CMA'S SUPPORT FOR INJECTION SITES SLAMMED

VANCOUVER - Federal Health Minister Tony Clement used his podium at
the Canadian Medical Association conference Monday to once again slam
Vancouver's supervised injection site, saying the association's
recent endorsements of Insite are "dangerously misleading."

"Clearly, we are on a slippery slope here. Already there are people
saying injection sites are not enough, that government should give
out heroin for free. Others are now calling for 'inhalation rooms'
for people who smoke their drugs," Clement said in his speech, a copy
of which was provided to Canwest News Service.

"I feel our government is now drawing the line in a place with which
Canadians are comfortable, and I continue to review new information
as it comes forward."

Clement devoted the bulk of his address on the opening day of the CMA
conference, which is being held in Montreal, to the supervised
injection site in Vancouver's Downtown Eastside.

"Insite may slow the death spiral of a deadly drug habit, but it does
not reverse it. I do not regard this as a positive health outcome,"
Clement said.

He added that he questioned whether it is ethical for health workers
to support the distribution of drugs that are of "unknown substance,
or purity, or potency, drugs that cannot otherwise be legally prescribed.

"If this were done in a doctor's office the provincial college would
rightly be investigating."

But proponents of the program argue the majority of studies done on
Insite - including those conducted by the government's own health
committee - have shown that the program saves money and encourages
addicts to seek treatment.

Dr. Thomas Kerr, of the B.C. Centre for Excellence in HIV/AIDS at St.
Paul's Hospital, said Clement is "highly selective" in his facts,
saying his information is based on articles that haven't been
subjected to a peer review. "It's just a real pathetic manipulation
of data," he said.

In material published in the New England Journal of Medicine, Kerr
said, "You find evidence pointing clearly to Insite as doing what it
is supposed to do.

"Of course it's working.

"Who do you want to believe? Do you want to believe published
articles in the New England Journal or Lancet, do you want to believe
the World Health Organization or do you want to believe Tony Clement?
It's embarrassing."

In his speech, Clement took issue with a letter he received in May
from CMA president Dr. Brian Day and an opinion piece Day wrote in June.

"The letter and article from the CMA supported the supervised
injection site, saying, 'There is growing evidence that harm
reduction efforts can have a positive effect on the poor health
outcomes associated with drug use,'" Clement said, adding that the
injection site has crossed a line and is no longer advocating simply
"harm reduction."

Clement said an expert panel commissioned by the federal Health
Department last year found that Insite has had no impact on reducing
the transmission of blood-borne illnesses such as HIV/AIDS. Nor has
it significantly cut the 50 overdose deaths annually in Vancouver's
Downtown Eastside.

"Over the last five years, while Insite has been operating, we could
have provided treatment to 5,000 addicts. Instead, during that time,
250 addicts have died of drug overdose alone," Clement said.

He said the vast majority of injections still take place in back
alleys and seedy hotels, and the centre's $3-million annual cost
would be better spent elsewhere.

Kerr concedes there are users still shooting up in alleys because
Vancouver has such a large crack problem and there isn't space for
everyone to get help at Insite. There are 5,000 to 8,000 drug users
in the Downtown Eastside, he said, and Insite can't serve them all.

However, he said, the scientific community and leading public health
authorities agree injection sites are one of the components in the
larger fight against HIV and AIDS. He added it won't be known for
several years what impact the site has had on HIV/AIDS transmission.

"This is a small pilot facility and it's running at capacity," Kerr
said, noting the facility isn't open 24 hours. "The biggest deterrent
facing us is the waiting time [to get a space at Insite]."

Clement argued every dollar spent on the supervised injection site
potentially diverts a dollar away from treatment leading to full recovery.

On Monday, the minister announced that $130 million will be spent
over the next 10 years to fund the Canadian Mental Health Commission.

Mark Townsend, director of a Vancouver non-profit group that helps
people with mental illness and addictions, said Clement's comments
are "bizarre."

"It seems strange to go to a place like that and rile up a team of
doctors," he said. "The general public knows there is no simple
answer. It's like losing weight.

"All these things are saying they have made a contribution. They
don't say it's the be-all-and-end-all and it isn't."