Mayor s Round Table on Mental Health and Addictions

Mayor s Round Table on Mental Health and Addictions Mayor s Round Table on Mental Health and Addictions Addressing serious mental health and addictions and the health of our City October 2, 2013 Media Resource Part 1 Seriously Addicted & Mentally Ill (SAMI)

More information

THE DISTURBING TRUTH

THE DISTURBING TRUTH POLICING VANCOUVER'S MENTALLY ILL: THE DISTURBING TRUTH Beyond Lost in Transition Inspector Scott Thompson Youth Services Section Drug and Mental Health Policy For The Vancouver Police Board and Chief

More information

Seek and Treat to Optimally Prevent HIV/AIDS (STOP HIV/AIDS) Evaluation and Monitoring

Seek and Treat to Optimally Prevent HIV/AIDS (STOP HIV/AIDS) Evaluation and Monitoring Seek and Treat to Optimally Prevent HIV/AIDS (STOP HIV/AIDS) Evaluation and Monitoring Collaborative A partnership between BC Ministry of Health and other agencies with the British Columbia Centre for

More information

Brief to the Toronto Board of Health regarding Supervised Injection Services in Toronto

Brief to the Toronto Board of Health regarding Supervised Injection Services in Toronto HL10.1.16 Submitted by Amy Wah Brief to the Toronto Board of Health regarding Supervised Injection Services in Toronto March 2016 Toronto 1240 Bay Street, Suite 600, Toronto, Ontario, Canada M5R 2A7 Telephone:

More information

Best Practices for British Columbia s Harm Reduction Supply Distribution Program

Best Practices for British Columbia s Harm Reduction Supply Distribution Program Best Practices for British Columbia s Harm Reduction Supply Distribution Program A provincial best practices document published by the BC Harm Reduction Strategies and Services (BCHRSS) Committee to provide

More information

IN THE SUPREME COURT OF CANADA (ON APPEAL FROM THE COURT OF APPEAL FOR BRITISH COLUMBIA)

IN THE SUPREME COURT OF CANADA (ON APPEAL FROM THE COURT OF APPEAL FOR BRITISH COLUMBIA) Court File No.: 33556 IN THE SUPREME COURT OF CANADA (ON APPEAL FROM THE COURT OF APPEAL FOR BRITISH COLUMBIA) BETWEEN: AND: ATTORNEY GENERAL OF CANADA and MINISTER OF HEALTH FOR CANADA Appellants/Cross-Respondents

More information

Testimony of. Daliah Heller, PhD, MPH Assistant Commissioner Bureau of Alcohol and Drug Use Prevention, Care and Treatment

Testimony of. Daliah Heller, PhD, MPH Assistant Commissioner Bureau of Alcohol and Drug Use Prevention, Care and Treatment Testimony of Daliah Heller, PhD, MPH Assistant Commissioner Bureau of Alcohol and Drug Use Prevention, Care and Treatment New York City Department of Health and Mental Hygiene before the New York City

More information

B.C. s Responsible Gambling Strategy and Three Year Plan (2011/12 2013/14)

B.C. s Responsible Gambling Strategy and Three Year Plan (2011/12 2013/14) Gaming Policy and Enforcement Branch B.C. s Responsible Gambling Strategy and Three Year Plan (2011/12 2013/14) The majority of people play games of chance for fun and entertainment. A small percentage

More information

Overview of Chemical Addictions Treatment. Psychology 470. Background

Overview of Chemical Addictions Treatment. Psychology 470. Background Overview of Chemical Addictions Treatment Psychology 470 Introduction to Chemical Additions Steven E. Meier, Ph.D. Listen to the audio lecture while viewing these slides 1 Background Treatment approaches

More information

The purpose of this policy is to support a comprehensive and collaborative approach to responding to child abuse and neglect by:

The purpose of this policy is to support a comprehensive and collaborative approach to responding to child abuse and neglect by: SECTION 1000: STUDENTS AND SCHOOLS POLICY 1045: CHILD PROTECTION Date Adopted: June 18, 2014 POLICY STATEMENT The Board affirms that children have a right to be protected from abuse and neglect, and employees

More information

Distributing safer crack use kits in Canada

Distributing safer crack use kits in Canada Questions & Answers A number of public health departments and community organizations in Canada distribute safer crack use kits to people who use crack cocaine. The kits typically include mouthpieces,

More information

IN THE SUPREME COURT OF BRITISH COLUMBIA. Edward Killough, Patricia Nicholson, Irene Fead, Daphne Martin, Deborah Lutz, and Melanie Crehan PLAINTIFFS

IN THE SUPREME COURT OF BRITISH COLUMBIA. Edward Killough, Patricia Nicholson, Irene Fead, Daphne Martin, Deborah Lutz, and Melanie Crehan PLAINTIFFS No. C976108 Vancouver Registry IN THE SUPREME COURT OF BRITISH COLUMBIA BETWEEN: AND: Edward Killough, Patricia Nicholson, Irene Fead, Daphne Martin, Deborah Lutz, and Melanie Crehan PLAINTIFFS The Canadian

More information

We include a series of recommended questions for the Swedish delegation at the end of our letter.

We include a series of recommended questions for the Swedish delegation at the end of our letter. United Nations Committee on Economic Social and Cultural Rights Palais Wilson CH 1211 Geneva 10 Switzerland 2 October 2008 Re: Review of Sweden s fifth periodic report, 41 st Session of the Committee on

More information

King County Drug Trends 2015

King County Drug Trends 2015 Brad Finegood, MA, LMHC Assistant Division Director, Acting RSN Administrator Prevention and Treatment Coordinator King County Behavioral Health and Recovery Division Caleb Banta-Green PhD, MPH, MSW Senior

More information

STATEMENT TO THE SENATE OPPOSING BILL C-2, AN ACT TO AMEND THE CONTROLLED DRUGS AND SUBSTANCES ACT

STATEMENT TO THE SENATE OPPOSING BILL C-2, AN ACT TO AMEND THE CONTROLLED DRUGS AND SUBSTANCES ACT STATEMENT TO THE SENATE OPPOSING BILL C-2, AN ACT TO AMEND THE CONTROLLED DRUGS AND SUBSTANCES ACT We believe in health, human rights, harm reduction, scientific evidence and the well-being of our communities.

More information

Corrections Branch Strategic Plan 2013/2014 2015/2016 Corrections Branch Ministry of Justice Strategic Plan 2013/2014 2015/2016

Corrections Branch Strategic Plan 2013/2014 2015/2016 Corrections Branch Ministry of Justice Strategic Plan 2013/2014 2015/2016 Corrections Branch Ministry of Justice Strategic Plan 1 Introduction The 2013/14 2015/16 B.C. Corrections Strategic Plan reflects our ongoing commitment to six key Corrections objectives: enforcing court

More information

The Recovery Pathway Service forms a key component of the Sunderland Integrated Substance Misuse Service, as illustrated below:

The Recovery Pathway Service forms a key component of the Sunderland Integrated Substance Misuse Service, as illustrated below: SERVICE SPECIFICATION LOT 1 RECOVERY PATHWAY 1.0 SERVICE MODEL The Recovery Pathway Service forms a key component of the Sunderland Integrated Substance Misuse Service, as illustrated below: Recovery Outcomes

More information

Key Questions to Consider when Seeking Substance Abuse Treatment

Key Questions to Consider when Seeking Substance Abuse Treatment www.ccsa.ca www.cclt.ca Frequently Asked Questions Key Questions to Consider when Seeking Substance Abuse Treatment The Canadian Centre on Substance Abuse (CCSA) has developed this document to address

More information

A Review of the Impacts of Opiate Use in Ontario: Summary Report

A Review of the Impacts of Opiate Use in Ontario: Summary Report A Review of the Impacts of Opiate Use in Ontario: Summary Report A Provincial Summary Report of the Impacts of the Discontinuation of Oxycontin in Ontario: January to August 2013 December 2013 This report

More information

Judicial Council of the Provincial Court of Newfoundland and Labrador

Judicial Council of the Provincial Court of Newfoundland and Labrador Judicial Council of the Provincial Court of Newfoundland and Labrador APPLICATION FOR JUDICIAL APPOINTMENT TO THE PROVINCIAL COURT OF NEWFOUNDLAND AND LABRADOR INFORMATION ABOUT THE PERSONAL HISTORY FORM

More information

Preventing Fatal Opioid Overdose Among Injection Drug Users. Skye Tikkanen Connections Counseling Scott Stokes AIDS Resource Center of Wisconsin

Preventing Fatal Opioid Overdose Among Injection Drug Users. Skye Tikkanen Connections Counseling Scott Stokes AIDS Resource Center of Wisconsin Preventing Fatal Opioid Overdose Among Injection Drug Users Skye Tikkanen Connections Counseling Scott Stokes AIDS Resource Center of Wisconsin I have no relevant financial interests to disclose for this

More information

Master of Ceremonies Distinguished guests Colleagues Delegates Ladies and Gentlemen

Master of Ceremonies Distinguished guests Colleagues Delegates Ladies and Gentlemen SPEECH FOR DR J BENJAMIN, THE DEPUTY MINISTER OF SOCIAL DEVELOPMENT AT THE LAUNCHING OF THE WESTERN CAPE SUBSTANCE ABUSE FORUM IN CAPE TOWN ON THE 25 TH OF FEBRUARY 2005 Master of Ceremonies Distinguished

More information

HIV in British Columbia: Annual Surveillance Report

HIV in British Columbia: Annual Surveillance Report HIV in British Columbia: Annual Surveillance Report 214 214 Contact Information BC Centre for Disease Control Clinical Prevention Services 655 West 12th Avenue Vancouver BC V5Z 4R4 Phone: 64-77-5621 Fax:

More information

drug treatment in england: the road to recovery

drug treatment in england: the road to recovery The use of illegal drugs in England is declining; people who need help to overcome drug dependency are getting it quicker; and more are completing their treatment and recovering drug treatment in ENGlaND:

More information

DECREASING HIV INFECTIONS AMONG PEOPLE WHO USE DRUGS BY INJECTION IN BRITISH COLUMBIA: Potential explanations and recommendations for further action

DECREASING HIV INFECTIONS AMONG PEOPLE WHO USE DRUGS BY INJECTION IN BRITISH COLUMBIA: Potential explanations and recommendations for further action DECREASING HIV INFECTIONS AMONG PEOPLE WHO USE DRUGS BY INJECTION IN BRITISH COLUMBIA: Potential explanations and recommendations for further action Report from the Office of the Provincial Health Officer

More information

Naloxone: Overview, Criminal Justice and other Special Settings

Naloxone: Overview, Criminal Justice and other Special Settings Naloxone: Overview, Criminal Justice and other Special Settings Ingrid Binswanger, MD, MPH, MS Division of General Internal Medicine Affiliated Member, Division of Substance Dependence University of Colorado

More information

Hepatitis C, Prisons and Treatment Opportunities (HePaTO) preliminary findings. Tony Butler PhD Justice Health Research Program Kirby Institute

Hepatitis C, Prisons and Treatment Opportunities (HePaTO) preliminary findings. Tony Butler PhD Justice Health Research Program Kirby Institute Hepatitis C, Prisons and Treatment Opportunities (HePaTO) preliminary findings Tony Butler PhD Justice Health Research Program Kirby Institute Acknowledgements Dr Susan Carruthers Curtin University Dr

More information

European report on drug consumption rooms Executive summary

European report on drug consumption rooms Executive summary Page 1 of 7 European report on drug consumption rooms Executive summary June 2004 Dagmar Hedrich, Project Manager, P2 - Responses General public Introduction The European report on drug consumption rooms

More information

Nanaimo Restorative Justice Program

Nanaimo Restorative Justice Program Nanaimo Restorative Justice Program International Centre for Criminal Law Reform and Criminal Justice Policy 1822 East Mall, Vancouver British Columbia, Canada V6T 1Z1 Tel: 1 (604) 822-9875 Fax: 1 (604)

More information

Naloxone Distribution for Opioid Overdose Prevention

Naloxone Distribution for Opioid Overdose Prevention Naloxone Distribution for Opioid Overdose Prevention Caleb Banta-Green PhD, MPH, MSW Alcohol and Drug Abuse Institute, University of Washington Alan Melnick, MD, MPH Clark County Public Health Chris Humberson,

More information

Treatment System 101

Treatment System 101 Treatment System 101 A brief overview for courtroom decision-makers and people working in criminal justice sectors March 11, 2015 West Toronto Human Services & Justice Coordinating Cttee. Agenda Introduction

More information

Overdose Events in British Columbia: Trends in Substances Involved, Contexts and Responses

Overdose Events in British Columbia: Trends in Substances Involved, Contexts and Responses Overdose Events in British Columbia: Trends in Substances Involved, Contexts and Responses Kate Vallance¹, Gina Martin¹,Tim Stockwell¹, Scott Macdonald¹, Clifton Chow², Andrew Ivsins¹, Jane Buxton³, Andrew

More information

-HHS Secretary Donna Shalala, 1998

-HHS Secretary Donna Shalala, 1998 Needle exchange programs can be an effective part of a comprehensive strategy to reduce the incidence of HIV transmission and do not encourage the use of illegal drugs -HHS Secretary Donna Shalala, 1998

More information

Date of Release: December 10, 1992 No.C913510 Vancouver Registry IN THE SUPREME COURT OF BRITISH COLUMBIA

Date of Release: December 10, 1992 No.C913510 Vancouver Registry IN THE SUPREME COURT OF BRITISH COLUMBIA Date of Release: December 10, 1992 No.C913510 Vancouver Registry IN THE SUPREME COURT OF BRITISH COLUMBIA BETWEEN: ) ) REASONS FOR JUDGMENT SARAH JANE BARBEAU ) ) PLAINTIFF ) ) OF ) ) AND: ) ) THE HONOURABLE

More information

Adviceguide Advice that makes a difference

Adviceguide Advice that makes a difference Health in prison Getting medical treatment in prison If you re in prison, you should get the same health services as you'd get from the NHS. This includes mental health services. Qualified doctors, dentists,

More information

THE AHOUSAHT, EHATTESAHT, HESQUIAHT, MOWACHAHT/MUCHALAHT, AND TLA-O-QUI-AHT INDIAN BANDS AND NATIONS. And MINISTER OF FISHERIES AND OCEANS

THE AHOUSAHT, EHATTESAHT, HESQUIAHT, MOWACHAHT/MUCHALAHT, AND TLA-O-QUI-AHT INDIAN BANDS AND NATIONS. And MINISTER OF FISHERIES AND OCEANS Date: 20150227 Docket: T-70-15 Citation: 2015 FC 253 Vancouver, British Columbia, February 27, 2015 PRESENT: The Honourable Mr. Justice Manson BETWEEN: THE AHOUSAHT, EHATTESAHT, HESQUIAHT, MOWACHAHT/MUCHALAHT,

More information

Review of Regulations Governing Marihuana for Medical Purposes

Review of Regulations Governing Marihuana for Medical Purposes STAFF REPORT ACTION REQUIRED Review of Regulations Governing Marihuana for Medical Purposes Date: June 13, 2016 To: From: Wards: Reference Number: Licensing and Standards Committee Executive Director,

More information

Office of the Information and Privacy Commissioner Province of British Columbia Order No. 16-1994 July 8, 1994

Office of the Information and Privacy Commissioner Province of British Columbia Order No. 16-1994 July 8, 1994 Office of the Information and Privacy Commissioner Province of British Columbia Order No. 16-1994 July 8, 1994 INQUIRY RE: A Request for Access to Records of the Insurance Corporation of British Columbia

More information

The National Anti-Drug Strategy: A CAMH Response September 2008

The National Anti-Drug Strategy: A CAMH Response September 2008 The National Anti-Drug Strategy: A CAMH Response September 2008 The Centre for Addiction and Mental Health, (CAMH) is Canada s leading mental health and addictions teaching hospital. CAMH has played a

More information

Family Law Client Information Package

Family Law Client Information Package Family Law Client Information Package The end of a relationship can be very difficult. In addition to the obvious emotional issues, couples are often faced with challenging financial and legal problems.

More information

POSITIVE LIVING SOCIETY OF BRITISH COLUMBIA. Medical Marijuana. Adopted by the Positive Living Society of British Columbia Adopted: August 2015

POSITIVE LIVING SOCIETY OF BRITISH COLUMBIA. Medical Marijuana. Adopted by the Positive Living Society of British Columbia Adopted: August 2015 POSITIVE LIVING SOCIETY OF BRITISH COLUMBIA Medical Marijuana Adopted by the Positive Living Society of British Columbia Adopted: August 2015 Written by the Positive Living Society of British Columbia,

More information

Court Record Access Policy

Court Record Access Policy SUPREME COURT OF BRITISH COLUMBIA Court Record Access Policy The Supreme Court of British Columbia 800 Smithe Street Vancouver, BC V6Z 2E1 www.courts.gov.bc.ca Page 1 of 39 TABLE OF CONTENTS PART I: GENERAL

More information

Travis Baggett, MD, MPH Jessie M. Gaeta, MD Jennifer Brody, MD, MPH Boston Health Care for the Homeless Program

Travis Baggett, MD, MPH Jessie M. Gaeta, MD Jennifer Brody, MD, MPH Boston Health Care for the Homeless Program Travis Baggett, MD, MPH Jessie M. Gaeta, MD Jennifer Brody, MD, MPH Boston Health Care for the Homeless Program Substance- attributable mortality Presentation of the data Implications for our model of

More information

Downtown Eastside of Vancouver, British Columbia

Downtown Eastside of Vancouver, British Columbia Downtown Eastside of Vancouver, British Columbia The Mission Be innovative and problem-solving Improve offender accountability Address the underlying causes of criminal behavior Operate an efficient, cost-effective

More information

Briefing Note: Hepatitis B & Hepatitis C. Summary:

Briefing Note: Hepatitis B & Hepatitis C. Summary: Briefing Note: Hepatitis B & Hepatitis C Summary: In Canada, hepatitis B and hepatitis C infections remain serious public health concerns due to high prevalence rates, high health care expenditures and

More information

Methadone Maintenance Treatment Program

Methadone Maintenance Treatment Program Methadone Maintenance Treatment Program Answers to Frequently Asked Questions Why is the College involved in the MMT program? The methadone maintenance treatment (MMT) program of the College of Physicians

More information

Hepatitis C: Reducing Incidence

Hepatitis C: Reducing Incidence Hepatitis C: Reducing Incidence Brian R. Edlin, MD, FACP, FIDSA Senior Principal Investigator National Development and Research Institutes Associate Professor of Medicine Weill Cornell Medical College

More information

Why invest? How drug treatment and recovery services work for individuals, communities and society

Why invest? How drug treatment and recovery services work for individuals, communities and society Why invest? How drug treatment and recovery services work for individuals, communities and society What is drug addiction? Drug addiction is a complex but treatable condition Those affected use drugs compulsively,

More information

Getting help for a drug problem A guide to treatment

Getting help for a drug problem A guide to treatment Getting help for a drug problem A guide to treatment Who we are The National Treatment Agency for Substance Misuse is part of the National Health Service. We were set up in 2001 to increase the numbers

More information

IN BRIEF SECTION 1 OF THE CHARTER AND THE OAKES TEST SECTION 1 OF THE CHARTER. Ontario Justice Education Network. Section 1 reads as follows:

IN BRIEF SECTION 1 OF THE CHARTER AND THE OAKES TEST SECTION 1 OF THE CHARTER. Ontario Justice Education Network. Section 1 reads as follows: THE CHARTER AND STUDENT HANDOUT SECTION 1 OF THE CHARTER The Canadian Charter of Rights and Freedoms, enacted in 1982, changed the law so that Canadians now have constitutionally guaranteed rights that

More information

Concurrent Session A: HIV/AIDS The Role of Criminal Law in Public Health

Concurrent Session A: HIV/AIDS The Role of Criminal Law in Public Health Canadian Conference on the Public s Health and the Law November 5-7, 2006 (Toronto) Concurrent Session A: HIV/AIDS The Role of Criminal Law in Public Health Moderator: Dr. Brian Cornelson HIV Family Practice

More information

POLICE RECORD CHECKS IN EMPLOYMENT AND VOLUNTEERING

POLICE RECORD CHECKS IN EMPLOYMENT AND VOLUNTEERING POLICE RECORD CHECKS IN EMPLOYMENT AND VOLUNTEERING Know your rights A wide range of organizations are requiring employees and volunteers to provide police record checks. Privacy, human rights and employment

More information

The Attorney General in Nova Scotia

The Attorney General in Nova Scotia The Attorney General in Nova Scotia Department of Justice Copyright 2009 2 Role of the Attorney General Simply stating the powers of the Attorney General, of course, does not make clear the principles

More information

Courts & Our Legal System

Courts & Our Legal System Courts & Our Legal System 2012 (Version 1.0) This booklet has been prepared, published and distributed by the Public Legal Education Association of Saskatchewan (PLEA). The purpose of PLEA and this booklet

More information

Treatment of Opioid Dependence: A Randomized Controlled Trial. Karen L. Sees, DO, Kevin L. Delucchi, PhD, Carmen Masson, PhD, Amy

Treatment of Opioid Dependence: A Randomized Controlled Trial. Karen L. Sees, DO, Kevin L. Delucchi, PhD, Carmen Masson, PhD, Amy Category: Heroin Title: Methadone Maintenance vs 180-Day psychosocially Enriched Detoxification for Treatment of Opioid Dependence: A Randomized Controlled Trial Authors: Karen L. Sees, DO, Kevin L. Delucchi,

More information

Treatment Seeking and Non-Treatment Seeking Individuals Living with HIV and Opioid Use Disorders in Washington, D.C.

Treatment Seeking and Non-Treatment Seeking Individuals Living with HIV and Opioid Use Disorders in Washington, D.C. Falling in Line with the HIV Cascade of Care Model: A Comparison of HIV and Substance Abuse Outcomes for Treatment Seeking and Non-Treatment Seeking Individuals Living with HIV and Opioid Use Disorders

More information

Estimates of New HIV Infections in the United States

Estimates of New HIV Infections in the United States Estimates of New HIV Infections in the United States CDC HIV/AIDS Fa c t s A u g u s t 28 Accurately tracking the HIV epidemic is essential to the nation s HIV prevention efforts. Yet monitoring trends

More information

PROVINCIAL BRIEFING DOCUMENT 1: EXECUTIVE SUMMARY

PROVINCIAL BRIEFING DOCUMENT 1: EXECUTIVE SUMMARY PROVINCIAL BRIEFING DOCUMENT 1: EXECUTIVE SUMMARY Legal Aid for Abused Immigrant, Refugee, and Non-Status Women Since 2002, Legal Aid funding and services have declined dramatically in BC. Many in desperate

More information

Notes for an Address by. Hilary Geller. during the. General Debate on the Special Session of the UN. General Assembly on the World Drug Problem

Notes for an Address by. Hilary Geller. during the. General Debate on the Special Session of the UN. General Assembly on the World Drug Problem Notes for an Address by Hilary Geller during the General Debate on the Special Session of the UN General Assembly on the World Drug Problem at the 59 th Session of the United Nations Commission on Narcotic

More information

Where Can I FInd Out MOre? how Can I SuppOrt a hat program In Canada?

Where Can I FInd Out MOre? how Can I SuppOrt a hat program In Canada? www.pivotlegal.org 1 What Is heroin? A chemical compound derived from opium, diacetylmorphine was first synthesized in London in 1874. A few years later, the German pharmaceutical company Bayer trademarked

More information

This report was created in a software product that did not support conversion to pdf files.

This report was created in a software product that did not support conversion to pdf files. HIV, HEPATITIS, AND INJECTION DRUG USE IN BRITISH COLUMBIA * PAY NOW OR PAY LATER? NOTE: This report was created in a software product that did not support conversion to pdf files. The graph shadings in

More information

American Society of Addiction Medicine

American Society of Addiction Medicine American Society of Addiction Medicine Public Policy Statement on Core Benefit for Primary Care and Specialty Treatment and Prevention of Alcohol, Nicotine and Other Drug PREFACE Statement of the Problem:

More information

Resources for the Prevention and Treatment of Substance Use Disorders

Resources for the Prevention and Treatment of Substance Use Disorders Resources for the Prevention and Treatment of Substance Use Disorders Table of Contents Age-standardized DALYs, alcohol and drug use disorders, per 100 000 Age-standardized death rates, alcohol and drug

More information

African Americans, of people in the United States with AIDS are women, injection drug users,

African Americans, of people in the United States with AIDS are women, injection drug users, Appendix D-- Epidemiology of AIDS in Women, Injection Drug Users, African Americans, and Hispanics The epidemic of acquired immunodeficiency syndrome (AIDS) in the United States has now entered its second

More information