Friday, July 04, 2008

Dr. Brian Day (Pres. Cdn Med. Assoc) on Insite

Missed an article in yesterday's round up. This appeared in the Toronto Star and is by Brian Day, President of the Canadian Medical Association (CMA).

Ottawa's bad prescription on addiction

Jun 08, 2008 04:30 AM
Brian Day

When the federal government announced it would appeal the B.C. Supreme Court's decision on Vancouver's safe injection site, it chose to dismiss growing scientific evidence of the positive role harm-reduction programs can play in society.

It is hardly a surprise, however, that the Conservatives would favour a "law-and-order" approach. They made their position pretty clear when they rejected harm-reduction programs in the new national drug strategy.

While the federal government rejects scientific evidence that harm- reduction programs are successful, health-care professionals and public-health experts know they are an important part of the puzzle in addressing illegal drug use. Harm reduction, along with treatment, policing and prevention are cornerstones of a comprehensive, integrated public-health strategy.
Conservatives contend that money could be diverted away from Insite into treatment and rehabilitation programs for addicts. Money does need to be diverted, but it's not from facilities like Insite.

Of all the money that Canada spends to combat illegal drug use, less than 10 per cent is spent on treatment and rehabilitation. The vast majority of the money goes to interdiction and law enforcement. While law enforcement has an important role to play, it is obvious we need a rebalancing of resources and focus.

Not unlike mental illness, there exists a negative view and stigma around addiction, that these members of society are somehow weaker than others, that it is acceptable for us to turn a blind eye to their suffering. It's time to clear the air – addiction is a disease and those who suffer with it need medical assistance just as those who suffer from heart disease or cancer.
We know that stigma prevents individuals with an addiction from seeking help. We are now concerned that this stigma may also be affecting the development of appropriate public policy in this area.

Evaluation of safe injection sites show that they help prevent overdose fatalities. They help reduce needle-sharing, which is an important contributor to the spread of HIV and other infectious diseases. They encourage users to seek counselling and treatment. They do not increase the rate of injection drug use or crime in surrounding neighbourhoods. In fact, the government's own Expert Advisory Committee confirmed many of these facts.

Programs such as Insite are often the first and only contact people have with mainstream health and social services. It can also act as an important door into other areas of the health-care system for those who likely wouldn't or couldn't access the care they need.

Instead of closing down this site, the federal government should be working with public-health officials to see if such sites might work in other areas.

Health Minister Tony Clement has stated that "science is one of the issues that must be taken into account when it comes to a public policy decision." In this matter, the science is clear: Harm reduction is a proven and effective tool.

Marginalizing an already vulnerable population and leaving them at even greater risk of disease and death is bad medicine and, as the polls show, even worse politics. And with the B.C. government's plans to intervene on behalf of Insite, Canadians should rightly wonder why their tax dollars are going to be financing both sides of this argument.

They also should wonder why the federal government seems to be opposed to safe injection sites in British Columbia, but is willing to consider them in Quebec. Clement's public hedging on Quebec's proposal is further proof that his decision appears to be based on political science and not the real thing.

When it comes to safe injection sites, Conservatives need to consider the health of all Canadians, not just those who agree with the government's ideological bias against drug-addicted patients.
Dr. Brian Day is president of the Canadian Medical Association.

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