News (Media Awareness Project) - CN BC: LTE: Too Early To Draw Conclusions About Injection Site |
Title: | CN BC: LTE: Too Early To Draw Conclusions About Injection Site |
Published On: | 2004-12-08 |
Source: | Vancouver Courier (CN BC) |
Fetched On: | 2008-01-17 07:33:57 |
TOO EARLY TO DRAW CONCLUSIONS ABOUT INJECTION SITE
To the editor:
Is the Vancouver supervised injecting site (SIS) having a positive impact?
("Cop union boss questions injection site impact," Nov. 24).
Let's consider the available evidence. In September, the Canadian Medical
Association Journal published a study showing that the SIS had reduced
public drug use and publicly discarded syringes. However, according to a
recent Courier report there have been three more overdose deaths between
January and September of this year than there were during the same period
last year. So has the SIS failed to reduce overdoses? The answer is simply,
"It is too soon to tell."
The study of health outcomes is a complex business and requires careful
consideration of the many factors that can influence health, and an overly
simple comparison of two years' of overdose statistics is fraught with
potential pitfalls. For example, years of scientific study have
demonstrated that overdose rates are predicted by a multitude of factors,
including the changing purity of street drugs. In light of this, consider a
situation where a SIS was reducing fatal overdoses during a time when
heroin purity was increasing, as is presently occurring in many places in
North America. Under these circumstances, we might see an increase in
overdoses despite the underlying benefit of SIS.
Alternatively, in a situation where an SIS was ineffective at reducing
overdoses, a reduction in street purity of drugs could give the mistaken
impression that the SIS was helpful. Changes in drug use patterns can also
affect overdose rates, which leads us to wonder if Courier writer Mike
Howell investigated whether recent overdose deaths are in fact occurring
among injection drug users (i.e. people who can use SIS)?
Quick and simple analysis such as those recently offered in the Courier are
problematic for many reasons, but more importantly have the potential to
undermine public support for an intervention before it has been rigorously
evaluated. Given that we are dealing with a problem that has taken the
lives of literally thousands of British Columbians, such superficial
analysis are highly inappropriate and potentially dangerous.
Thomas Kerr, Mark Tyndall and Julio Montaner, British Columbia Centre for
Excellence in HIV/AIDS
To the editor:
Is the Vancouver supervised injecting site (SIS) having a positive impact?
("Cop union boss questions injection site impact," Nov. 24).
Let's consider the available evidence. In September, the Canadian Medical
Association Journal published a study showing that the SIS had reduced
public drug use and publicly discarded syringes. However, according to a
recent Courier report there have been three more overdose deaths between
January and September of this year than there were during the same period
last year. So has the SIS failed to reduce overdoses? The answer is simply,
"It is too soon to tell."
The study of health outcomes is a complex business and requires careful
consideration of the many factors that can influence health, and an overly
simple comparison of two years' of overdose statistics is fraught with
potential pitfalls. For example, years of scientific study have
demonstrated that overdose rates are predicted by a multitude of factors,
including the changing purity of street drugs. In light of this, consider a
situation where a SIS was reducing fatal overdoses during a time when
heroin purity was increasing, as is presently occurring in many places in
North America. Under these circumstances, we might see an increase in
overdoses despite the underlying benefit of SIS.
Alternatively, in a situation where an SIS was ineffective at reducing
overdoses, a reduction in street purity of drugs could give the mistaken
impression that the SIS was helpful. Changes in drug use patterns can also
affect overdose rates, which leads us to wonder if Courier writer Mike
Howell investigated whether recent overdose deaths are in fact occurring
among injection drug users (i.e. people who can use SIS)?
Quick and simple analysis such as those recently offered in the Courier are
problematic for many reasons, but more importantly have the potential to
undermine public support for an intervention before it has been rigorously
evaluated. Given that we are dealing with a problem that has taken the
lives of literally thousands of British Columbians, such superficial
analysis are highly inappropriate and potentially dangerous.
Thomas Kerr, Mark Tyndall and Julio Montaner, British Columbia Centre for
Excellence in HIV/AIDS
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