Pubdate: Tue, 19 Aug 2008 Source: Vancouver Sun (CN BC) Copyright: 2008 The Vancouver Sun Contact: http://www.canada.com/vancouversun/letters.html Website: http://www.canada.com/vancouversun/ Details: http://www.mapinc.org/media/477 Authors: Ken Meaney, Canwest News Service and Kelly Sinoski, Vancouver Sun Bookmark: http://www.mapinc.org/find?142 (Supervised Injection Sites) Bookmark: http://www.mapinc.org/topic/insite (InSite) Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction) FEDERAL HEALTH MINISTER SLAMS INSITE INJECTION SITE Medical Association's Backing Of Program Puts It On 'A Slippery Slope,' Clement Warns VANCOUVER - Federal Health Minister Tony Clement used his platform at the Canadian Medical Association conference Monday to once again slam Vancouver's supervised injection site, saying the association's recent endorsements of Insite are "dangerously misleading." "Clearly, we are on a slippery slope here. Already there are people saying injection sites are not enough, that government should give out heroin for free. Others are now calling for 'inhalation rooms' for people who smoke their drugs," Clement said in his speech, a copy of which was provided to Canwest News Service. "I feel our government is now drawing the line in a place with which Canadians are comfortable, and I continue to review new information as it comes forward." Clement devoted the bulk of his address on the opening day of the CMA conference, which is being held in Montreal, to the supervised injection site in Vancouver's Downtown Eastside. "Insite may slow the death spiral of a deadly drug habit, but it does not reverse it. I do not regard this as a positive health outcome," Clement said. He added that he questioned whether it is ethical for health workers to support the distribution of drugs that are of "unknown substance, or purity, or potency, drugs that cannot otherwise be legally prescribed. "If this were done in a doctor's office the provincial college would rightly be investigating." But proponents of the program argue the majority of studies done on Insite -- including those conducted by the government's own health committee -- have shown that the program saves money and encourages addicts to seek treatment. Dr. Thomas Kerr, of the B.C. Centre for Excellence in HIV/AIDS at St. Paul's Hospital, said Clement is "highly selective" in his facts, saying his information is based on articles that haven't been subjected to a peer review. "It's just a real pathetic manipulation of data," he said. In material published in the New England Journal of Medicine, Kerr said, "You find evidence pointing clearly to Insite as doing what it is supposed to do. "Who do you want to believe? Do you want to believe published articles in the New England Journal or Lancet, do you want to believe the World Health Organization or do you want to believe Tony Clement? It's embarrassing." In his speech, Clement took issue with a letter he received in May from CMA president Dr. Brian Day and an opinion piece Day wrote in June. "The letter and article from the CMA supported the supervised injection site, saying, 'There is growing evidence that harm reduction efforts can have a positive effect on the poor health outcomes associated with drug use,' " Clement said, adding that the injection site has crossed a line and is no longer advocating simply "harm reduction." Clement said an expert panel commissioned by the federal Health Department last year found that Insite has had no impact on reducing the transmission of blood-borne illnesses such as HIV/AIDS. Nor has it significantly cut the 50 overdose deaths annually in Vancouver's Downtown Eastside. "Over the last five years, while Insite has been operating, we could have provided treatment to 5,000 addicts. Instead, during that time, 250 addicts have died of drug overdose alone," Clement said, adding that the vast majority of injections still take place in back alleys and seedy hotels, and the centre's $3-million annual cost would be better spent elsewhere. Kerr concedes there are users still shooting up in alleys because Vancouver has such a large crack problem. There are 5,000 to 8,000 drug users in the Downtown Eastside, he said, and Insite can't serve them all. - --- MAP posted-by: Jay Bergstrom