INSITE'S PROVEN EFFECTIVE, UNLIKE REST OF DRUG STRATEGIES

Federal Health Minister Tony Clement insists the government's only
concern is sound public policy. Does Insite really work?

If so, the government will allow the Vancouver drug-injection facility
to stay open. If not, Insite will have to close when its federal
exemption runs out on June 30.

Some question Clement's sincerity. After all, 22 studies examining
various facets of Insite's operations have passed the rigorous
peer-review process and been published in prestigious scientific
journals. Every one of those studies reported positive results.

But who am I to doubt Clement? He's one of the brighter lights in
Stephen Harper's cabinet. Besides, drug policy is a matter of life and
death. To put politics ahead of evidence, a politician would have to
be callous and ruthless.

I'll assume Clement is better than that. The fact that he has balked
at declaring Insite a success despite having those 22 peer-reviewed
studies is easily explained: He simply has very demanding evidentiary
standards.

That's a good thing. All politicians should.

But I've got terrible news for Clement, Harper, and all leaders who
base their decisions solely on scientific evidence: Almost every
element of Canada's approach to illicit drugs is unsupported by
scientific evidence.

Forget Insite and all the other harm-reduction programs such as needle
exchanges. They might get all the attention, but they're actually very
minor in the big scheme. They don't change the underlying approach to
dealing with drugs one iota.

That underlying approach is where the real resources
go.

First, there's prevention and treatment. A reasonable person could
argue both are underfunded. Still, both get far more money than harm
reduction and are considered far more important to Canadian drug policy.

Then there's law enforcement. A few years ago, the auditor general
estimated that 90 per cent of all the money spent on the illicit drug
problem by Canadian governments goes to law enforcement.

Given how long these policies have been kicking around, one might
think there's plenty of research on all three. But one would be wrong.

In a 2006 paper published in the journal Addiction, Peter Reuter -- a
professor at the University of Maryland whose work is respected by all
sides in the drug debate -- surveyed the scientific literature. His
results?

"Many studies have found treatment to have large effects on
individuals' consumption and harms," he wrote. "However, there is an
absence of evidence that even relatively well-funded treatment systems
have much reduced the number of people in a nation who engage in
problematic drug use."

Oh dear. And prevention? "The scientific literature shows useful and
modest effects at the individual level but there is little support for
substantial aggregate effects."

How unfortunate. But what about the policy that dominates Canada's
approach to drugs? "For enforcement, research has almost uniformly
failed to show that intensified policing or sanctions have reduced
either drug prevalence or drug-related harm."

Reuter is hardly alone in his assessment. In 2001, a committee of the
U.S. National Academy of Sciences issued a report examining the state
of the evidence on drug policy. In a phrase, the committee said
there's very little. Evidence, that is. "The nation possesses little
information about the effectiveness of current drug policy, especially
of drug law enforcement."

Incidentally, the state of research is actually worse in Canada than
in the U.S. The federal government doesn't even know how much money it
spends on drug policy.

One might think that the police would be bothered by the paltry
evidence in support of prevention, treatment and law enforcement. But
again, one would be wrong.

The Harper government's drug strategy rejects harm reduction and calls
for greater efforts in prevention, treatment and enforcement.

Which is why I am sure the news I have delivered today will devastate
Tony Clement. Not even Insite's 22 peer-reviewed scientific studies
are enough to satisfy the minister's evidentiary standards. Imagine
how he will feel when he learns that Insite is supported by far
stronger evidence than almost anything his government is doing about
drugs.

Imagine spending all that money and having no idea whether it's doing
what it's supposed to! Where's the research?

No doubt Clement will leap up and rush over to the prime minister's
office to share the awful news.

A wholesale review of drug policy will follow. And of course, there
will be new money for research -- so politicians will have something
other than politics and prejudice to guide their decisions about what
does and does not work.

Oh, and in the meantime, Insite will be permitted to keep
operating.

After all, it would be unconscionable to close a facility supported by
evidence while continuing to pour vast sums into policies not
supported by evidence.

And as we have agreed, Clement is better than that.