Tag Archives: injection_site

CNN's converage of Insite

The Insite supervised injection site is starting to attract more and more attention. Last week CNN broadcast this 3 minute bit about the site.

What’s fascinating is how a simple parsing of the language in the video reveals the depth of the differing perspectives.

Listen carefully and you’ll notice how those opposed to the injection site deal in abstract terms whereas those who support it talk in tangible outcomes.

For example, in the clip, Dr. Thomas Kerr and Insite workers/supporters cite tangible benefits: a 45% reduction in public drug use in the area, users being 33% more likely to enter detox, the reduction of discarded used needles in parks and schools. This are measurable, tangible benefits and outcomes.

Contrast that to the quote from an unnamed US official: “It that is a cruel illusion. Because they’re still addicted, trapped trying to get help and dying by virtue of the drug itself.”

Here is a vague comment designed to appeal to your emotions. More importantly, it is devoid of fact, research, or for that matter, logic. Being addicted, trapped, and dying from drug use is a reality for users whether the injection site exists or not. The injection site at leasts gets users in regular contact with social workers – which is why users who use the site are 33% more likely to enter detox – those relationships build trust, which enables users to seek help.

But the worse quote is from Dr. Colin Mangham, director of the Drug Prevention network. His “research” shows that 800 people overdosed at Insite in 4 years.

First off, this isn’t research, this is publicly available information. Second, Mangham’s statement presumes that those 800 overdoses would not have occurred if Insite did not exist. This is pure fantasy. Indeed one of the main purposes behind creating Insite was to ensure overdoses would occur within the site as opposed to on the street. Those who overdose at Insite receive medical attention quickly and cheaply (a nurse is on hand who provides the necessary treatment). It is worth noting that despite these 800 overdoses, they has not been one death at Insite.

In contrast, when drug use occurs on the street, deadly overdoses are both commonplace and expensive. Victims invariably require paramedics, who in turn may require a police presence. In addition, overdose victims may get taken to an emergency room – the most expensive point of contant in the medical system.

I expect with the Olympics coming there is going to be more coverage of this type. One things the Federal Government will have to consider is that, if they shut Insite down, an army of international reporters swarming the downtown east side are going to want to know: what more effective policy did you replace it with? (Hint: there isn’t one).

Insite – Incremental Death?

Yesterday the federal government announced it would extend the legal exemption that allows Insite, Vancouver’s supervised injection site, to stay open until June 2008. (to understand why the Injection site is important click here, here and/or here)

So the good news is brief and temporary: Insite, gets to stay open an additional 6 months.

And here’s the bad news. Tom Flanagan, Harper’s chief strategist has recently published his tell all book: Harper’s Team: Behind the Scenes in the Conservative Rise to Power. One of the books key messages? Conservatives must adopt an “incrementalist” strategy. In other words, they must slowly when advancing the conservative agenda – move too quickly and the electorate will turn against them.Insite Logo

This begs the question. Is the reprieve for Insite genuinely designed to give the Federal Government more time to assess whether it is having a sufficiently positive impact? This is very much my hope. Those in the know tell me that the Federal Government only got around to appointing the team to assess Insite a few weeks ago. Given that this team’s report was never going to be ready in time for Christmas deadline another temporary extension was widely expected.

Part of me desperately wants to believe in the Harper as “policy wonk” narrative. If this is the case, then the overwhelming evidence in favour of Insite may be persuasive to a person focused on outcomes. On the evidence it would be hard to justify pulling the plug on Insite.

Flanagan’s incrementalism thesis however, plays on Insite supporters’ worst fears. If Flanagan is to be believed (and there are good reasons to believe him) then the reprieve is simply a way to hold off a decision until after an election (and a hoped for majority government) at which point it will be politically “safe” to kill Insite. As I mentioned in an earlier post, it is very hard to imagine the Conservatives picking up a seat in Vancouver if they kill Insite. If however, they appear to be moderate and are considering saving it, they boost their chances of capture a seat like Vancouver-Quadra. This is certainly the fear of Keith Martin and other local federal Liberals.

So am I excited that Insite got a 6 month extension? Not really. Insite works. Moreover it is operating at capacity. We shouldn’t be debating whether or not it stays open. This is akin to arguing if we should keep open a single public hospital in a country where there is no public healthcare insurance. It’s the wrong debate. The question should be – how do we scale this policy up nationally?

But that’s not the debate we are having, and likely won’t be having for a few years. So in the interim let’s save Insite.

As far as I can tell our fate in this capacity rests on whether Harper is an incrementalist, or a policy wonk.