SAFE-INJECTION SITE DESERVES TO CONTINUE

On East Hastings St., on Vancouver's drug-addled Lower Eastside, as
many as 800 addicts go to the same address every day to inject
themselves with heroin and other dangerous drugs.

Since 2003, Insite has been Canada's only "safe-injection facility,"
operating under special permission from the federal government. That
permission lapses Sept. 12, and Stephen Harper's government has been
mute about the centre's future.

During last winter's election campaign, Harper said, in British
Columbia, "a priority of our government will not be to use taxpayers'
money to fund drug use." And he has promised to consult the RCMP
before making a decision.

Many Canadians, no doubt, share the gut reaction that fuels Harper's
caution. Isn't it just wrong to help people be junkies?

That's not the right question. Here's a better one: Should society
try to prevent medical disaster for people who have, on average, been
addicts for 15 years?

The evidence, including but not limited to the testimonials of many
who have grappled with Vancouver's drug-related social problems, adds
up to a logical conclusion that should outweigh any qualms: Insite
should remain open. Unless someone has new evidence to consider, in
fact, the time has now come to decide which other Canadian cities
need their own safe-injection sites.

Vancouver's Lower Eastside has long been a miserable swamp of
addiction, where drugs are easily available and hope is in short
supply. With addiction comes misery in many forms: from unemployment
and poverty to petty crime, violent crime, squalor, suicide,
accidental death and, of course, HIV/AIDS, hepatitis C and other
deadly diseases spread through needle sharing.

A safe-injection site does, it appears, help with some of the medical
issues on that list. Using $1.5 million in federal money, the
respected B.C. Centre of Excellence for HIV/AIDS has conducted a
range of rigorous, peer-reviewed studies of many aspects of Insite,
and found good results across the board, with no significant negative
consequences.

Specifically, the studies found Insite was attracting - and, thus,
protecting - many of those at the highest risk of infection, was
reducing the incidence of on-the-street injection and of needles
being discarded in public, and was increasing the flow of referrals
to addiction-treatment services.

No increase in crime was detected in the area around the site. In an
18-month period studied, there were 336 "overdose events" at Insite
but no overdose deaths; on the street the toll would plainly have been higher.

Most significantly in terms of resistance to the whole idea,
researchers found no increase in drug use in the community as a
result of Insite's existence; in other words Insite is not leading
more people into shooting up. Researchers led by University of B.C.
Professor Thomas Kerr found the 1,000 Insite users interviewed had
been injecting for, on average, 15 years. "There was only one person
we talked to who said he performed his first injection at the site,"
said Kerr, and that man "said he had been smoking crack for several years."

Some of these studies involved only Insite users who volunteered to
be counted; comprehensive data might be somewhat different. But the
broad outlines are undeniable: this approach works. No doubt that's
why Vancouver Mayor Sam Sullivan and B.C. Premier Gordon Campbell
both want Ottawa to extend Insite's life. So do former Vancouver
mayors Mike Harcourt, Philip Owen and Larry Campbell. So does
Vancouver Police Chief Jamie Graham. So do Liberal leadership
candidates Scott Brison and Ken Dryden.

Critics express concern that safe-injection sites are just the
beginning. Sure enough, there is the grandly named North American
Opiate Medication Initiative (NAOMI), which actually gives out free,
pure, pharmaceutical-grade heroin to selected addicts.

Beyond dirty needles, after all, adulterated street-bought drugs are
another major medical risk for addicts. And now Mayor Sullivan is
pushing for another program, this one to extend free substitute drugs
to those hooked on amphetamines and cocaine. Vancouver begins to
sound like paradise for junkies.

All such programs demand careful consideration, prudent design and
rigorous monitoring. Free heroin might reduce crime rates, but
wouldn't it simply encourage more people to get hooked?

Not at all, say NAOMI defenders: The program is only for the most
seriously addicted, and comes with strings attached in the form of
medical contact, follow-up interviews, and the like.

NAOMI has not yet had the same kind of impact studies that Insite has
passed with flying colours. Until we know much more about free-heroin
programs, they are not really an issue. But Insite is an issue,
because it has worked and because its lease on life expires in two weeks.

Vancouver's Lower Eastside is by all accounts Canada's worst drug
scene, so it made sense to operate the prototype safe-injection site
there. We have not, to date, heard any sustained clamour for such a
service in other cities. Now that the results of the Insite
experiment are clear, however, the same sort of facility should be
made available wherever there is a need for it.

The evidence is unequivocal and the community leaders closest to the
problem on Vancouver's Lower Eastside are all but unanimous.
Observers elsewhere cannot reasonably disagree: Insite's
authorization should be renewed, with more funding for more research
if anyone thinks more is still needed.

If the Harper government thinks otherwise, it needs to explain why,
in detail, and to say what other measures it plans to help reduce the
damage addiction does, to individuals and to society.