A Vancouver woman says the city's supervised injection site put her on the path to a two-month heroin binge after nurses at the facility helped her inject herself for the first time in her life.
Since her first visit in March, 32-year-old Cherie says she has visited Insite as many as 100 times to support her sudden addiction – something she says she wouldn't have done if the site had warned her away.
"It was way too convenient," she told CTV News. "It made me use more. If there wasn't an Insite I wouldn't use as often as I was. It made my addiction spiral downhill basically."
Cherie's story is fodder for critics who say the safe-injection site is too easy to access, but those behind Insite say they can't set up too many barriers if they want to protect the health of drug users.
Cherie, who spoke to CTV News from inside Vision Quest, her court-ordered rehab facility, asked that her last name not be used because she would face stigma as a drug user.
She says she smoked heroin regularly for two years in Vancouver's Downtown Eastside, where despite the drug use, she said she functioned well at a job and in classes at college.
About two months ago a friend offered to inject heroin -- a much more potent way of experiencing the drug -- and, enticed by the experience, Cherie went to Insite to try it again.
"I figured it would be cleaner, and safer, in case I OD'd," she said.
Cherie says she was asked at the door if she was an IV drug user, and she said she was. But she says no one asked her how long she had been using the drug, or if she considered herself an addict.
A nurse taught her how to do her second injection, and after that she says she visited Insite several times a day as the addiction took hold.
"It got to the point that I would start crying right before I would inject myself. I knew that wasn't me. I wanted to stop, but I didn't know how," she said.
Cherie asked about getting into detox programs, and staff told her they were available. But ultimately it was a judge who sentenced her to rehab for missing a court date.
Insite is critical for first-time users: proponents
Vancouver Coastal Health, which oversees Insite, says that intake staff strive to make sure any new user is taken aside and offered counselling and advice before they inject.
"If someone is a new user, we would do further counselling and talk to them privately to make sure that they really understand the implications and the harms associated with drug use," said Anne McNabb, Vancouver Coastal Health's director of mental health and addiction services.
Cherie would have been supervised in her injection use and avoided an overdose or disease from dirty needles, McNabb said, adding that the site worked in that respect. She said she would look into Cherie's case to determine if Cherie was properly counselled.
McNabb says the site must be "low barrier" to attract addicts it is trying to help who would otherwise not trust the health care system. She says standard practice is to ask would-be users of Insite if they are an injection drug user, but not how long they have been a user.
"Our objective is to engage people in health care, not pushing them out and excluding them," she said. "It's a low barrier site and meant to be used as a way to access other health care services."
Mark Townsend of the Portland Hotel Society, which operates Insite in conjunction with Vancouver Coastal Health, says the site needs to supervise first-time users.
"First-time users are the most at risk of dying," he said, adding that an injection site in Australia faced a lawsuit for failing to welcome a first-time user, who subsequently died.
Peer-reviewed studies have shown that Insite saves lives, reduces HIV transmission and helps refer addicts to rehab and treatment. Addicts are able to use clean needles and have nurses there to care for them if anything goes wrong.
The facility does not supply heroin, and studies show the vast majority of users are long-term addicts, and cases like Cherie's are rare.
‘Insite makes it easy'
But critics say Insite isn't living up to its responsibility to deter new drug users.
"Insite makes it easy," said Jim O'Rourke, who runs Vision Quest Recovery Society, which has several houses in the Vancouver area. "It promotes drug use. Okay, so I want to get to the next level of addiction, right, let's rock and roll."
It's not the first time that Insite has faced criticism for being too easy to access. Last year, a filmmaker claimed nurses at Insite helped him use heroin for the first time in a documentary "Streets of Plenty."
Cherie says she might have reconsidered if Insite staff had taken her aside, or asked her more questions.
"I think they should ask how long you've been a drug addict, or when the last time you injected," she said.
