SAFE-INJECTION SITE HAS EARNED SUPPORT

Concerns Legitimate, But Government's Waffling Ignores The Benefits
For Community And Addicted

The Harper government's waffling on the future of North America's
first, and only, safeinjection site is discouraging.

The facility is in Vancouver's Downtown Eastside. All three levels of
government agreed to suspend the country's drug laws for 36 months to
allow the experimental project a trial period.

That term was to expire on Sept. 12.

The Conservative government put off making a decision until less than
two weeks remained -- and then stalled some more. Health Minister
Tony Clements said last week that he remains undecided. The site was
granted only temporary extension until the end of next year instead
of the longer-term commitment that it clearly deserved.

When the facility was set up, the understanding was that an extension
might be granted if the project proved effective. Vancouver Mayor Sam
Sullivan and Premier Gordon Campbell have both urged Ottawa to keep
the facility alive.

The federal government's inability to reach a decision is evidence,
some believe, of a divide in the Harper cabinet.

That would hardly be surprising. The project itself, known locally as
Insite, is a compromise between two seemingly incompatible positions.

Supporters of the facility are concerned principally about health
issues. They point out that a third of existing addicts are infected
with HIV/AIDS and nearly all have hepatitis C. They fear that a
strict law-enforcement approach, with the best of intentions, has
only heightened this health crisis by increasing high-risk behaviours
like sharing needles.

Opponents worry more about the signal that decriminalization of drug
use sends. They argue that the purchase of illicit drugs must remain
a crime to prevent the spread of addiction. The site, they say, sends
the message that illegal drug use is tolerated by our society.

Insite is supposed to offer a middle ground between these competing viewpoints.

Addicts cannot buy drugs at the facility, but they can bring whatever
they purchase elsewhere, no questions asked.

Clean needles are available and staff are on hand to assist in case
of an overdose.

So far, the evidence is positive.

Although 500 addicts use the site daily, drug sales have not
increased in the area and there are fewer discarded needles and less
drug paraphernalia in nearby streets. And although overdoses occur at
the facility, the presence of trained staff has reduced the death rate.

Measured against its own objectives then, it appears Insite is a
success. For those already addicted, the facility is clearly
preferable to the alternative -- shooting up in a back alley.

Yet there is another aspect to consider.

Safe-injection sites do more than offer refuge. Unavoidably, they
take society some way along the road to complicity in what remains a
hugely destructive activity.

The International Narcotics Control Board, which oversees United
Nations drug efforts, calls safe-injection sites "a source of grave
concern," and points out, "These may sometimes be positive for an
individual or for a local community while having far-reaching
negative consequences at the national and international levels." The
concern rests on some troubling evidence about the spread of illicit
drugs. The Canadian Addiction Survey, funded by Health Canada, shows
that between 1989 and 2002, the number of people who reported using
cocaine tripled, from 3.5 per cent to 10.6 per cent.

Speed usage also tripled, while LSD usage more than doubled. While
these numbers include people who might have been merely
experimenting, the trend is alarming.

Meanwhile cannabis usage has become endemic: Almost half the
population reports having smoked pot.

And B.C., perhaps not surprisingly, leads the country. Our rates of
drug consumption are almost 30 per cent higher than the national
average and more than twice the level of some provinces.

Incidence rates this high have serious social costs. In the past
decade the number of deaths due to illegal drugs has more than
doubled. The potential years of life lost to drug use -- an important
measure -- now tops 60,000.

The cost of substance abuse, including tobacco and alcohol, is close
to $40 billion annually.

It is this broader context that might be giving Ottawa pause. Can a
way be found to extend a project that appears effective at the local
level, without undermining the broader effort to combat illicit drugs
and reduce their use? Most of the research on safeinjection sites has
focused on the benefit to users and on local impacts. There has been
little effort to determine broader social outcomes, including the
effect on drug-interdiction strategies.

That needs to be part of the continued research into Insite and
similar harm-reduction efforts. We cannot be asked to make a deal
with the Devil, where the price of reduced harm now might be
increased harm later.

Government support for safe-injection sites -- including a site for
Victoria -- should be maintained. They offer an important way to save
lives and provide a gateway to treatment for addicts who are ready
for that step. But there must also be a continuing full-scale
investigation of the effect, at all levels, of this strategy.

There is probably no area of public policy with less to show for
time, effort and money than the war on drugs.

The approach we have taken for the past three decades has not worked.
We are entitled to demand some new approaches.