Tag Archives: Insite

Conservative Senator Talks Harm Reduction

The Canadian Government's War on Science

For those who did not catch this excellent piece in the Toronto Star I encourage you to take a look.

During the Bush era the Canadian war on science was an embarrassing side show to that of its more wildly offensive southern neighbour which regularly silenced scientists, withheld reports, or simply appointed “expert” panels whose credentials were dubious but whose members could be counted on to produce the “right” answer. Indeed, these sad events are well chronicled in Politics And Science In The Bush Administration drafted for Representative Henry Waxman. (This, as an aside, is what happens when you give elected representatives real research budgets – they look into all sorts of issues to keep the government of the day honest. A similar study by a Canadian MP would have stretched their resources beyond their limit).

But just in case you think the Canadian context is radically different, remember that our government has installed unqualified dependents of the oil industry to government scientific bodies. It has censored government scientists, preventing them from talking about their research at scientific conferences. It has barred officials from talking about climate change or harm reduction strategies for drug users. (It even banned one public servant from talking about a fictional book he”d written on climate change). It also disingenuously claims “more research is needed” on issues and then either cuts research programs that look into these questions or attempt to manipulate the process to produce outcomes that align with what they already believe (see the above Toronto Star piece).

This is the sad state of science and policy development in Canada. We alone in the world retain a government that is not interested in uncovering what is actually happening, but in fabricating a reality that conforms to an ideologically pre-determined world view. Our government’s two great allies, the Bush administration in the United States and the John Howard’s government in Australia, have moved on.

Today science is regaining its rightful place in the policy development process as evidenced by Obama’s inauguration speech:

The state of the economy calls for action, bold and swift, and we will act—not only to create new jobs, but to lay a new foundation for growth. We will build the roads and bridges, the electric grids and digital lines that feed our commerce and bind us together. We will restore science to its rightful place, and wield technology’s wonders to raise health care’s quality and lower its cost. We will harness the sun and the winds and the soil to fuel our cars and run our factories. And we will transform our schools and colleges and universities to meet the demands of a new age.

The mention is short and quick, but it was a powerful signal that, for scientists, the Bush era was over. Suddenly science mattered again in the United States. For the Canadian government this line is still more ominous. Their war on science can no longer hide in the shadow of Bush. And none to soon. As a believer in the power of effective public policy the undermining of science has been an attack on the effectiveness of good government. If our government doesn’t believe in science, how are we then to measure success, on what basis are we to decide which policies are more effective?

Oh, and don’t think the world isn’t noticing. You really have to work extra hard to prompt the world’s preeminent scientific journal – Nature – to write a special oped about how your government has become anti-science.

A couple of other fun links regarding our government’s war on science:

Tony Clement, who happily is not longer the Canadian Minister of Health received a swift rebuke for accusing doctors that work at Insite of being unethical.

Gary Goodyear Canada’s Scientific Minister is a creationist. Best response to this sad state of affairs is the incredulous Brian Alters, founder and director of the Evolution Education Research Centre at McGill University in Montreal. He noted this is akin to asking someone “‘Do you believe the world is flat?’ and he doesn’t answer on religious grounds…”

Emerging Neo-Progressive Issues: Drug Policy

As many of you know Taylor and I wrote a piece on what we termed neo-progressivism in last September’s Literary Review of Canada.

Since then we’ve keep our eye out for other discussions where we think neo-progressives are gaining traction in the public discourse. Some of the indicators we looking for are policies where:

The conversation is deadlocked and going nowhere
The conversation isn’t possible because alternatives to the status quo are considered taboo
Areas where the gap between ideology and research or evidence is significant
Debates where their are real divisions within either the left or right
Debates which unite odd factions from within the left and right
Policy areas where individual freedom is curtailed
Places where the impact on the public in general is growing

This list isn’t exhaustive nor is it a scientific – they are just a couple of triggers wer look our for.

Well, if you are looking at this list you may have noticed that last month a potential candidate emerged far on the horizon. It was a surprising one for me since I do some volunteering around this issue here in Vancouver and I really didn’t see it coming.

I’m talking of drug prohibition.

The aha moment was seeing the (very) conservative Cato Institute publish a report by Glen Greenwald (a case study neo-pragmatists) in which he analyzed the impact of drug decriminalization in Portugal. As the report’s summary states:

For over seven years, drugs have been decriminalized in Portugal. This new study examines the Portuguese model and the data concerning drug-related trends in Portugal, and argues that, “judged by virtually every metric, the Portuguese decriminalization framework has been a resounding success.”

Then consider drug prohibition against the list I outlined above. This topic should not have snuck up on me:

Deadlocked conversation: The “War on Drugs” vs. “Marijuana activists” increasingly leaves the public turned off. The war on drugs industry and its militarization of the police is costly, dangerous to civil liberties and has failed to address the problem for 30 years. Indeed, as the RCMP now admits, reducing the flow of drugs actually renders the situation more dangerous for citizens. Conversely, the counter-culture movement around pot activists is equally alienating. It is hard to attract middle class support when every middle class parent fears that this counter-culture will become the norm and their children will be destined life as a pot-head.

Alternatives to the status quo are taboo: For most politicians talking about ending drug prohibition is absolutely taboo, although this is shifting. Vancouver’s mayor recently stated that the sate should “regulate, control and tax marijuana,” and that “the prohibition approach to it is not working.” The Liberals under Martin considered decriminalizing marijuana. Even in the US there is movement. The legislatures of New York State, California and Massachusetts have begun to reconsider overly punitive drug laws. Senators Jim Webb and Arlen Specter recently proposed Congress create a national commission to explore prison reform and drug-sentencing policy.

Large gap between ideology and research or evidence: Here the Cato report, along with the data coming out of the Downtown Eastside around Insite and NAOMI trials is most devastating. The rhetoric around law & order does not stack up against the results. Consider that in Portugal after decriminalization (pulled from this Time Magazine article on the report)
- lifetime use of any illegal drug among seventh through ninth graders fell from 14.1% to 10.6%; drug use in older teens also declined. (a 33% drop!!!)
- lifetime heroin use among 16-to-18-year-olds fell from 2.5% to 1.8% (although there was a slight increase in marijuana use in that age group). (a 25% drop!)
- new HIV infections in drug users fell by 17% between 1999 and 2003, and deaths related to heroin and similar drugs were cut by more than half.
- the number of people on methadone and buprenorphine treatment for drug addiction rose to 14,877 from 6,040, after decriminalization, and money saved on enforcement allowed for increased funding of drug-free treatment as well. (150% increase in people seeking treatment!)

Divides the left or right: Check out this Western Standard blog (possible the most conservative publication in Canada) in which a conservative columnist argues with a conservative reader about the evidence around ending prohibition. I never thought I’d see the day where a Western Standard columnist would explore the possibility of ending prohibition. Could endorsing harm reduction strategies be far behind?

Unite odd factions from within the left and right: Could possible unite traditional left wing progressives with right-wing libertarians.

Individual freedom is curtailed: Check. The literature of the impact of the “war on drugs” on civil liberties in the United States is vast.

Growing impact on the public: drug violence in the US and Canada appears to be on the rise and a bordering country, Mexico, is becoming unstable. Much like alchohol prohibition in the 30’s at some point the public is going to connect gang violence with drugs – at which point a wider debate may become possible.

Do I think drug prohibition is going to end tomorrow? Absolutely not. But I won’t be surprised if we see movement at the local and state/provincial level this issue. Indeed, I believe it has been gaining traction for some time.

Follow the link to get a free copy of the Cato Institute’s study “Drug Decriminalization in Portugal: Lessons for Creating Fair and Successful Drug Policies.”

Why Insite Matters

For 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?

Injection site lies

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So the conservatives have started sending around this flier which very subtly uses language to undermine the Insite injection site and harm reduction strategies. It also, of course, misleads the public about the course of action that is effective in addressing drug use. Pumping billions of dollars into a 3 decades old “drug war” that has seen drug use increase and narcotics become more available and cheaper, is portrayed as the only effective answer.

It is a fear based approach more and more people are starting to question. For example, in this piece, Mark Easton of the BBC charts how the war on drugs has actually helped grow the drug industry in the UK.

So in order to help fight the disinformation of the Conservative machine, I’ve taken a quick stab at highlighting some of the fliers problems.

Update: Turns out that the Vancouver Sun has deemed this news worthy as well. 24 hours after this post they published this story.

Wente’s disgraceful piece on Insite and harm reduction

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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.

No 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

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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.

Yaffe: the best post on the politics of Insite

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I highly recommend reading Barbara Yaffe stellar piece on the Insite injeciton site in yesterday’s Vancouver sun. In short, she points out that if Insite were in Montreal, the Conservatives would let it slide out of fear of upsetting the nationalists and treading on provincial powers. BC however, appears to be fair game.

So much for principles.

Vancouver to Cape Town: Cities coming in from the Cold

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