You learn more when you are put outside of your comfort zone and surround yourself in a whole new environment. Today, a group of my nursing student buddies and I went to Vancouver, Canada to visit Insite, Canada’s first supervised injection site. So, the reactions that I get from my friends when I explain to them the purpose of these supervised injection sites is, “These places are just enabling these people to do more drugs.” I mean, yes. These people are using drugs and getting supplies to do them, so this place has to be bad, right? Ever since nursing school, my whole opinion about drug addicts, homeless people, and/or people with mental illnesses have greatly turned around. It is not just drugs that is the main problem, but the terrible things that has happened to these people that have gotten to this point of being addicted to heroine, cocaine, and other drug stimulants. These people have no support system. No family. No help from others. Women have been raped and abused. There is so much pain that these people feel and they use drugs to mask their pain.
Insite is located in one of Vancouver’s poorest neighborhoods. There were tons of homeless people sitting, laying, and standing around block to block. When walking up the block, I saw a woman whose arm had a stream of blood after shooting up her drugs with a syringe. I saw a guy sitting on the ground with a folded piece of paper with his powder in it ready to take it up his nose. I saw people who were clearly in another reality due to being so high.
So, what is the point of having a service like this for these people? Harm reduction.
“Harm reduction incorporates a spectrum of strategies from safer use, to managed use to abstinence to meet drug users “where they’re at,” addressing conditions of use along with the use itself. Because harm reduction demands that interventions and policies designed to serve drug users reflect specific individual and community needs, there is no universal definition of or formula for implementing harm reduction.”
Drug addicts aren’t going to stop taking drugs after one day. Addictions are difficult to deal with and may even take years for people to commit changing their behaviors. So, by meeting them where they are at, we as nurses can still reach out to them and help them with their immediate concerns. At Insite, over 1,000 drug users come to inject their drugs with clean needles, clean water, clean equipment, and medical supervision. Nurses are able to educate to them about vein care, wound care, how to inject safely, and most especially, how to keep themselves safe from contracting HIV/AID and/or Hepatitis.
You may think that addicts just use this place to do their dope and leave afterwards. Yes, there are some people who do that. Some people who are still caught up with their addiction that it just consumes them. That is all they want. Some people come to Insite for services, especially their detox program. There are users who want to be clean, but that doesn’t happen in a week or two, you know? I was walking on the block with one of the workers who works at Insite and this guy came up to us, walking zig-zags, dressed with baggy clothing, dirty hands, and messed up hair. He told us, “I have been five months sober, but I relapsed on Monday and it has fucked me up as you can tell. But once I told Dave about my relapse, he told me to come back to Insite to take care of me.”
This guy who probably has no support system due to his struggle with his addiction, has a support system with Iniste. He has help he can turn to when he relapses and he can protect himself from contracting infections from not sharing needles and injecting safely with the observation of nurses. My thoughts about harm reduction have been made so much clearer to me after this visit with Iniste. There is so much more that I learned, like other services that Insite provides like a drug community center, alcohol exchange program, crack pipe vending machines, and methadone treatment programs.
By meeting people at where they are at, we are able to talk to people more about their current situation and how to deal with it at that moment. Whether it is changing a wound dressing or connecting them with resources for housing or helping them get signed up for a methadone treatment program or the detox one. I think that harm reduction is a program that works and wish that Seattle grew into the idea in the future. One can hope.