The Point of Diminishing Returns: An Examination of Expanding Vancouver’s Insite

Abstract

North America’s only government-sanctioned supervised injection facility, Insite, has been subjected to substantial research. This research has found evidence for numerous public health benefits: decreased risky injection behaviour, decreased fatal overdoses, increased probability of initiating and maintaining addiction treatment, and cost-effectiveness. To date, a small number of costing studies have emerged with none of them investigating Insite expansions. Such an analysis is reported in this paper and it is found that, based on benefit–cost ratios, Insite should be expanded. However, this expansion is dependent on altering injection drug user behaviour outside Insite.