A SMOKESCREEN

I write to clarify my support for supervised injection sites and the city
of Vancouver's four pillars approach to substance abuse. The April 26
headline "Injection sites touted as 'best chance'" suggested that I
championed supervised injection sites as "Vancouver's best chance" for
addressing the significant health and social problems associated with
injection drug use in the Downtown Eastside.

But I would like to clarify my position. I support the four pillars
approach -- prevention, enforcement, treatment and harm reduction in a
balanced and coordinated strategy -- as being the "best chance" of
responding to these complex problems. During the "scrum" following my
presentation to city council, this response was reported and associated
specifically with the issue of supervised sites.

I strongly support and advocate for a scientific trial of supervised
injection sites in the Vancouver context. The information from Europe and
Australia suggests that as part of a coordinated and balanced approach such
sites can play a critical role in reducing deaths and infections, improving
public order and attracting persons who use drugs into care and treatment.

Would they be effective in Vancouver? We cannot know this without evaluated
pilots, but to my mind the evidence is robust enough that we should not
turn our backs on a promising intervention. Until such trials have
occurred, however, it would be premature to characterize such sites as
either "best chances" or "wrong-headed" approaches.

Perry Kendall, MD

Provincial Health Officer

Victoria