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.
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MAP posted-by: Jay Bergstrom