Category Archives: Insite

Conservative Senator Talks Harm Reduction

First, for those who have not seen it Maxine Davis, Executive Director of the Dr. Peter Foundation has an important op-ed in the Vancouver Sun titled Attention Ottawa: Insite is a health care service.

More intriguing Safe Games 2010 and the Keeping the Door Open Society (which, for full disclosure, I sit on the board of) are hosting a panel discussion on harm reduction. One of the speakers will be Senator Pierre Claude Nolin, who sits as a Conservative and has been deeply supportive of harm reduction strategies generally and the four pillars strategy specifically here in Vancouver.

For those in Vancouver who are interested in the event – details below. Hope to see you there.

Keeping the Door Society and SafeGames 2010

invite you to attend

Global Insite – A panel discussion and public dialogue on Vancouver’s

innovative response to the international question of What to do About Drugs?


Friday 19th February 2010

7.00 pm – 9.00 pm; doors open 6.30 pm


Japanese Language Hall

487 Alexander Street @ Jackson Street / Vancouver


  • DR. ETHAN A. NADELMANN Executive Director, Drug Policy Alliance; New York
  • SENATOR PIERRE CLAUDE NOLIN, Senate of Canada; Ottawa
  • LIZ EVANS Executive Director, Portland Hotel Society; Vancouver
  • DONALD MACPHERSON Co-founder, Canadian Drug Policy Consortium; Vancouver
  • SHARON MESSAGE Past President, Vancouver Area Network of Drug Users; Vancouver
  • TARA LYONS Executive Director, Canadian Students for Sensible Drug Policy; Canada
  • GILLIAN MAXWELL (mc) Project Director, Keeping the Door Open Society, Vancouver

Please join us to hear a panel of experts discuss the Canadian Government’s recent announcement that it will continue its efforts to close down Insite – North America’s only legal supervised injection site.  We invite you to participate in the dialogue that will follow.

Why Insite Matters

insiteFor those who have not seen it there is a stunning piece on the 5th Estate about Insite – the Supervised Injection Site in the Downtown Eastside of Vancouver – where TV cameras are allowed inside the facility for the first time.

I wish I could embed the video in this blog post and walk you through it, but sadly the CBC doesn’t allow me to do this. To view the piece you have to go to the 5th Estate’s website.

The piece is long, so below I recommend some specifics point that touched me. You can scroll directly to them:

02:20 – A basic video walk through of Insite that explains, plainly how it works.

04:15 –  Interview with Darwin Fisher – the Insite intake manager – who shares with us the logic of Insite. In short, the facility connects some of the most marginalized citizens with society, giving us an opportunity to provide them with services, develop relationships, and keep the door open to the possibility of getting into detox programs.

09:58 – An interview with a user – David Brodrick – who talks about why he uses Insite and his desire to respect his community. Insite’s critics sometimes want us to forget these people are humans – living in our own backyard – this clip makes that impossible to do.

25:09 – A discussion about how the Federal Government is trying to shut Insite down and how four successive Vancouver Mayors – from across the political spectrum – are supportive, along with the community, local business and the BC Government (who funds it).

31:00 – It is hard not to be blunt here. But for those who don’t support Insite, are you prepared to tell this person, their friends, and their family, that you believe their addiction comes from a moral failing and that they should either go into detox right now, or die on the streets of Vancouver? Without Insite, this is essentially the choice we are putting before people like David. Insite is not the solution, but it is a step in the process that helps us address the problem.

My only critique of the piece is that it opens by stating Insite is experimental and controversial. This language that perpetuates a false story. Insite is no longer experimental. It is a piece of the healthcare system in Vancouver that is proven – in peer reviewed medical journals – to be an effective way to save lives. Moreover, it is proven, by a federal government report, to save taxpayers’ money. Finally, in Vancouver, Insite is not controversial. It enjoys overwhelming support, among business leaders, community groups, within conservative and liberal political parties and among the public at large. Insite – and harm reduction strategies – are about as controversial in the lower mainland as public transit. The debate isn’t about whether it should exist, but how we can do more of it.

If you are intersted in supporting Insite – consider visiting this website.

Shootings in Vancouver – how our definition of success leads us to failure

After a rash of shootings in Vancouver last week (which continues) I was completely astounded to read this quote by the RCMP in the Globe and Mai:

Violence between competing Mexican cartels is squeezing the flow of drugs from source countries such as Mexico and Colombia through cities such as Los Angeles, one of the major sources for Vancouver-based groups that buy and sell illegal drugs, says Pat Fogarty, RCMP superintendent with the combined forces special enforcement unit. Gangs in the Lower Mainland are now fighting over the dwindling supply.

“The distribution lines have been disrupted,” Supt. Fogarty said yesterday in an interview. “It’s like in any marketplace – the demand stays high, but there’s not as many distributors out there because the little guys get knocked off.”

“The bigger ones survive, the other ones don’t. And these guys don’t resolve things through a court process. It’s ‘I want my piece of the pie’ – well, there’s none left for you.”

Essentially, the RCMP is admitting that the more successful it becomes – the more capable it gets at limiting the flow of drugs – the more violence we can expect from drug dealers on our streets.

Why? Because when demand remains constant and fewer drugs are available, their value will increase making it more tempting to use violence to hold on to, or increase, your share of the marketplace. In essence, the RCMP is admitting that attacking the supply side of the drug trade is an ineffective approach. (The irony of course, is that the reduction has nothing to do with RCMP strategy or tactics but, as the Center for Strategic International Studies notes, everything to do with the geopolitics of the drug trade).

So, the RCMP has inadvertently admitted that the key to managing the War on Drugs is not to reduce supply, but to reduce demand.

This is precisely what makes projects like the NAOMI trial and the Insite injection site so important – they help to both reduce demand for drugs and, in the case of NAOMI, eliminate the demand from illegal sources altogether. This is what makes the RCMP’s opposition to Insite and NAOMI even more puzzling. If – by their own admission – reducing demand is the only way to effectively reduce the crime associated with the drug trade, why are they trying to shut down our most effective tools?

Wente’s disgraceful piece on Insite and harm reduction

Last Saturday Margaret Wente wrote this disgraceful piece on harm reduction in Vancouver.

In short, what is written is a compilation of anecdotal statements that ignore the actual research and science that has measured Insite’s positive impact. A quote from a sergeant who may or may not have an axe to grind is apparently worth more than the numerous peer reviewed articles in publications like the New England Journal of Medicine or The Lancet. This is of course Wente’s MO – she doesn’t need science or research, like Colbert her gut is her guide – something we learned long ago from her coverage of global warming.

This sadly, is not the worst of it. Wente goes on to misrepresent both the goals of Insite and the position of its advocates.

insiteNo one – least of all Insite’s advocates – believes Insite is the entirety of the solution. The goal is, and always has been to have a complete response (hence the four pillars). Insite seeks to reduce harm but it can’t ‘solve’ the drug problem alone, no one claimed it would and judging it by such a bar is misleading.

Is rehabilitation and treatment essential? Absolutely – something Insite supporters also believe. This is why OnSite (a temporary treatment facility pointedly not included in Wente’s article) was placed atop Insite so that users would have somewhere to stay while a permanent facility was found for them. Insite was never designed to replace treatment, but to reduce harm for those who refused or could not get it as well as provide a vehicle to help users seek help and get on treatment.

There are plenty of commentators I disagree with but enjoy reading because they challenge my assumptions and provoke interesting or thoughtful insights. Sadly, most of the time I read Wente I’m reminded why she’s not one of them.

Two additional points. The first is how the injection site has become an East vs. West phenomenon. Here in Vancouver the debate is over. Insite has public support, on the street, in the newspapers and in the halls of power. Even the comments in the Globe reflect a bias in favour from those commenting from Vancouver especially but BC in general.

Second, I initially wrote this in the comment section on the globe website (where one is exposed to some truly horrifying thinking) and thought nothing more of it until Andrew F. emailed me a supportive note. And I thought comments on newspaper articles were simply a cathartic exercise!

Tory logic: Injection sites in Quebec = good, in BC = bad

So Yaffe’s Wednesday column (which I talked about yesterday) about how Insite would not be challenged by the conservative government if it were in Quebec has turned out to be sadly prescient.

Today, the Globe is reporting that Federal Conservative Health Minister Tony Clement is willing to consider Quebec’s request for an injeciton site even as he works to shut down the site in Vancouver. For a party that was supposed to let the west in, this is a complete outrage.

Health Minister Tony Clement says his government will not necessarily oppose safe-injection sites for illegal drugs in Quebec even though it will appeal a court decision allowing a similar facility in British Columbia…

…”I am obligated to consider each situation as a unique situation. That’s my obligation as the Minister of Health.”

Appalling. Apparently the local consensus reached in Vancouver about this approach means nothing to this government. Nor apparently, do the votes in Vancouverites. With this move it is hard to imagine the Conservatives winning any seats in Vancouver.

For those interested in a sensible drug policy… sign here.

Here is an opportunity to sign the resolution coming out of the Community Forum on the National Anti-Drug Strategy held in Toronto on March 26th.

Signatures generated at the Forum and from the on-line version total over 1600, from people across Canada.  We will be presenting the resolution to Parliament soon, so please add your signature asap, if you haven’t already.  Please also forward this message to any interested contacts or networks. And while you are at it, consider signing the Insite injection site petition as well.

As many of you know I believe a drug policy built on scientific research and evidence – not fear – is one that will most likely generate results.

That said, I know this won’t change the world, but it might help a little.

Expert Advisory Committee report: Insite works

insiteLate Friday afternoon (PST) Health Canada tried to quietly release the Final report of the Expert Advisory Committee on Supervised Injection Site Research. (Since government reports are public domain I’ve created a downloadable, easier to read, PDF version that can be found here).

Why quietly release such an upbeat report? Because the Health Minister is ideologically committed to closing Insite. Unfortunately for him, the report confirms what researchers and scientists have been telling us all along: that Insite works.

Consequently, for what must be the first time in Health Canada’s history the department is trying to bury a study that highlights how one of its programs improves healthcare outcomes to Canada’s most marginalized citizens.

Ah, the irony.

Well, one can’t blame him. The Minister simple doesn’t want anyone to know that his own hand picked experts have robbed him of any scientific basis for ending the program.

Below are some of the report’s highlights about how INSITE benefits the public:

  • 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. Translation: INSITE helps drug users get off drugs.
  • Observations taken 6 weeks before and 12 weeks after the opening of INSITE indicated a reduction in the number of people injecting in public. Translation: INSITE gets drug users off the streets, making the safer and more community friendly.
  • There was no evidence of increases in drug-related loitering, drug dealing or petty crime in areas around INSITE. Translation: INSITE doesn’t increase crime.
  • A private security company contracted by the Chinese Business Association reported reductions in crime in the Chinese business district in a surrounding area outside the DTE. Analysis of police data for the DTE and surrounding areas showed no changes in rates of crime recorded by police. Translation: INSITE definitely doesn’t increase crime.
  • There is no evidence that INSITE influence rates of drug use in the community or increase relapse rates among injection drug users. Translation: INSITE doesn’t encourage drug use.
  • Every dollar spent on INSITE saved 0.97 to 2.90 in government spending on other services. Translation: INSITE saves taxpayers dollars – especially in heathcare costs.

These benefits are significant. However, the Conservatives spin machine is already hard at work. Specifically, it is trying to use this line – out of context – to support its claim that INSITE is ineffective:

“The injections at INSITE account for less than 5% of injections in the Downtown Eastside. This limits the likelihood of significant direct impact from INSITE in the Downtown Eastside.”

However, since the report also points out (contrary to what James Moore has misleadingly telling his constituents) that:

“An average of more than 600 visits a day shows that INSITE operates near capacity.”

The report isn’t arguing that INSITE is ineffective, it’s simply pointing out that it isn’t large enough to meet the demand. This is akin to claiming that a hospital should be declared “ineffective” and shut down because the people it didn’t have the capacity to serve were still dying of heart attacks.

The Conservatives now have two months before the June deadline they created to decide: are they going to shut down a program that reduces drug addiction and saves the public money?