THE DEAD CAN'T KICK DRUGS

Safe Injection Sites Aren't The Entire Solution to Addiction, but
They Do a Great Deal of Good

I remember my first experiences in the Downtown Eastside as shocking,
and I too was naive about the problems there when I left the hospital
as a nurse to work in the community.

It's now been almost 17 years working in that very neighbourhood.

Addiction is clearly dreadful and tragic, but those who offer
simplistic solutions offer false hope.

Meanwhile, people with addictions suffer and die.

Those suffering with addiction across Canada, including those helped
by InSite, Vancouver's supervised injection site, are someone's
sister, or brother, or son, or daughter.

I have called the parents of addicts who had overdosed to tell them
their child was dead. I met one mother who had flown across the
country to visit her dying son at the airport. She arrived too late
and fell to the floor screaming in grief when she heard the news.

I was a young, inexperienced nurse. What comfort could I really offer
in this tragedy? She wanted her addict son alive, addicted or not.
There are things we can do. Harm reduction is one. It can keep people
alive, so one day they can enter treatment.

Harm-reduction strategies buy time because not everyone is ready to
enter treatment. Clean needles and condom distribution prevent the
spread of disease. These are basic health interventions that are
accepted across the world, from the United Nations to the medical
health officers of every single jurisdiction of this country.

InSite is neither the problem nor the solution. It is one measure
designed to prevent drug overdose deaths, which it has done; reduce
public disorder, which it has done; reduce the spread of HIV, which
it has done; provide a doorway into the health system and into
treatment, which it has also done.

Twenty-five academic papers have now been published in the world's
most renowned medical journals including The Lancet, the New England
Journal of Medicine, the British Medical Journal, and the Canadian
Medical Association Journal. To date, not one single independently
peer-reviewed article has disputed the scientific evidence, which
Health Canada paid close to $2 million to compile.

The most recent piece of research indicates there has been a 30 per
cent increase in the number of people entering detox and methadone
therapy as a result of using the injection site -- which strengthens
further the argument that harm reduction is a necessary part of the
health-care continuum. Making this link from the chaos of the streets
to the path of recovery even stronger, OnSite opened above InSite
this September, offering 30 beds to addicts wanting to detox and
escape the cycle of addiction.

The public is aware that addiction is a complex issue that requires a
comprehensive strategy -- one that incorporates improved enforcement,
comprehensive prevention programs and flexible and accessible detox
and treatment interventions. But it also needs to include harm
reduction -- so people don't die unnecessarily, and parents don't
continue to lose their children.

Other jurisdictions now also involve harm-reduction strategies as
part of their overall plans to tackle addiction. Sweden has now
established needle-exchange programs in order to stop the spread of
disease and to comply with UN expectations, while conforming to
international efforts to limit the global AIDS pandemic. Britain,
where a heroin prescription maintenance program has been in place for
many years, has now expanded its addiction-treatment program to
include stimulant maintenance for cocaine addicts.

In no place where harm-reduction approaches have been used have
advocates argued they be implemented exclusive of prevention,
treatment and enforcement. In every jurisdiction where harm reduction
is practised, it is done so in collaboration with local police,
businesses and residents to ensure the individual users and the
broader community equally benefit.

Since InSite opened in 2003, there has been a dramatic decrease in
the number of public injections and injection-related litter. As a
resident of the neighbourhood, I have witnessed a stark contrast in
the livability of the Downtown Eastside since InSite opened its
doors. Over the past four years of operation, InSite nurses have now
supervised more than one million injections, each of which would have
otherwise occurred outside, in the public view, and with a much
higher risk of drug overdose death or spreading HIV and hepatitis C.

While I welcome the significant improvement to my neighbourhood for
both myself and my children, the primary reason I continue to support
InSite is its ongoing life-saving work. More than 900 overdose
interventions have happened at InSite -- each someone's child who
would not be with us today if InSite nurses had not been there to
take immediate action.

I hope politicians like Prime Minister Stephen Harper and federal
Health Minister Tony Clement think about the children when they
consider public health policy relating to drug addiction. I hope
desperately that resources are finally put into prevention efforts to
stop kids from using drugs in the first place. But I also hope to
never again explain to a crying mother why her child died from a drug
overdose that could have been prevented in a civilized country like Canada.