Pubdate: Tue, 31 Oct 2006
Source: Varsity, The (CN ON Edu)
Copyright: 2006 The Varsity
Contact:  http://www.thevarsity.ca/
Details: http://www.mapinc.org/media/2663

FACE-OFF: INJECTION SITES FOR SORE EYES?

Thus far, Vancouver is the only Canadian city that has implemented a 
federal program to open safe injection sites in its notoriously 
heroin-infested east end. The program has been successful in getting 
addicts off the streets, due in part to a government-approved amnesty 
from drug-related prosecution for users and care-givers alike, though 
whether the sites have led to reduced drug use is open to debate.

Toronto has mulled over the idea of safe injection sites at various 
times over the last five years, but with the city's drug problem 
nowhere near as bad as Vancouver's, and with the lack of a central 
neighbourhood known for overt heroin use, the program has never been 
implemented here. David Miller has never formally endorsed the 
approach, though he does favour "harm reduction" as one of the four 
pillars of the strategy to combat drugs. Though she has not commented 
publicly on the issue, it is unlikely that Jane Pitfield would 
support a service that caters to the homeless on the streets.

Empirical evidence from the West Coast is making it increasingly 
difficult for those opposed to safe-injection sites to maintain their 
scientific footing. A study conducted by UBC last year indicates that 
Vancouver's program has caused a significant reduction in 
syringe-sharing, which is the main source of HIV and Hepatitis C 
infection among intravenous drug users.

Safe injection sites foster contact between addicts and health care 
workers who can provide addiction counseling and treatment referrals. 
Added to this is the mitigating effect use of the sites has on the 
marginalization of users, a factor that has been identified in 
studies as significantly contributing to the cycle of addiction.

Without robust scientific support for their position, those opposed 
to safe injection sites cling desperately to outdated, erroneous 
assumptions about substance abuse. They continue to tout 
criminalization and abstinence-based treatment as the most effective 
tools for fighting the "war on drugs," despite overwhelming evidence 
to the contrary. Indeed, the creation of a black market drug trade 
responsible for many of the social ills associated with addiction, 
such as violent crime, poverty, and the transmission of HIV can be 
attributed to these misguided policies.

These assumptions merely cloak a racist, class-based view of 
intravenous drug use. It is no secret that the majority of addicts 
hail from disadvantaged segments of the population, and that a 
disproportionate number of users are Aboriginal.

A drug policy that emphasizes criminalization and outdated treatments 
does little to address the pathology of addiction, and instead works 
to reinforce the status quo. Conversely, approaches aimed at reducing 
the harm associated with drug use may help to alleviate pre-existing 
social disadvantages by giiving addicts a much-needed sense of dignity.

- - Anji Samarasekera

By refusing to provide Canadian drug addicts with government 
resources, we are in effect turning our back on some of society's 
most vulnerable people. It's about time we stop treating substance 
abusers as though they were second-class citizens. There are alarming 
rates of death and contraction of HIV/AIDS amongst drug users across 
Canada, and regardless of their lifestyle they too are entitled to 
health care and compassion.

Safe injection sites would not promote drug use. Rather, they would 
help reduce the rate of infection and provide resources for Toronto's 
addicted. At the proposed clinics, there would be safe needle 
exchange programs in which medical professionals could monitor the 
injection of intravenous drugs and be on hand in case any 
complications occurred.

Vancouver health officials have reported that since their initiation 
in 2003, the safe injection sites boast a zero overdose rate.

In a July 2006 letter, the Canadian HIV/AIDS Legal Network claimed 
that shutting down already existing Canadian sites would be "a huge 
step backwards in Canada's response to HIV/AIDS." Moreover, a recent 
report in the New England Journal of Medicine stated that drug users 
who frequent such clinics are more likely to get into detox.

Injection sites will be able to provide life-saving services and 
support for Toronto's most at-risk population-homeless drug users. 
Without safe injection sites, the homeless use dirty, infected 
needles and resort to shooting up in back alleyways, abandoned 
parking lots, and, what's worse, schoolyards. Why unnecessarily 
expose our children to the problems of drug use when the solution is 
so simple and effective?

- - Aisha Ansari

On the surface, safe injection sites seem loaded with benefits. They 
provide intravenous drug users with a place to inject their drugs 
under supervision by clinical staff. They decrease HIV rates and 
clean up the streets. They reduce the drug problem and lead to 
happier, healthier communities.

Unfortunately, the reality is not so rosy. While proponents of safe 
injection sites often cite encouraging data from Vancouver's Insite, 
North America's only legal safe injection site, not all the results 
have been positive. Several studies have shown that most users do not 
visit the site each time they require their drug fix. They may go 
when it is convenient for them, but they would be just as likely to 
inject their drugs (likely with dirty needles) on the street if they 
are not near the facility. Having addicts casually frequent the safe 
injection site while continuing to inject drugs elsewhere is clearly 
counterproductive and translates into a waste of government resources.

It also must be noted that Vancouver is sometimes notoriously 
referred to as the "heroin capital of North America" because of its 
extremely high rates of heroin addiction. Translating results from 
Insite to the city of Toronto, where the drug problem is not as 
great, should only be done with great discretion.

Perhaps the most compelling argument against safe injection sites is 
that they do not address the key issues behind drug addiction. For as 
long as users remain addicted, they cannot contribute to society in a 
meaningful way. As such, the harm reduction concept is merely an 
inconsistent 'band-aid solution' to a much bigger problem.

On the contrary, many addicts receiving treatments such as methadone 
(a long-acting synthetic heroin substitute) have been able to return 
to "normal" life. They have been able to gain employment, reconnect 
with family, and, most importantly, free themselves from the 
destructive cycle of drug addiction.

- - Mayce Al-Sukhni
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