CLOSING DOWN INSITE WILL BRING OUT THE ANGEL OF DEATH

At the 2006 International AIDS Conference in Toronto, many people
were puzzled by federal Health Minister Tony Clement's refusal to
make any public comment about the future of Insite, Vancouver's
supervised injection site.

Now the reasons for Clement's silence seem perfectly clear, as he
managed to embarrass himself, Canadian scientists and health workers,
the World Health Organization and the Joint United Nations Program on
HIV/AIDS with his comments at the 2008 International AIDS Conference
in Mexico City.

Speaking ostensibly in support of the WHO's guide on fighting
HIV/AIDS -- which includes an explicit statement of support for
injection sites -- Clement launched into an incoherent and
contradictory diatribe against Insite and harm reduction measures in general.

So bizarre was Clement's rant that it's necessary to take it line by line:

"Allowing and/or encouraging people to inject heroin into their veins
is not harm reduction . . . we believe it is a form of harm addition."

Clement failed to provide any evidence for this belief, which isn't
surprising since there isn't any. Indeed, all of the evidence points
the other way: In addition to educating users about safer injecting
and providing them with a safe, clean place to do so, use of Insite
has been associated with increased uptake of detox and treatment.

Insite therefore represents a powerful method of reducing harm and,
better yet, it reduces harm among some of the most vulnerable and
marginalized individuals, people who would otherwise be unlikely or
unable to seek treatment.

And this is to say nothing of the incoherence of supporting needle
exchanges -- as Clement does -- while attacking injection sites.

The government is "not prepared to allow people to die."

While Clement failed to expand on this statement, it's clear he was
attempting to create an association between Insite and death. Once
again, the research suggests that, if anything, Insite saves lives,
which means that shutting the site down is more appropriately
associated with allowing people to die.

"It's not my job to kowtow to orthodoxy."

This is a trick that's increasingly used by harm reduction opponents:
Convince people that harm reduction is orthodoxy and that opponents
are intrepid folks who wish to blaze a brave new path.

Of course it's quite the opposite. While harm reduction has gained
adherents thanks to the evidence in its favour, the orthodox position
is, and always has been, that drug problems are best dealt with
through enforcement.

This is certainly true in Canada: Researchers from the B.C. Centre
for Excellence in HIV/AIDS found that for the years 2004-05 -- before
the Conservatives announced their anti-drug strategy -- the feds
spent 73 per cent of anti-drug money on enforcement, compared to 14
per cent for treatment, and three per cent each for prevention and
harm reduction. The remaining seven per cent was allocated for
coordination and research.

In October 2007, the Conservatives announced the $64-million National
Anti-Drug Strategy, and managed to convince some people, and some
news outlets, that it was all about treatment.

Yet when that money is added to the base, the new percentages are as
follows: Enforcement receives 70 per cent of the total, with 17 per
cent going to treatment, four per cent for prevention and two per
cent for harm reduction. The remaining seven per cent is again
allotted for coordination and research.

The Conservatives are therefore following tradition -- orthodoxy --
by relying on enforcement to solve the drug problem despite
overwhelmingly evidence that it has been a failure, and could,
therefore, rightly be called a form of harm addition. Clement is not
merely kowtowing to orthodoxy; he's a slave to it.

The numbers also show that for all their talk about treatment and
prevention, the Conservatives are little more interested in them than
any previous government was. Yet Clement somehow managed to tell the
world, with a straight face, that Canada has achieved the right
balance among prevention, treatment and enforcement.

"I believe I'm on the side of compassion and on the side of the angels."

Clement must be using a very odd definition of compassion here,
because his "compassionate" strategy involves removing from
vulnerable people a scientifically proven public health measure. And
instead of spending the considerable anti-drug funds on treatment, he
supports the orthodox position of wasting them on enforcement.

Many people assume Clement's opposition to Insite stems from a desire
to appeal to the Conservative base. So perhaps his compassion is
directed toward them. Yet since drug addiction costs everyone,
throwing taxpayers' money away on failed methods can hardly be
construed as being compassionate toward anyone.

Finally, given that Insite might well prevent the spread of disease
and save lives, the only angel who could support its elimination is
the angel of death.