Pubdate: Tue, 12 Dec 2006
Source: Globe and Mail (Canada)
Copyright: 2006, The Globe and Mail Company
Author: Rod Mickleburgh
Bookmark: (Supervised Injection Sites)
Bookmark: (Harm Reduction)
Bookmark: (Treatment)
Bookmark: (Heroin Maintenance)


Force's Research Criticizes The Lauded Safe-Injection Site And 
Asserts That The Program Increases Drug Use

VANCOUVER -- The RCMP is under heavy fire for its criticism of 
Vancouver's pioneering supervised injection site for heroin users, a 
project that has won positive reviews from more than a dozen rigorous 
research studies.

In a critical, three-page report on the site, Staff-Sergeant Chuck 
Doucette questioned findings of the numerous peer-reviewed studies, 
while pointing to "considerable evidence" that making drug use safer 
increases the number of users.

Staff-Sgt. Doucette is Pacific regional co-ordinator for the RCMP's 
drug and organized crime awareness division. His report, submitted 
this summer, was made public through a Freedom of Information request.

Yesterday, the head of addiction medicine for the Vancouver Coastal 
Health Authority charged that the RCMP report is full of "falsehoods 
and prejudice."

At the same time, a leading investigator of North America's first 
safe-injection site for illegal drug users accused Staff-Sgt. Ducette 
of taking a "frightening" approach and playing politics with issues 
of life and death.

And Vancouver police Inspector Scott Thompson, saying he represents 
the views of local beat police officers who deal with the facility on 
a regular basis, reiterated the Vancouver Police Department's support 
for the experimental project.

"The RCMP doesn't deal directly with a safe-injection site. That's 
for sure," said Insp. Thompson, head of youth services and drug 
policy co-ordinator for the Vancouver Police Department.

"We're the ones on the ground, and we support the public health 
objectives of reducing fatal overdoses and lessening the risk of HIV 
and AIDS among drug users."

The latest furor over the 12-seat site, known as Insite, refocuses 
attention on Prime Minister Stephen Harper's professed distaste for a 
supervised location that allows addicts to shoot up with illegal drugs.

Mr. Harper previously indicated that he was partial to the views 
expressed to him by the RCMP about the site.

Despite widespread community support and many studies in prestigious 
medical journals espousing the benefits of Insite, the Conservative 
government refused this fall to grant it another three-year legal 
exemption, extending its operation only until next December.

Federal Health Minister Tony Clement said more information is needed, 
but then cut off federal funding for research into Insite's operation.

David Marsh, physician leader of addiction medicine at the Coastal 
Health Authority, bluntly rejected Staff-Sgt. Doucette's assertion 
that drug use rises when risk is reduced.

A study of Vancouver drug addicts published recently in the British 
Medical Journal found that Insite did not have that effect, Dr. Marsh said.

"I think he is drawing conclusions without fully reviewing the facts, 
reflecting false information and prejudice. His report appears to be 
based on his beliefs, rather than facts," Dr. Marsh said.

Studies have found that Insite has reduced fatal drug overdoses, 
increased a desire among users to access detoxification centres, and 
lessened risky needle-sharing that can lead to the spread of AIDS, 
without quantifiably increasing the use of heroin.

"It's performing beyond our expectations," Dr. Marsh said. "We are 
extremely pleased."

Thomas Kerr, a research scientist with the B.C. Centre for Excellence 
in HIV-AIDS, said all scientific studies on the site's impact have 
been rigorously peer reviewed, appearing in respected publications 
such as The Lancet, the New England Journal of Medicine, the British 
Medical Journal and the Canadian Medical Association Journal.

"It's upsetting to note that you can do all this science, and at the 
end of the day, it can be set aside by politics," Dr. Kerr said. 
"These are life and death issues. They are not places for ideology 
and political beliefs."

He said the RCMP report is "fraught with errors. It's frightening to 
think that this person [Staff-Sgt. Doucette] is reporting to 
government based on this kind of misinformation.

"Politics are interfering with the scientific process, and, as a 
researcher, I find this particularly disheartening."

Dr. Kerr said the undoubted controversy surrounding the supervised 
injection site has spurred researchers "to take the hard route. . . 
to submit everything to independent, scientific review."

Yet nothing the RCMP has said about the site, or its research, has 
been submitted anywhere for scrutiny, he said.

"I find it baffling that the government includes them [on this matter]."

Since Insite opened three years ago as a pilot project, not a single 
fatal drug overdose has occurred at the site. The clean facilities 
and clean needles also reduce the risk of contracting HIV.

"Yes, drug addiction is a great evil," Insp. Thompson said. "But 
people dying from a drug overdose or getting a fatal disease is also terrible."
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