DISCOMFITING WORDS CAST A PALL OVER THE GOOD NEWS ABOUT INSITE

Insite, Vancouver's supervised injection facility, will operate for
at least the next 16 months, and that's positive news for both
addicts and Insite's surrounding community, both of whom have been
helped immeasurably by the facility.

But federal Health Minister Tony Clement's decision to continue the
operations of the site to Dec. 31, 2007, while welcome, included
certain comments which suggest the Conservative government expects
Insite to do the impossible.

In a news release, Clement asked: "Do safe-injection sites contribute
to lowering drug use and fighting addiction?" Then he answered his
own question by saying: "Right now the only thing research to date
has proven conclusively is drug addicts need more help to get off drugs."

Consequently, the health minister concluded, "Given the need for more
facts, I am unable to approve the current request to extend the
Vancouver site for another 31/2 years."

Now several things are troubling about these statements. First, if
it's more facts Clement wants, then he should have provided the full
extension, since the only way to get the facts is to provide
sufficient time to conduct more research. The site's exemption from
Canada's drug laws was, after all, granted so that scientific
evaluators could determine the impact of the site, and scientific
research takes time.

Indeed, it will take far longer than 16 months to determine if the
site is effective in lowering drug use. In addition to the time it
takes to overcome addiction, a study would have to follow its newly
sober subjects over a number of years to determine if they have
remained sober or returned to using drugs.

Although one study published in the New England Journal of Medicine
suggests that Insite might be facilitating entry into detox and
treatment programs, no study can prove "conclusively" that an
injection site actually leads to reduced drug use, especially within
just 16 months.

So Clement has guaranteed that the site will fail to answer his
question. But more troubling still is that Insite's primary purpose
is not, and never has been, to get addicts off drugs. Rather, as a
form of harm reduction, it was intended to reduce public disorder,
overdoses, emergency room visits and needle sharing. The plethora of
studies conducted thus far have confirmed that it has done so.

But that's really all it can do. If we really want to fight
addiction, we need a multifaceted strategy, one that encompasses the
four pillars of prevention, enforcement, harm reduction and
treatment. So far, we've been focused on only two: enforcement and
harm reduction.

So Clement's other comment -- that the Conservatives hope to
introduce a National Drug Strategy at the end of 2007 -- is also
welcome news. But that strategy, too, is bound to falter and fail if
it embodies a single-minded approach, one that refuses to sanction
any measure unless there is incontrovertible evidence that it results
in lowered drug use. In fact, it's unlikely that any single measure
could pass such a stringent test.

Clearly, we need better prevention and treatment programs, but they
must complement our highly successful harm reduction and enforcement
efforts, rather than replace them.