Tuesday, October 23, 2007

Editorial from the McGill Tribune


EDITORIAL: Needles in a political haystack
Issue date: 10/23/07

Political opposition to drug harm reduction centres is nothing new. Insite-a supervised injection site located in the downtown eastside of Vancouver has encountered nothing but disdain from Stephen Harper's federal government, while the UN's International Narcotics Control Board routinely condemns various harm reduction centres abroad for violating international treaties concerning narcotic drugs.

The U.S. government has also been an outspoken global critic of harm reduction projects that provide legal exemptions for drug use ever since Richard Nixon coined the term "war on drugs." Therefore, it should come as no surprise that early efforts by the San Francisco Department of Public Health to open America's first legal safe-injection site have been met by political
stonewalling and moral indignation.

The scientific evidence supporting supervised injection sites is overwhelmingly positive. Insite, the only facility of its kind in North America, has been the subject of over a dozen studies conducted by the BC Centre for Excellence in HIV/AIDS, none of which have uncovered a single negative effect of the SIS. Furthermore some of the positive effects revealed in their
peer-reviewed research are extremely encouraging: Insite has reduced the overall rate of needle sharing in the area, led to increased enrollment in detox programs and has not led to an increase in drug-related crime or intravenous drug usage.

Nurses at Insite provide care for wounds, supply users with sterile drug paraphernalia and educate users about sanitary practices that cut down on the spread of HIV and Hepatitis C. They are also on-hand for any overdoses-of which there have been over 800 at Insite. Thanks to prompt medical care, not a single overdose at the facility has resulted in a fatality and, not coincidentally, emergency room visits for intravenous drug users are down dramatically.
Unnecessary hospital visits are prevented by simple care at an SIS, saving tax-payers money and cutting waitlists at emergency rooms.

Perhaps most importantly, safe-injection sites put drug users in close contact with social workers. In fact, a recent study showed that intravenous drug users were 20 per cent more likely to enrol in a detox program after using Insite on a regular basis. The power of personal contact, something that is almost impossible to establish when dealing with users in back-alleys, is undeniable.

An SIS in the downtown eastside of Vancouver was an crucial step towards improving the community. It is estimated that the area is home to over 1,500 homeless people, as well as thousands of others living well below the poverty line. The percentage of HIV-positive men and women in the community parallels that of many third-world countries.

San Francisco has similar problems, with estimates of intravenous drug users in the city ranging from 11,000 to 15,000 people. For them, the old methods of enforcement are not working. In fact, a study published in the International Journal of Drug Study concluded that street-level arrests and confiscations only serve to exacerbate drug-related crime and prompt increased
needle sharing.

The Harm Reduction Centre here on campus is based on much of the same ideology. The centre, which became a Students' Society Service in November of last year, aims to educate students on safe alcohol and drug use and bridge the disconnect between the average student and the officials that preach on the evils of drugs. Quebec pharmacy Jean Coutu offers a kit of inexpensive needles and condoms in order to prevent the spread of disease and facilitate safe drug use and sex for low-income individuals.Yet most politicians still believe "The war on drugs" is the answer and refuse to use the formidable powers of government to offer such harm reducing services.

Ideologically it's easy to see why they have a knee-jerk reaction to anything that might seem to make drug use easier, but what they fail to realize is that supervised injection sites don't condone or legitimize drug use at all. The facts show that facilities such as Insite do not increase drug use in the community, nor cause additional relapses. The staff at safe-injection sites work
to save users' lives, while idealistic politicians stick their heads in the sand and pretend drug-busts, harsher jail sentences and preventative campaigns will rid society of the problem. They refuse to see the reality that prohibition and punishment will never completely eradicate drug use from the general population.

This sad state of affairs among our politicians was revealed, yet again, earlier this year, when Harper's government denied Vancouver Coastal Health's request for a three-year extension to Insite's operating exemption. Instead, Insite was granted an additional six months to "gather more proof of its effectiveness." Harper commented that he was "sceptical" about Insite's value,
despite the favourable studies published in over a dozen reputable medical journals such as the Lancet and the New England Journal of Medicine.

Supervised injection sites are not the be-all, end-all solution to the problem of drug usage, but rather, they are an important tool in the battle against intravenous drugs. They cost a measly $2-millon per year to operate, which is pocket-change compared to the millions spent on enforcement and education. Some object to them on moral or philosophical grounds; but the
science behind them is sound, and when morality and pragmatism meet, pragmatism should always triumph.The bottom line is that programs like Insite work.

If Mr. Harper and the politicians in California believe otherwise, then they must be high on something.

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