Pubdate: Thu, 23 Oct 2008
Source: Globe and Mail (Canada)
Copyright: 2008 The Globe and Mail Company
Author: Andre Picard
Bookmark: (Insite)
Bookmark: (Supervised Injection Sites)
Bookmark: (Harm Reduction)


The Facilities Will Not Cure Drug Abuse But They're Integral To 
Strategies For Prevention And Rehabilitation

In the waning days of the federal election campaign, there was an 
important development in the continuing saga surrounding Insite, 
Vancouver's safe-injection site.

Pivot Legal Society released documents, obtained under an 
access-to-information request, that show the RCMP paid for research 
that was clearly designed to attack and undermine Insite.

Numerous scientific publications have shown that providing addicts 
with clean needles, condoms and a safe place to inject can sharply 
cut the risk of transmission of diseases such as HIV-AIDS and 
hepatitis C, and prevent overdoses.

While safe-injection facilities may be emotionally unpalatable to 
many, they are a sound public health measure, particularly as an 
integral part of a broader strategy of prevention, treatment and 

A couple of government-sponsored reviews have come to the same 
conclusion, but because they did not fit the war-on-drugs ideology 
held by the federal Conservative government (or senior Mounties 
presumably), the RCMP went shopping for an opinion they liked: that 
Insite is a failure.

It has been pointed out by editorialists and columnists that although 
the RCMP can inform itself by consulting independent experts, it has 
no business shopping around for research that will provide 
predetermined conclusions.

The job of the national police is to enforce the law, not to attack 
and undermine laws and public policies they don't like.

This begs the question: Is the commissioning of politically motivated 
critiques of Insite the work of a rogue police force, or did this 
despicable behaviour have the tacit approval of the RCMP's political masters?

The answer to that key question is not going to come from a summary 
internal review.

And whatever the answer is, we are left with a disconcerting state of 
affairs. In the grand scheme of things, Insite is not, in itself, 
that important. It is a single safe-injection site that provides 
temporary respite for a small group of drug users - a few hundred 
desperate souls on Vancouver's Downtown Eastside who are hooked on 
heroine, cocaine or speed.

But the attacks on Insite are really an attack on the philosophy of 
harm reduction, which is a pragmatic approach that recognizes that 
addiction and treatment are not flip sides of a black-and-white coin.

Addiction is an illness, one with powerful clutches. Treatment fails, 
often repeatedly, and treatment and rehabilitation from addiction (be 
it heroin, alcohol or tobacco) take time. In the interim, it is best 
to reduce harm as much as possible by preventing transmission of 
disease and other problems that are part and parcel of drug abuse.

There are hundreds, if not thousands, of harm-reduction programs 
around the country that are rooted in the same philosophy.

There are wet shelters that provide alcohol to homeless alcoholics, 
who are turned away from traditional shelters. There is distribution 
of glass pipes to crack addicts. There are needle-exchange programs 
and methadone-maintenance programs for intravenous drug users. There 
are condom-distribution programs for street-level sex workers.

Technically, many of these programs operate on the margins of the 
law. The irony here is that Insite, with an exemption from the law 
and the backing of the courts, is getting the most grief.

The bottom line is that, more often than not, these programs work.

Alcoholics turned away from shelters end up on the streets drinking 
Lysol and are frequent visitors to emergency rooms. Crack addicts 
tend to smoke rock from busted-up pop cans that leave their lips 
bloodied and raise the risk of blood-borne infections. Junkies 
desperate for a hit share needles if clean ones aren't available, 
fuelling outbreaks of HIV and hepatitis C.

Heroin addicts treated with methadone can be weaned from their 
addiction or, at the very least, they temporarily break their pattern 
of injecting.

These programs are intended to reduce harm to individuals with 
substance-abuse problems. They also recognize that outbreaks of 
infectious disease often have their genesis in these high-risk 
groups. In other words, if you minimize HIV and hepatitis C 
infections among IV drug users, you largely keep those infections 
away from the broader population.

These programs are not a panacea. They will not eliminate the scourge 
of alcohol and drug abuse. But they do not pretend to do so.

These methods were developed over time by street-level workers who 
recognized that no amount of repression and political rhetoric would 
eliminate drug abuse in society, but that at least some harm could be 

This insight was hard-earned.

Yet, our federal government and our national police force, rather 
than embracing harm reduction as complementary to law enforcement, 
have developed a hatred for Insite that is irrational and unseemly, 
one that threatens and undermines public health policy to its core.
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MAP posted-by: Jay Bergstrom