EVIDENCE DEMONSTRATES CONSERVATIVES SHOULD KEEP SUPPORTING
INSITE

In the next few months, the federal government will decide whether to
continue supporting Insite, Vancouver's supervised injection facility.

For the sake of everyone in the Lower Mainland, the Conservatives
should throw their support behind, not just continuing, but expanding
the program.

Prime Minister Stephen Harper and other Conservatives have expressed
reservations about Insite, but the feds maintain that they will look
at the evidence before making any decision. If they do, they will find
that it resoundingly supports continuation of the facility.

About a dozen studies have thus far been conducted, and all suggest
the site has had a positive impact on the region.

An early study published in the Canadian Medical Association Journal
found that the opening of the site led to a significant decrease in
public disorder, including the the number of syringes and
injection-related litter discarded in public.

A subsequent study in the medical journal The Lancet found that
regular users of the site are less likely to share needles than those
who don't go to it. (This is so even when regular site users inject
drugs elsewhere, as occasionally happens.) Since needle-sharing is one
of the main avenues for blood-borne disease transmission, there's
reason to believe the site is helping keep down the rates of HIV and
hepatitis C infections.

A further study in the American Journal of Infectious Diseases
replicated The Lancet study's results, and found there was zero
needle-sharing among the site's users.

Perhaps one of the most important studies to date was published in the
American Journal for Preventative Medicine. The study found that the
site was primarily attracting high-risk drug users, including those
under 30 years of age, the homeless, public drug users (as opposed to
those who use at home), daily users of either heroin or cocaine, and
those who had recently overdosed.

All of these factors increase the risk of blood-borne disease
transmission and further overdoses, and also increase the likelihood
of contributing to the problem of public drug use and unsafe disposal
of syringes. So it's a positive sign that high-risk users are availing
themselves of the site in disproportionate numbers.

Moreover, many high-risk users suffer from skin problems associated
with injection drug use. Two separate studies, in the Canadian Medical
Association Journal and the Journal of Public Health, found that
soft-tissue infections (skin abscesses and the like) are by far the
most common reasons drug users wind up in hospital emergency rooms.

Since Insite staff educate addicts concerning safer injection -- a
study in The International Journal of Drug Policy found that Insite
users were twice as likely to have received safer-injection education
than those who inject on the street -- it's reasonable to believe that
the site is also keeping down emergency room visits among addicts.

Instructing people about how to use drugs might sound to the site's
detractors like staff are facilitating drug use. But a study published
in the British Medical Journal found that Insite is not increasing
rates of relapse among former users, nor is it a negative influence on
those seeking to stop drug use.

Further, a paper awaiting publication in the journal Substance Abuse
Treatment, Prevention and Policy looked at police data and found that
there has been no increase in drug-related crime, including property
crime, since the site opened.

Finally, according to a study discussed at the recent International
Harm Reduction Conference in Vancouver, there were 344 overdoses
during Insite's first 18 months of operation, but none resulted in a
fatality because those who overdosed received prompt medical attention.

All of this evidence led Julio Montaner, director the B.C. Centre for
Excellence in HIV/AIDS, which is charged with evaluating the site, to
conclude that Insite is the single most successful project he has studied.

The centre therefore recommends that the site remain open, and be
subject to further external evaluation and monitoring. In addition,
the centre advises that the hours of, and number of, sites be expanded
and integrated into a more comprehensive program involving detox and
treatment services, health care and social housing.

These are eminently reasonable recommendations and ought to resonate
not just with those who value harm reduction, but also with those who
favour more emphasis on treatment.

If the federal government is serious about tackling the drug problem,
it will give its stamp of approval to the continuation and expansion
of these life-saving measures.