Pubdate: Fri, 19 Jul 2013
Source: Vancouver Sun (CN BC)
Copyright: 2013 The Vancouver Sun
Contact: http://www.canada.com/vancouversun/letters.html
Website: http://www.canada.com/vancouversun/
Details: http://www.mapinc.org/media/477
Author: David Berner
Cited: Drug Prevention Network of Canada: http://dpnoc.ca/
Page: A11

LITTLE EVIDENCE HARM REDUCTION REDUCES HARM

A report by the B. C. Centre for Excellence in HIV/ AIDS on harm
reduction programs and Insite released last month is not science; it's
public relations.

Authors Drs. Julio Montaner, Thomas Kerr and Evan Wood have produced
nearly two dozen papers on the use of Insite. They boast of good
results in connecting addicts to treatment but convincing evidence is
lacking.

The current campaign reports significant reductions in drug overdoses,
yet the Government of British Columbia Selected Vital Statistics and
Health Status Indicators show that the number of deaths from drug
overdose in Vancouver's Downtown Eastside has increased each year (
with one exception) since the site opened in 2003.

In addition, the federal government's Advisory Committee on Drug
Injection Sites report only five per cent of drug addicts use the
injection site, three per cent were referred for treatment and there
was no indication the crime rate has decreased, as well as no
indication of a decrease in AIDS and hepatitis C since the injection
site was opened.

Claims of success for Insite made in The Lancet, the British medical
journal, in 2011 were challenged in a 15- page, heavily-documented
response penned by addictions specialists from Australia, the U. S.
and Canada, and by a former VPD officer who worked the DTES for years.

In A Critical Evaluation of the Effects of Safe Injection Facilities
for The Institute on Global Drug Policy, Dr. Garth Davies, SFU
associate professor wrote: "The methodological and analytic approaches
used in these studies are compromised by an array of deficiencies,
including a lack of baseline data, insufficient conceptual and
operational clarity, inadequate evaluation criteria, absent
statistical controls, dearth of longitudinal designs, and inattention
to intra-site variation. None of the impacts attributed to SIFs can be
unambiguously verified."

The doctors evaluating Insite are the same people who created Insite
and who have been awarded more than $ 18 million of taxpayers' money
for their initiatives in recent years. Dr. Colin Mangham, on our Board
of Directors, has been a researcher in this field since 1979.

"The proposal for Insite was written by the same people who are
evaluating it - a clear conflict of interest. Any serious evaluation
must be independent. All external critiques or reviews of the Insite
evaluations, there are four of them - found profound overstatements
and evidence of interpretation bias. All of the evidence - on public
disorder, overdose deaths, entry into treatment, containment of serum
borne viruses, and so on - is weak or non-existent and certainly does
not support the claims of success. There is every appearance of the
setting of an agenda before Insite ever started, then a pursuit of
that agenda, bending or overstating results wherever necessary."

Our President, Chuck Doucette, asks to see an independent and unbiased
cost/ benefit analysis.

"The four pillar approach only works when each pillar is properly
funded. Prevention reduces the flow of people into addiction.
Treatment reduces the number of addicts including those living in the
DTES. Policing keeps a lid on the open drug dealing and the affects of
the associated problems on the community. Only after these three
pillars are properly funded can we afford to spend money on Harm
Reduction initiatives that do not encourage abstinence. Putting HR
first is like running up debt on your credit card and never paying
more than your minimum payments."

No one would object to free needles, crack pipe kits, methadone,
heroin and places to shoot up if only they were the side show and not
the main event, if only they ever led to real health.

Harm reduction and Insite are palliative. They both spring from a
deeply cynical and arrogant world view: You are an addict and you are
hopeless. We will keep you "comfortable" while you continue to die.

This is a curious position considering the millions of men and women
who admit they are addicts and choose every day not to pick up their
poison. I know many such clean and sober citizens.

We owe one another a chance at dignity. To offer less is not only
costly, it is monstrous.
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MAP posted-by: Matt