Pubdate: Wed, 17 Sep 2003
Source: Manitoban, The (CN MB Edu)
Copyright: 2003, The Manitoban
Contact:  http://www.umanitoba.ca/manitoban/
Details: http://www.mapinc.org/media/2665
Authors:  Erin Haluschak and Joel Trenaman

Shooting Themselves in the Foot

GOVERNMENT OPENS SAFE INJECTION SITE WITH QUESTIONABLE INTENTIONS

On Sept. 15, Canada's poorest neighbourhood finally received some good
news: the first supervised, government-sponsored heroin injection site
in North America opened its doors in Vancouver's Downtown Eastside, an
area home to an estimated 4,000 injection drug users.

To former Vancouver mayor and safe-injection site proponent Philip
Owen, the Vancouver Area Network of Drug Users and countless groups
and organizations pushing for these sites, the announcement was well
received. The federal and provincial governments picked up the $2
million tab.

However, it is the government involvement that has turned proponents
of the plan into critics of its clumsy provisions. A study published
in the Canadian Medical Association Journal (CMAJ) surmised that
"bureaucratic complexities" would drastically reduce the number of
users visiting the site, originally estimated at 800 per day.

A CBC News photo of the site prominently displays a shiny, sterile,
stainless steel counter adorned with an assortment of sparkling
medical supplies, a sink, and a large glass vase filled with white
tulips. This aesthetically-pleasing sugar-coated image is
representative of the highly-regulated environment that threatens the
effectiveness of the entire program.

The CMAJ study notes that 92 per cent of Vancouver's drug users would
be likely to use the new facility. However, when informed that
mandatory registration and rules barring the sharing of drugs and
assisted injections would be enforced, the number of willing users
dropped to 31 per cent. Only 22 per cent said they would frequent the
site when told police would be stationed nearby.

Although bureaucratic policies against sharing of drugs and assisted
injections are seemingly sensible regulations, it's compulsory user
registration and intrusive policing that are the biggest concerns for
the people the project is meant to help.

The site is part of a three-year research project, which raises
ethical questions: are these rules truly in place to help users, or
are they just a way for the government to gain access to information
that would be otherwise ethically unattainable? Mandatory registration
would require users to sign in each time they visit the site. Their
names and other personal information would be collected and used as
part of "research" on Canadian heroin use.

This places the whole initiative under the guise of a research
experiment, rather than it acting as a treatment centre. European
models are effective because they place a greater emphasis on
treatment and have more stable funding.

Once the moniker of "research" is tagged to a site, certain ethical
protocols must be followed, such as practicing informed consent for
intoxicated clients. It is essential to ensure that a research ethics
committee be formed and that the dilemmas that arise are published for
public knowledge, a necessary step that the study claims is often not
a part of other research projects.

A heavy police presence around the site will obviously deter users, as
addicts will have to bring their own drugs, purchased from illegal
dealers. Although present at the site's opening ceremony on Monday,
Vancouver Police Chief Jamie Graham said that "we're going to give
this site ... the best possible chance of success, but let there be no
mistake as to our resolve to enforce the law." This contradictory
position seems sure to inhibit the short-term success of the project
and longer term attempts to revitalize the area.

Despite these "bureaucratic complexities," the Canadian government's
harm-reduction approach to drug use is far superior to the
longstanding pursuit of the "drug-war" south of the border.

Yet if Canadian governments are serious about implementing programs
that have a legitimate chance to offer social aid and change attitudes
toward drug abuse, then more work must be done to prevent Vancouver's
safe injection site from becoming a tulip-adorned white elephant.

In the words of Liberal MP Paddy Torsney, chair of the Special
Committee on Non-Medical Use of Drugs and a strong proponent of drug
prevention and education: "we have to talk about (illegal drugs) as a
health issue and not as a moral issue." 
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