Sunday, September 17, 2006

From the Globe and Mail, Sept. 11th, 2006

Setback not stopping injection-site plans
Victoria, Prince George ready proposals despite limited extension in Vancouver

VANCOUVER -- Officials in Victoria and Prince George say they still hope to open supervised injection sites in their cities soon, despite the federal government's limited extension for the Vancouver facility.

Victoria Mayor Alan Lowe said it's regrettable that Health Canada will not consider any new applications for injection sites until Ottawa reviews the effectiveness of Vancouver's Insite clinic. But he said his city still intends to submit its proposal by early next year, adding that Victoria would learn from the Vancouver experience.

"The Insite project in Vancouver has proved to be successful, and a facility similar to that will be beneficial to Victoria, but I also agree with the Canadian Police Association that you cannot rely on the supervised injection site alone. In Vancouver, they only focused on the supervised injection site and I think there are fears that the other pillars aren't getting the same focus."

Last week, the Canadian Police Association said the federal government should close Insite and focus on education, enforcement and treatment. A few hours later, federal Health Minister Tony Clement announced he would keep the site open until December, 2007, but was unable to approve a request to keep it open another 3½ years.

More research needs to be done about whether the site is achieving results, he said.

The province provides most of the funds for the injection site but Ottawa must provide an exemption from federal drug laws so that addicts can take drugs inside without fear of being arrested.

Insite, the first such facility in North America, accommodates more than 600 drug users a day.

The main argument in favour of supervised injection sites is that they reduce the number of overdoses and curb the rate of HIV and hepatitis-C infections.

Victoria wants to set up a number of smaller injection sites in its downtown, which is more compact than Vancouver's, rather than a single facility like the one operating in Vancouver's Downtown Eastside.

Prince George would also like to set up a supervised injection site in its downtown core. The city has a big hepatitis-C problem and HIV rates have skyrocketed in recent years.

Lorna Medd, chief medical health officer for the Northern Health Authority, said the immediate concerns are increasing hours and staffing of a needle exchange and getting a mobile van on the road.

"We've been watching what the process has been with the long hard look at the safe injection site in Vancouver and we're feeling if there isn't a long-term solution in Vancouver it will be a difficult thing for Prince George," she said.

Dr. Medd said despite the setback in Vancouver, she and other members of the community in Prince George are still proceeding with developing a plan to open a supervised injection site.

Thursday, September 07, 2006

From the Globe and Mail

Drugs and 'consequences'

Vancouver -- In his column on Insite, Vancouver's safe-injection site, Gary Mason quotes approvingly a British psychiatrist who suggests that reducing the number of overdose deaths is "not our responsibility . . . it's the responsibility of the addicts themselves."

Would Mr. Mason extend the same principle to other groups, such as, say, smokers with lung cancer or emphysema, type-A business executives who work themselves into a heart attack, battered women or people injured in automobile accidents?

As a physician at a clinic that serves drug addicts in the vicinity of Insite, I know who these drug addicts are. Without exception, they are children who were severely abused physically, sexually and emotionally and who endured abandonment and neglect.

Such maltreatment has physiological effects on brain structures and brain functioning and creates an overwhelming craving for self-medication to soothe a suffering most people cannot even imagine. Most addicts began using in adolescence and have since become psychologically and physiologically dependent on their drugs.

To neglect, ostracize, and punish such people when they become adults is shortsighted and inhumane. Insite is a small but necessary step toward helping and, perhaps, rehabilitating drug users.

More updates

This one from the National Post:

Addicts are not criminals

Adam Radwanski, National PostPublished: Tuesday, September 05, 2006

Almost all of the arguments against Insite, Vancouver's groundbreaking "safe injection" facility for heroin addicts, crumble under the weight of modest scrutiny. It has not, as critics predicted it would, prompted a spike in the local crime rate. It does not discourage junkies from seeking rehabilitation; on the contrary, it has given thousands of referrals to help them try to kick the habit. And contrary to the claims of some of its more confused critics, it most certainly does not turn the government into a supplier of illegal narcotics.

But as the federal government continues to deliberate over its future, having granted it a temporary reprieve until the end of next year, there is one legitimate strike against Insite: the blatant hypocrisy of effectively legalizing possession of heroin at a single, government-sanctioned facility, while arresting addicts for exactly the same offence elsewhere.

"So long as the drug laws remain on the books, the government cannot simply do as it likes, selectively enforcing prohibitions here while openly ignoring them there," Marni Soupcoff wrote in these pages last year. "At least not without a price." That price, she argued, is the authorities encouraging a disrespect for all laws by itself flouting the ones that it finds inconvenient.

That is a valid argument - so valid, in fact, that it should probably rule out more ventures like Insite. It's probably also the reason that, even as Vancouver police's support for the program has pointed to its effectiveness, the Canadian Police Association has taken a strong stance against it. But the answer is not to slowly kill off the safe-injection site, as the current federal government would seemingly prefer, and go back to treating all junkies like criminals. The answer is to stop treating any of them like criminals.

Decriminalizing or legalizing possession of hard drugs is not a decision to be taken lightly. We're not talking about marijuana, a substance that should be legalized because it does little harm to anyone. But it's explicitly because of the harm it currently does users that we need to reform our approach to heroin.

Study after study tells us that we can't force junkies to clean up; they have to be willing and able to do so themselves. In those cases, the best we can do is harm reduction. And that means pulling them out from underground - from flophouses with dirty shared needles, and back alleys where there's no one to help them when they overdose -- and into places like Insite.

The numbers from that one facility alone suggest it has already saved its share of lives. While too early to know just how many AIDS/HIV infections it's prevented, an RCMP report found that it's helped addicts learn how to inject themselves more safely and to prevent overdoses. For those who have overdoses while at the facility -- 453 of them over a two-year period in which it averaged 607 visits daily -- Insite has had the wherewithal to ensure that not a single one of them died. And the New England Journal of Medicine has reported that users who go there are more likely to go into rehab -- analysis born out by the 4,083 referrals handed out by Insite over that same two-year period, 40% of which were for addiction counselling.

If every city had its own version of Insite -- or ideally, several versions of Insite -- fewer Canadians would be killing themselves with drugs. It's that simple. But those services shouldn't be provided by government in a vacuum, while anyone else who tries to help gets busted. If there's to be an expansion, the work should be done mostly by the independent not-for-profits that already provide other social services.

None of this need get in the way of fighting the drug trade -- going after dealers and the networks that supply them. If anything, it could free up resources to go after them more effectively. But it's time to start treating their customers more as victims than perpetrators.

Yes, addicts are more likely to commit crimes -- stealing to pay for their drugs, or behaving anti-socially once they've taken them -- than the rest of us. But that means cracking down on them once they've committed those offences, not because they might do so at some point. In the meanwhile, we should be helping them deal with their sickness rather than arresting them for it.

Saturday, September 02, 2006

Temporary Reprieve--Watch this space!

YAY! Insite has been given a reprieve of 16 months (Curious mandate for research on crime prevention--more on this later...)

Anyways, this site is ready to go--I'll keep compiling interesting info about this issue and in 12- 15 months start the drive to lobby folks again.

Here's the news from CBC:

B.C. injection site to continue operating, for now
Last Updated Fri, 01 Sep 2006 21:31:48 EDT
CBC News
Federal Health Minister Tony Clement announced Friday his department wouldn't give another three-year exemption to Vancouver's safe-injection site for heroin addicts, adding that the site will remain open until a decision is made by the end of 2007.

Insite will stay open until at least the end of 2007. (CBC)

Clement said in a statement that before a decision is made, additional studies will be conducted into how supervised injection sites affect crime prevention and treatment .

"Do safe injection sites contribute to lowering drug use and fighting addiction? Right now the only thing the research to date has proven conclusively is drug addicts need more help to get off drugs," Clement said.

"Given the need for more facts, I am unable to approve the current request to extend the Vancouver site for another three and a half years."

Intensive campaign
North America's only safe-injection site opened its doors in the Downtown Eastside in September 2003. It was established in Vancouver following a intensive campaign for a safe, clean place for the estimated 5,000 injection drug users in the neighbourhood, an area with above average HIV and hepatitis C infection rates.

Health Canada gave the clinic a three-year operating exemption under Section 56 of the Controlled Drugs and Substances Act. The B.C. government provided $1.2 million to get started and provides operating funding through Vancouver Coastal Health.

The exemption was set to expire on Sept. 12.

The impending deadline has resulted in a number of declarations for and against the site in recent weeks.

Last week, former city mayors Mike Harcourt, Philip Owen and Senator Larry Campbell released a joint statement in support of keeping the Insite clinic, saying that it made sense both scientifically and financially.

Current Mayor Sam Sullivan and Premier Gordon Campbell, a former Vancouver mayor, have previously spoken out in support of the clinic.

Police have mixed reaction
The reaction from the law enforcement community has been mixed. In May, Vancouver Police Insp. Larry Thompson credited the clinic for its interventions and said the department was in favour of another exemption.

But on Friday, Tony Cannavino, the president of the Canadian Police Association, said the group, which represents 54,000 members, voted unanimously on a motion to press Ottawa to stop financing Vancouver's safe-injection site and invest in a national drug strategy instead.

As well, the province's RCMP spokesman this week said the site was problematic.

"We only support an injection site that would have as its approach the four pillars strategy, and that of course is harm reduction, education, prevention and enforcement. Does this particular program have those four pillars? It doesn't at this point," said Staff-Sgt. John Ward.
Report contradicts critics

That statement came despite a report from two criminologists commissioned by the RCMP, Ray Corrado of Simon Fraser University and Irwin Cohen of University College of the Fraser Valley.

"The main argument for those against supervised injection sites would be that it would bring crime to the area, that it would increase the use of drugs, that it would actually encourage people who don't use drugs to begin to use drugs," said Cohen. "And none of that has been borne out by the research anywhere." However, Cohen noted that the site is not yet attracting enough users, adding that the vast majority of addicts in the area are still injecting drugs somewhere else.

Statistics compiled by the clinic over a two-year period ending March 31 show there was an average of 607 visits a day to the clinic, and that 453 addicts overdosed at the clinic — but with no deaths because of the trained staff. There were also 4,083 counselling referrals during the two-year period, including about 1,600 referrals to addiction counselling.

Some city activists have vowed they would keep running a site even if the federal government withdraws its support.

Clement also said in his statement that Ottawa is planning to launch a new national drug strategy.

"We believe the best form of harm reduction is to help addicts to break the cycle of dependency," Clement said. "We also need better education and prevention to ensure Canadians don't get addicted to drugs in the first place."