Thursday, August 14, 2008

Tony Clement is Right

As the largest contributor to the World Health Organization, Canada's opinion matters. Last week Tony Clement, Canada's Health Minister, made the government's position clear with respect to government sponsored injection sites for illegal drugs. Minister Clement said, "Allowing and/or encouraging people to inject heroin into their veins is not harm reduction, it is the opposite. … We believe it is a form of harm addition.” He is absolutely right, providing not just clean needles, but a government sanctioned safe zone where addicts can take illegal drugs without fear of prosecution sends a mixed message about what our society thinks and makes it easier for addicts to continue with their life risking behaviour.

The Economist has a good report on the effectiveness of Canada's only 'safe injection site' in Vancouver:

BACK in 2003 many residents of Vancouver reckoned that an answer had finally been found to the worsening hard-drug problem in the liberal-minded city’s downtown Eastside district. A reformist city council, borrowing a European idea, opened the first supervised heroin-injection clinic in North America. It was set up as a research experiment, with a three-year remit (since twice extended). The idea was that giving addicts a safe place to inject themselves would remove them from crime, disease and other risks, and make them more amenable to treatment. The Liberals who were then running the federal government agreed, and blessed Insite, as the project is called, with C$1.5m (then worth $1.1m) and a vital exemption from drug laws.

Five years on, Insite has proved a disappointment to many in Vancouver. It has also become the object of partisan conflict. The Conservative federal government of Stephen Harper dislikes the project. A committee set up to advise it on the issue found that only about 500 of Vancouver’s 8,000 addicts use Insite each day, and fewer than 10% of those use it for all their injections. It found no clear evidence of any increase in treatment, nor of any fall in HIV cases. It did estimate that the project might have saved one life per year but found that overdose deaths were still about 50 a year among addicts. Crime continues unabated as addicts steal to feed their habits, something which frustrates the local police.

So there is close to no benefit to the drug users, or societ at large by providing the injection site. At the same time, the injection site makes it easier for addicts to continue feeding their addiction. Tony Clement should be applauded for taking a stand saying, “We're not prepared to allow people to die” by condoning their continued drug use.

1 comment:

Anonymous said...

A few things to consider:

- The statistic that "500 of Vancouver’s 8,000 addicts use Insite" is misleading. It suggests that Insite is underused. Not true. The facility is running past capacity, and it is very likely that if there were more spaces available, or more safe-injection sites, that number would rise.

- Also, to clarify some of the conclusions of the advisory panel report (

==> Regarding benefits to addicts and effect on treatment uptake: "INSITE encourages users to seek counseling, detoxification and treatment. Such activities have contributed to an increased use of detoxification services and increased engagement in treatment. VCH has now increased access to detoxification by opening a number of beds for detoxification in rooms above INSITE.

The existence of INSITE facilitated the immunization of injection drug users in the DTE during an outbreak of pneumoccocal pneumonia in 2006.

==> The one-life-saved-a-year statistic is based on modeling that the report acknowledges uses "assumptions that may not be valid." The facility has overseen 1,000 overdoses since opening (without a fatality), a large number of which very likely would have otherwise occurred on the street. It's difficult to imagine that none of those 1,000 overdoses would have been fatal had they occurred outside the facility.

==> Insite's opening was immediately followed by "a reduction in the number of people injecting in public."

==> No evidence of any increases in public disorder or crime connection to Insite.

==> While it's true that some officers have their own opinions, the Vancouver Police Department supports Insite.

==> The report found a cost-benefit ratio of between 1.5 and 4.2 in favour of the facility.

The scientific and medical community is overwhelmingly in support of Insite. Tony Clement is a politician not a scientist, and is clearly basing policy on ideology and not facts.

- an Insite supporter