Pubdate: Fri, 2 May 2008
Source: Globe and Mail (Canada)
Copyright: 2008, The Globe and Mail Company
Author: Andre Picard
Cited: British Columbia Centre for Excellence in HIV/AIDS
Bookmark: (Insite)
Bookmark: (Harm Reduction)


Ideological Opposition to a Vancouver Safe-Injection Site Caused 
Muzzling and Misrepresentation of Findings, Researchers Say

The federal government committed a "serious breach of international 
scientific standards" in its handling of Vancouver's safe injection 
site, according to a new study.

An article published in the International Journal of Drug Policy 
charges that the Conservative government interfered in the work of 
independent scientific bodies, attempted to muzzle scientists and 
deliberately misrepresented research findings because it is 
ideologically opposed to harm-reduction programs.

"From a scientific perspective, it's despicable," said Evan Wood, a 
research scientist at the B.C. Centre for Excellence in HIV/AIDS and 
lead author of the study. "Governments should not hand-pick grants 
based on ideology."

In 2003, the Liberal federal government approved North America's 
first safe injection facility, allowing public health officials to 
provide sterile needles and emergency medical care to intravenous drug users.

The facility, called Insite, was granted an exemption from Canada's 
drug laws on the condition that the pilot project be subjected to 
rigorous scientific evaluation.

Since then, Dr. Wood said, there have been 22 peer-reviewed papers 
published on the program and they have all shown a positive benefit 
to users, such as reduced rates of transmission of HIV-AIDS and 
greater use of rehabilitation services.

An independent scientific review led Health Canada in the spring of 
2006 to recommend that funding for the project be extended and that 
similar programs be tried in other cities.

But federal Health Minister Tony Clement intervened, saying there 
were too many unanswered questions and placed a moratorium on this 
type of research. The journal article says that was done at the 
behest of police organizations and based on political concerns, not 
sound public health policy.

Rita Smith, a spokeswoman for Mr. Clement, told The Globe and Mail 
yesterday this claim is "completely inaccurate."

"Minister Clement put no moratorium on research - he actually 
commissioned more research," she said, adding Mr. Clement had Health 
Canada form an independent committee to produce a report on all 
domestic and international research surrounding supervised injection sites.

The Vancouver project continues because it was funded by the Canadian 
Institutes of Health Research, which operates at arm's length from government.

Ottawa subsequently offered money for additional research, but with 
the proviso that investigators refrain from disseminating their 
findings until after the exemption for the safe injection site expires.

Dr. Wood said this amounts to "muzzling researchers." The University 
of British Columbia deemed that condition ethically unacceptable and 
so its researchers did not apply for the grants.

The legal exemption for Insite expires at the end of June and 
operators of the facility are currently in B.C. Supreme Court trying 
to force the government to extend it.

Perry Kendall, B.C.'s Provincial Health Officer, said the safe 
injection site has proven its worth and he agrees with much of the 
criticism in the journal article.

"I'm a realist enough to know that public policy is not based solely 
on science, but you would hope that policy would be strongly swayed 
by science, particularly in health care," he said in an interview.

Dr. Kendall said the fact that the public health program involves 
intravenous drug users clouds the issue and has allowed government to 
intervene as it would never do in other areas.

"If there was a validated intervention for hernia repair would we 
accept that the government step in and say: 'We don't like hernia 
repair'? I don't think so," he said.

In a commentary also published in the International Journal of Drug 
Policy, Robert MacCoun of the Goldman School of Public Policy at the 
University of California, Berkeley described the Insite saga as a 
"policy horror story."

He said that the evidence demonstrates that a "well-executed piece of 
policy research on a promising innovation was discontinued for 
unstated but blatant political reasons."

Dr. MacCoun said that Mr. Clement's critique of Insite - "Do safe 
injection sites contribute to lowering drug use and fighting 
addiction?" - misses the point of harm reduction.

He said the project is designed to minimize the harm IV drugs users 
do to themselves and others, something a law-and-order approach cannot achieve. 
- ---
MAP posted-by: Richard Lake