Safe Injection Sites

RENEW INSITE'S LICENCE

Speaking to the Canadian Medical Association last week, federal
Health Minister Tony Clement was non-committal on the future of
Vancouver's safe injection site. But he seemed to be leaning against
extending Insite's licence when it expires at year's end, telling
doctors that recent research has cast doubt on the pilot project's usefulness.

Where is Mr. Clement getting his information? He hasn't said. Most
likely it is from a well-publicized article published this past
spring in the Journal of Global Drug Policy and Practice. The report
was authored by Colin Mangham, the director of research for the Drug
Prevention Network of Canada, a hard-line organization. Last year,
former Reform MP Randy White, the then-head of the network, lauded
what he saw as the Conservative government's tough approach on drugs.
"A new National Drug Strategy, mandatory minimum prison sentences and
large fines for marijuana grow operations, a nationwide awareness
campaign, withdrawal of support for injection sites, a crackdown on
drug crime and no marijuana decriminalization legislation is a breath
of fresh air for Canadians, as well as a reflection of real
leadership we have not seen in decades in Canada," he enthused.

Unsurprisingly, much of the report put out by Mr. White's research
director reads more like a rant against the "ideology" of
harm-reduction and its alleged infiltration into society than a
scientific study. It contains no first-hand research; the bulk of its
findings consist of simplistic efforts to poke holes in the litany of
more serious studies demonstrating Insite's benefits.

Indeed, virtually all serious research suggests that the program has
had considerable benefits with little downside. Reports in reputable
medical journals such as The Lancet and the BMJ (British Medical
Journal) have shown that Insite reduces needle-sharing in the
community, reducing the spread of disease. While 500 users overdosed
at Insite over a two-year period, onsite medical assistance prevented
a single one from dying - something that would never have been the
case on the street.

Far from encouraging drug use, as its opponents claim, Insite has
encouraged addicts to kick their habits. Over a one-year period of
study, it made 2,000 referrals, 40 per cent of them to addiction
counselling. One in five regular visitors to the site enlisted in
detoxification programs - resulting, said a recent report in the
British medical journal Addictions, in a 30-per-cent rise in the
number of local addicts making use of such services. Similar findings
were reported last year in the New England Journal of Medicine.

Last week, a group of 134 prominent Canadian doctors and health
professionals endorsed a commentary by Dr. Stephen Hwang in the
journal Open Medicine calling for Insite to be continued on the basis
that it "provide[s] a number of benefits, including reduced needle
sharing, decreased public drug use, fewer publicly discarded
syringes, and more rapid entry into detoxification services by
persons using the facility." And while the RCMP has been critical of
Insite, Vancouver's police department - which is on the ground and
thus aware that harm reduction makes the streets safer - has endorsed it.

Unfortunately, it appears that no amount of evidence will convince
the Conservatives, skeptical since the project was launched in 2003,
of Insite's value. Desperate, local activists and drug users are
going to court to argue that closing Insite would violate addicts'
Charter rights. That seems a dubious proposition; ultimately the
government will likely be free to decide whether or not to keep the
program. But if Mr. Clement resists any urge to cherry-pick his
information and looks at the overwhelming body of evidence, it should
not be a difficult decision.