FACE-OFF: INJECTION SITES FOR SORE EYES?

Thus far, Vancouver is the only Canadian city that has implemented a
federal program to open safe injection sites in its notoriously
heroin-infested east end. The program has been successful in getting
addicts off the streets, due in part to a government-approved amnesty
from drug-related prosecution for users and care-givers alike, though
whether the sites have led to reduced drug use is open to debate.

Toronto has mulled over the idea of safe injection sites at various
times over the last five years, but with the city's drug problem
nowhere near as bad as Vancouver's, and with the lack of a central
neighbourhood known for overt heroin use, the program has never been
implemented here. David Miller has never formally endorsed the
approach, though he does favour "harm reduction" as one of the four
pillars of the strategy to combat drugs. Though she has not commented
publicly on the issue, it is unlikely that Jane Pitfield would
support a service that caters to the homeless on the streets.

Empirical evidence from the West Coast is making it increasingly
difficult for those opposed to safe-injection sites to maintain their
scientific footing. A study conducted by UBC last year indicates that
Vancouver's program has caused a significant reduction in
syringe-sharing, which is the main source of HIV and Hepatitis C
infection among intravenous drug users.

Safe injection sites foster contact between addicts and health care
workers who can provide addiction counseling and treatment referrals.
Added to this is the mitigating effect use of the sites has on the
marginalization of users, a factor that has been identified in
studies as significantly contributing to the cycle of addiction.

Without robust scientific support for their position, those opposed
to safe injection sites cling desperately to outdated, erroneous
assumptions about substance abuse. They continue to tout
criminalization and abstinence-based treatment as the most effective
tools for fighting the "war on drugs," despite overwhelming evidence
to the contrary. Indeed, the creation of a black market drug trade
responsible for many of the social ills associated with addiction,
such as violent crime, poverty, and the transmission of HIV can be
attributed to these misguided policies.

These assumptions merely cloak a racist, class-based view of
intravenous drug use. It is no secret that the majority of addicts
hail from disadvantaged segments of the population, and that a
disproportionate number of users are Aboriginal.

A drug policy that emphasizes criminalization and outdated treatments
does little to address the pathology of addiction, and instead works
to reinforce the status quo. Conversely, approaches aimed at reducing
the harm associated with drug use may help to alleviate pre-existing
social disadvantages by giiving addicts a much-needed sense of dignity.

- - Anji Samarasekera

By refusing to provide Canadian drug addicts with government
resources, we are in effect turning our back on some of society's
most vulnerable people. It's about time we stop treating substance
abusers as though they were second-class citizens. There are alarming
rates of death and contraction of HIV/AIDS amongst drug users across
Canada, and regardless of their lifestyle they too are entitled to
health care and compassion.

Safe injection sites would not promote drug use. Rather, they would
help reduce the rate of infection and provide resources for Toronto's
addicted. At the proposed clinics, there would be safe needle
exchange programs in which medical professionals could monitor the
injection of intravenous drugs and be on hand in case any
complications occurred.

Vancouver health officials have reported that since their initiation
in 2003, the safe injection sites boast a zero overdose rate.

In a July 2006 letter, the Canadian HIV/AIDS Legal Network claimed
that shutting down already existing Canadian sites would be "a huge
step backwards in Canada's response to HIV/AIDS." Moreover, a recent
report in the New England Journal of Medicine stated that drug users
who frequent such clinics are more likely to get into detox.

Injection sites will be able to provide life-saving services and
support for Toronto's most at-risk population-homeless drug users.
Without safe injection sites, the homeless use dirty, infected
needles and resort to shooting up in back alleyways, abandoned
parking lots, and, what's worse, schoolyards. Why unnecessarily
expose our children to the problems of drug use when the solution is
so simple and effective?

- - Aisha Ansari

On the surface, safe injection sites seem loaded with benefits. They
provide intravenous drug users with a place to inject their drugs
under supervision by clinical staff. They decrease HIV rates and
clean up the streets. They reduce the drug problem and lead to
happier, healthier communities.

Unfortunately, the reality is not so rosy. While proponents of safe
injection sites often cite encouraging data from Vancouver's Insite,
North America's only legal safe injection site, not all the results
have been positive. Several studies have shown that most users do not
visit the site each time they require their drug fix. They may go
when it is convenient for them, but they would be just as likely to
inject their drugs (likely with dirty needles) on the street if they
are not near the facility. Having addicts casually frequent the safe
injection site while continuing to inject drugs elsewhere is clearly
counterproductive and translates into a waste of government resources.

It also must be noted that Vancouver is sometimes notoriously
referred to as the "heroin capital of North America" because of its
extremely high rates of heroin addiction. Translating results from
Insite to the city of Toronto, where the drug problem is not as
great, should only be done with great discretion.

Perhaps the most compelling argument against safe injection sites is
that they do not address the key issues behind drug addiction. For as
long as users remain addicted, they cannot contribute to society in a
meaningful way. As such, the harm reduction concept is merely an
inconsistent 'band-aid solution' to a much bigger problem.

On the contrary, many addicts receiving treatments such as methadone
(a long-acting synthetic heroin substitute) have been able to return
to "normal" life. They have been able to gain employment, reconnect
with family, and, most importantly, free themselves from the
destructive cycle of drug addiction.

- - Mayce Al-Sukhni