WELL, WELL, WELL: NO INSITE? NO INSIGHT

On my mind this week, in the wake of Stephen Harper's re-election,
are the realities facing some of those most marginalized among
us--the drug addicted, to be specific.

We now have a model of an effective approach to reducing harm among
addicts--Vancouver's safe injection program, InSite. But the Harper
government has repeatedly tried to shut it down, and Minister of
Health Tony Clement has called it an abomination. They believe harm
reduction strategies to be a misallocation of tax dollars.

InSite opened in 2003 in the heart of Vancouver's Downtown Eastside
as a pilot project aiming to reduce harm among those who have tried
unsuccessfully in the past to beat their drug addiction, those
injecting publicly in the streets of the city and the homeless.

Operating under a constitutional exception to the Controlled Drugs
and Substances Act, it's a place where addicts can connect to primary
healthcare services and addiction treatment. Since its inception,
over one million injections have taken place at InSite under the
supervision of a nurse.

Results have been carefully monitored, and it has yielded some 30
peer-reviewed scientific papers published in major medical journals
that have concluded it to be a success--it saves lives.

InSite has also made the community safer--a 70 per cent drop in
needle sharing has resulted in reduced HIV and hepatitis
transmission. Safe needle disposal has made the streets safer for
local residents and business owners. All those who overdosed at
InSite last year received immediate medical attention, and none died.
It has resulted in more people seeking addiction treatment. None of
the fears voiced by opponents have materialized.

Harper's own advisory committee has examined the evidence and
concluded that the site makes financial sense, saves lives, acts as a
deterrent to drug use, has not increased crime, drug dealing or
relapse rates and effectively increases the number of addicts seeking
detox and treatment. Criminologists commissioned by the RCMP say it
should be left open.

Still, Harper wants to shut it down. He has turned a deaf ear to the
World Health Organization, which calls supervised injection sites
priority interventions for slowing the spread of HIV. He has
dismissed the views of Vancouver's mayor and police department, who
say InSite helps them limit public disorder. He has ignored the views
of BC's premier and minister of health. He has seemingly not heard
the voices of the three out of four Vancouverites surveyed in a
recent Angus Reid poll who support InSite. And he hasn't heard the
voices of the healthcare workers in the trenches. He has apparently
ignored everyone who has looked at the science and endorsed harm
reduction strategies as essential components to dealing with problems
of drug addiction.

Judge Ian Pitfield of the BC Supreme Court gets it. He knows
addiction to be a complex, chronic and relapsing condition.
Recognizing InSite for what it is--a healthcare facility--he has
ruled to protect the program. Harper has appealed his decision.

The international science journal Nature has called the Harper
government's approach to drug addiction a "manifest disregard for
science," and I'm inclined to agree. The argument that addicts don't
go to InSite to stop using drugs is as narrow a way of looking at the
problem as any I can imagine. While harm reduction is only one
component of a broader addictions treatment strategy and won't solve
the tragedy of addiction, it is at least humane, and a major step in
the right direction.

We also need a serious look at root causes, root causes that include
the profound effects of forced dislocation and insufficient
psychosocial integration. The effects of ostracism, excommunication
and exile are well-known and have long been used as punishment. These
conditions, when prolonged and severe, regularly lead to suicide--and
to addictions. We need a serious look at the roles of brain circuitry
and neurotransmission, the roles of hungry spirits and nutrient-hungry brains.

Concerned scientists, academics, doctors, nurses and other medical
professionals can sign on to a letter urging Stephen Harper to
support the InSite facility at lettertostephenharper.com.