In 2003, the regional health authority in Vancouver opened North America's first medically supervised drug injection facility as a harm reduction measure . Insite — and the legal exemption that allowed it to open — was approved in response to a public health emergency in which HIV rates among injection drug users rose to nearly 30% and fatal overdoses reached epidemic levels . Feasibility studies in Vancouver suggested that a supervised injection facility had the potential to reduce public drug use, overdose deaths and public disorder .

Since its opening, over 30 peer-reviewed studies have documented the ways in which Insite, complemented by other harm reduction measures such as needle exchanges, has benefited the public. These positive outcomes include a reduction in overdose deaths in Vancouver's Downtown Eastside by 35% , a reduction in HIV risk behaviors such as syringe sharing and associated rates of disease transmission, and reduced public injecting . Insite has also led to higher enrollment in addiction treatment and other positive outcomes . Multiple studies found no evidence of any negative effects of the facility on its clients or the surrounding community .