A BETTER WAY TO TREAT ADDICTS

Yesterday I announced that I would ask Cabinet colleague Rob
Nicholson, Canada's Minister of Justice, to appeal this week's
decision of the B. C. Supreme Court with regard to the supervised
injection function of Insite, in Vancouver. This was a decision to
which I gave my most careful consideration. It was based on both
science and public policy.

I've read many of the studies that have been published on Insite, and
the results can only be described as "mixed." For example, Health
Canda's Expert Advisory Committee (EAC) found Insite caused an uptake
in treatment -- yet from 2004 to 2005, only 3% of Insite clients were
referred to long-term treatment.

After five years of intensive study, researchers still aren't sure if
Insite makes any difference at all in the transmission of blood-born
diseases, including HIV/AIDS, or whether Insite's benefits are
greater than its $3-million annual cost.

What do we know specifically about supervised injections at Insite?
We know that:

. nsite is dominated by a group of about 500 regular clients;

. Up to 97% of injections in the area (4.4 million per year) occur
outside of Insite;

. Since Insite opened, there have been 50 overdose deaths per year in
the Downtown Eastside area. There is no direct evidence that the
supervised injection site (SIS) influences the number of deaths
specifically due to overdoses; and

. Overall, Insite saves about one life per year.

My job as Canada's Health Minister is to balance that one life
against any possible negative effects of supervised injection that
might take one life elsewhere. It is a difficult job; in my
estimation. The science is mixed but the public policy is clear --
which is why I have asked Mr. Nicholson to appeal the B. C. Supreme
Court decision.

Advocates have claimed that Insite has reduced the level of crime in
the Downtown Eastside or, at least, made it no worse. But Vancouver
police added 65 beat officers to the streets of the Downtown Eastside
at the same time that Insite was established. Many police officers
feel that this is the real reason crime statistics did not skyrocket.

In fact, the EAC report noted that the typical addict needs to spend
about $35,000 per year to support his or her habit, and that about
$350,000 worth of crime needs to be committed to obtain that $35,000.
Law-abiding Vancouverites are beginning to see that what has been
presented as "victimless crime" -- the drug trade -- is not
"victimless" at all.

As Parliamentarians, we are sworn to uphold the rule of law. We also
believe every Canadian deserves hope of recovery through treatment.
That is why my government has announced over $150-million in
treatment funding in the past month.

Wealthy people who become addicted to drugs can check into expensive
rehab centres for months at a time. Yet for the poorest of Canadians,
enslaved by addiction from which full recovery is possible, we
instead have been offering supervised injection. We have been sending
a message: "We have given up on you."

Vancouver Mayor Sam Sullivan called the SIS "palliative care."
Palliative care is what you give someone when every other solution
has failed, and we are just waiting for death. But injection drug
users are not dying. There is hope for them.

In purely medical terms, it is unethical to offer palliative care
when treatment could help. While individuals working at Insite have
the best of intentions, I think the site itself represents a failure
of public policy, indeed, of ethical judgement. Every dollar spent on
the supervised injection site diverts a dollar away from treatment
that could lead to full recovery.

I believe we can do better, and we must.