Pubdate: Mon, 27 Aug 2007
Source: Globe and Mail (Canada)
Copyright: 2007, The Globe and Mail Company
Bookmark: (Harm Reduction)
Bookmark: (Supervised Injection Sites)

Safe Injection Sites


Speaking to the Canadian Medical Association last week, federal 
Health Minister Tony Clement was non-committal on the future of 
Vancouver's safe injection site. But he seemed to be leaning against 
extending Insite's licence when it expires at year's end, telling 
doctors that recent research has cast doubt on the pilot project's usefulness.

Where is Mr. Clement getting his information? He hasn't said. Most 
likely it is from a well-publicized article published this past 
spring in the Journal of Global Drug Policy and Practice. The report 
was authored by Colin Mangham, the director of research for the Drug 
Prevention Network of Canada, a hard-line organization. Last year, 
former Reform MP Randy White, the then-head of the network, lauded 
what he saw as the Conservative government's tough approach on drugs. 
"A new National Drug Strategy, mandatory minimum prison sentences and 
large fines for marijuana grow operations, a nationwide awareness 
campaign, withdrawal of support for injection sites, a crackdown on 
drug crime and no marijuana decriminalization legislation is a breath 
of fresh air for Canadians, as well as a reflection of real 
leadership we have not seen in decades in Canada," he enthused.

Unsurprisingly, much of the report put out by Mr. White's research 
director reads more like a rant against the "ideology" of 
harm-reduction and its alleged infiltration into society than a 
scientific study. It contains no first-hand research; the bulk of its 
findings consist of simplistic efforts to poke holes in the litany of 
more serious studies demonstrating Insite's benefits.

Indeed, virtually all serious research suggests that the program has 
had considerable benefits with little downside. Reports in reputable 
medical journals such as The Lancet and the BMJ (British Medical 
Journal) have shown that Insite reduces needle-sharing in the 
community, reducing the spread of disease. While 500 users overdosed 
at Insite over a two-year period, onsite medical assistance prevented 
a single one from dying - something that would never have been the 
case on the street.

Far from encouraging drug use, as its opponents claim, Insite has 
encouraged addicts to kick their habits. Over a one-year period of 
study, it made 2,000 referrals, 40 per cent of them to addiction 
counselling. One in five regular visitors to the site enlisted in 
detoxification programs - resulting, said a recent report in the 
British medical journal Addictions, in a 30-per-cent rise in the 
number of local addicts making use of such services. Similar findings 
were reported last year in the New England Journal of Medicine.

Last week, a group of 134 prominent Canadian doctors and health 
professionals endorsed a commentary by Dr. Stephen Hwang in the 
journal Open Medicine calling for Insite to be continued on the basis 
that it "provide[s] a number of benefits, including reduced needle 
sharing, decreased public drug use, fewer publicly discarded 
syringes, and more rapid entry into detoxification services by 
persons using the facility." And while the RCMP has been critical of 
Insite, Vancouver's police department - which is on the ground and 
thus aware that harm reduction makes the streets safer - has endorsed it.

Unfortunately, it appears that no amount of evidence will convince 
the Conservatives, skeptical since the project was launched in 2003, 
of Insite's value. Desperate, local activists and drug users are 
going to court to argue that closing Insite would violate addicts' 
Charter rights. That seems a dubious proposition; ultimately the 
government will likely be free to decide whether or not to keep the 
program. But if Mr. Clement resists any urge to cherry-pick his 
information and looks at the overwhelming body of evidence, it should 
not be a difficult decision.
- ---
MAP posted-by: Beth Wehrman