JUDGE INSITE ON SCIENCE, NOT POLICE ANECDOTES

Needless to say, we wouldn't expect, nor would we permit, scientists
to patrol our streets, as police officers do. But unfortunately, we
do need to say that we shouldn't expect police officers to conduct
evaluations of scientific experiments, as scientists do.

The need to say this arises from an RCMP report on Insite,
Vancouver's supervised injection facility. The harshly critical
report, written by RCMP Staff-Sgt. C.D. Doucette, suggests that harm
reduction efforts such as Insite actually increase drug use.

The report states that "there is considerable evidence to show that
when the perceived risks associated to drug use decreases, there is a
corresponding increase in the number of people using drugs," and that
harm reduction efforts "by themselves lead to a never-ending cycle of
drug use."

Yet nowhere does the report provide evidence that drug use has
increased as a result of Insite, nor does it address the scientific
evidence that suggests just the opposite.

Researchers at the B.C. Centre for Excellence in HIV/AIDS, which is
charged with providing scientific evaluations of the site, have
published a number of studies in top-flight medical journals
attesting to the fact that binge drug use decreased after the opening
of Insite, and that the site is not a negative influence on those
wishing to stop using drugs.

Further, a study published in the New England Journal of Medicine
found that "an average of at least weekly use of the supervised
injection facility and any contact with the facility's addictions
counsellor were both independently associated with more rapid entry
into a detoxification program."

While the RCMP report makes no explicit mention of this or any other
scientific study, it does say that "there is no evidence to indicate
that those 'referred' to treatment actually made it to a treatment
facility." Of course, there's no evidence that they failed to make it
either, and that's precisely why we need more research on Insite,
which the RCMP appears to oppose.

The report goes on to take issue with the interim evaluation, which
found a decrease in public drug use and public complaints. But rather
than providing scientific evidence to the contrary, the report merely
notes that such findings are "not supported by independent
observations of police officers in the area."

So the report uses anecdotal evidence to counter the peer-reviewed,
scientific studies published in world-renowned medical journals. This
is precisely why we need to leave science to scientists, rather than
to the police.

The report also states that "there is no evidence to show any
decrease in drug-related criminal activity." Yet it once again fails
to provide any scientific evidence data to substantiate this
contention, and ignores a study published in Substance Abuse
Treatment, Prevention and Policy, which concluded that the rates of
vehicle break-ins declined substantially.

Finally, the report notes a lack of evidence indicating a reduction
in rates of HIV and hepatitis C -- which in turn indicates the need
for more research -- and, relying on data from the B.C. Coroner's
Office, notes that overdose deaths in Vancouver increased between
2003 and 2004, while decreasing across the province.

Yet it's not appropriate to compare 2004 rates with those from 2003,
since Insite was in operation for the last four months of 2003, and
in any case, it's not clear if the overdoses were from injection drug use.

The report therefore gives us some insight into the RCMP's position
on this matter, but not much else. Indeed, RCMP Supt. Paul Nadeau,
while admitting that he hadn't read Doucette's report, said he agrees
in general with his position.

It's clear then, that the RCMP appears to have a pre-ordained
conclusion in mind, and is merely looking for evidence to support it.

That said, there are elements of the report that are valid. The
report notes that addicts are still required to purchase illicit
drugs on the street and that this keeps traffickers in business. This
is true, and the only way to stop it is to provide users with clean
drugs in a medical setting, as is being done in the North American
Opiate Medication Initiative (NAOMI) trials.

Finally, the report calls for "comprehensive prevention and effective
treatment" programs. These are undoubtedly necessary if we're ever to
get a handle on the scourge of drug addiction.

But we need such programs to complement proven harm reduction efforts
such as Insite, rather than replace them. Most of all, we need
scientists to tell us what works and what doesn't, and a government
that's willing to listen to them if it wants to provide a proven,
evidence-based approach to dealing with addiction.