Tag Archives: needle-injection-site

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?

Our New/Old Drug Policy: Welcome to the 1980s

The Tories are beginning to lay down the ground work for a new (or should we say old) drug strategy.

The ‘new’ strategy? A TV campaign informing kids that drugs are bad, an increased presence at the border and a slight increase in funding for drug rehabilitation. If it sounds like the 1980s all over again, it is.

Ironically, it is being billed under the new tagline: “Enforcement is harm reduction.”

This is bad news for all of us. The tentative progress of the last decade is about to be lost in one fall swoop, including of course, Vancouver’s Insite injection site.

Let’s be clear, enforcement is not harm reduction.

There is no evidence to suggest that an increased police presence will have any impact on the drug problem in Vancouver, or anywhere else in the country for that matter. Indeed, American’s 36 year old war on drugs demonstrates otherwise. My question to Tony Clement is: what are doing that Nixon (who coined the term “war on drugs“), Carter, Reagan, Bush Sr., Clinton, Bush Jr., and previous Canadian governments, didn’t try? With only a fraction of the resources America dedicated to similar campaigns, explain to us why this policy will be success?

In short, Clement’s strategy is analogous to yelling at a non-english speaker when they don’t understand you. It’s a strategy – and for some people it feels good – but it accomplishes nothing. This is because the problem isn’t that they can’t hear you – it’s that they don’t understand you. Similarly, it’s not that many drug users don’t know drugs are bad – or haven’t seen warning messages – it is that they have come to a place where they are truly dependent. Screaming at them, arresting them, and legally marginalizing them isn’t going bring them into the fold and increase the likelihood they’ll seek treatment – if anything it will accomplish the opposite. I would love to see Clement in the downtown eastside, yelling at users to seek treatment. It would be about as alienating and as effective as it sounds. Contrast that to the injection site’s strategy of developing a relationship with users over time, and keeping the door open for when they are ready. Is it ideal? No, nothing about the world of drugs is ideal. But at least it works.

The simple fact is, Clement wants to overturn a program that enjoys the support and cooperation of the Vancouver Police Department, local community leaders, local business leaders, and Vancouver Costal Health. Still more problematically, Clement wants to replace a program supported by evidence and science with one based on ideology and fear.

The benefits of the injection site and harm reduction strategies are clear. They include:

  • Saving lives by:
    • Reducing overdose fatalities
    • Reducing injection-related infections such as HIV and Hepatitis C
    • Increasing access to addiction treatment programs
  • Improving public order by:
    • Reducing public injections
    • Reducing drug-use related public disorder
    • Reducing drug related waste (such as needles) in public spaces
  • Reducing healthcare and policing costs associated with drug-use by:
    • Reducing emergency room visits
    • Reducing use of ambulatory and emergency response services
    • Reducing police resources dedicated to drug-use related public disorder

If the Conservatives aren’t interested good public policy, policy that saves lives, improves public order and reduces healthcare costs… so be it. But I am certain they are interested in electoral outcomes. Given the injection site’s support in Vancouver (the last polls show it receives a 70% support rate) it will be difficult to secure a seat in the city if the Insite injection site is perceived to be on the chopping block. With Emerson stepping down, the Conservatives won’t have a single MP from one of the country’s three largest cities. If evidence and science can’t persuade them, maybe, just maybe, electoral math can.

For myself, the Insite injection site is what re-invigorated my interest in municipal politics. I hope it survives the December 31st exemption renewal deadline. Otherwise, I’d hate to be the politician who saw Insite go down on their watch – I know I’ll be volunteering for who evers campaign is opposing theirs.