Safe Injection Sites

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Canadian Health Minister Attacks Doctors for Supporting Safe Injection Sites

The latest outrage in Canada's heated harm reduction debate came at the hands of Health Minister Tony Clement who went off the rails by questioning the ethics of doctors who practice harm reduction:

MONTREAL — The association representing Canada's doctors rapped Health Minister Tony Clement on Monday after he questioned the ethics of physicians who support the use of supervised injection sites for drug addicts.


"Is it ethical for health-care professionals to support the administration of drugs that are of unknown substance, or purity or potency, drugs that cannot otherwise be legally prescribed?" Clement said.

He said that in any other medical setting, supervised overdoses would be considered "highly unprofessional." [Canadian Press]

Canada's doctors beg to differ:

The Canadian Medical Association's president responded to Clement by saying 79 per cent of members agree that safe-injection sites and harm-reduction programs work.

Dr. Brian Day said sites that allow addicts to inject their own narcotics under the supervision of medical staff have been successful in curbing illegal drug use and slowing the spread of disease.

"We specifically take issue with the minister using that phrase," Day told reporters after Clement's speech.

"The minister was off base in calling into question the ethics of physicians involved in harm reduction.

"It's clear that this was being used as a political issue."

Doctors are not politicians. They work to save lives and they are the experts on how to do that. If they all agree that existing programs are working, and some politician disagrees, then he is just wrong and he should shut up.

The drug war debate is ugly and that's not gonna change anytime soon. But one thing we can do without is politicians feigning moral superiority over the doctors who are saving lives every day. That's what this is about. Harm reduction shouldn't be a political issue and if you succeed in politicizing it for the wrong reasons, people will die.

Canada: Quebec to Open Series of Safe Injection Sites

Spurred by a favorable court ruling in May allowing Vancouver's safe injection site, Insite, to stay open, health officials in Quebec say they are preparing to open a safe injection site in Montreal in coming months, and there could be many more to follow in the province.

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InSite (courtesy Vancouver Coastal Health)
So far, InSite is the only safe injection site in North America, but the idea of creating a network of such sites is already part of Quebec's public health plan. Officials there told the Canadian Press they are working to establish the Montreal site soon.

"There is a team in Montreal looking at the feasibility and acceptability of all this, but there is no date set yet," said public health director Alain Poirier. "We're working on it at the moment and we hope there will be one soon."

Vancouver's Insite, which was set up as a pilot project five years ago, operated under a limited exemption from Canada's drug laws. With the Conservatives controlling the federal government, Insite's future was precarious, but in May, the British Columbia Supreme Court ruled that Insite is a health facility subject to provincial -- not federal -- regulation and thus constitutionally exempt from federal drug laws. That ruling has cleared the way for other provinces to ponder starting similar facilities.

"It's an interpretation that views injection sites as health services and those are under provincial jurisdiction," Poirier said, referring to the ruling. "We're the ones who pay for the treatments of (addicts), we pay for their care if they contract HIV. It short, it falls under the panoply of preventive services."

But the Conservative federal government continues to oppose safe injection sites. Earlier this month, it announced it would appeal the BC Supreme Court ruling. Health Minister Tony Clement has repeatedly claimed that safe injection sites don't work.

"We don't consider it the best health outcome to keep people in a position where they continue to use the illicit drugs, to inject the illicit drugs," he said in May.

Quebec has already embraced harm reduction strategies to combat the ills of drug abuse. The province boasts nearly 800 needle exchange locations. Poirier said establishing safe injection sites was the logical next step.

"We can't do this in hiding without saying or announcing anything," Poirier said. "The public has to be aware that this is one step more. We'll probably start in Montreal, then look at Quebec City's downtown area," Poirier said. "We haven't ruled out other cities being chosen. We would like to have sites where they are justified by the need."

Public Forum on InSite and Harm Reduction

As you may know, the BC Supreme Court recently ruled that the application of Canada's Controlled Drugs and Substances Act in regards to InSite, Vancouver's Supervised Injection site is inconsistent with Section 7 of the Charter of Right and Freedoms, protecting life and security of the person. As a result, Justice Ian Pitfield's judgment grants InSite a permanent constitutional exemption from federal drug laws, allowing InSite to legally continue its life saving work. This was a unique court decision and has implications for communities across the country. Each community has its own drug problems to be dealt with in a unique manner, and this public forum will allow for discussion about these issues, as well as provide an opportunity to learn about other harm reduction initiatives around the world. Speakers will include Liz Evans, the founder and executive director of the Portland Hotel Society - the non-profit that operates Vancouver's supervised injection site, and Tony Trimingham, an Australian advocate for supervised injection sites whose own son died as the result of a drug overdose. Please RSVP to info@communityinsite.ca, as seating at these forums will be limited, and are expected to fill up quickly. If you are not in the Toronto area, please forward this invitation to anyone you know who does live close by. Thank you for your interest - we look forward to seeing you.
Date: 
Thu, 07/17/2008 - 7:00pm
Location: 
100 Queen St. West
Toronto, ON
Canada

Press Release: Groundbreaking founder says goodbye

FOR IMMEDIATE RELEASE: July 7, 2008 CONTACT: Rev. Harry Herbert, Executive Director, UnitingCare NSW & Tony Trimingham, founder of the Damien Trimingham Foundation. To organise an interview, please call Mardi Stewart on 0402 231 142. Groundbreaking founder says goodbye It's been a long and arduous journey for Dr Ingrid van Beek who as the medical director of Australia's first Medically Supervised Injecting Centre (MSIC) has put her heart and soul into this ground-breaking public health initiative over the past eight years. Today, in an historic announcement, Dr van Beek announces her resignation as its inaugural Medical Director. "It's been a great privilege to work in a field that I have such a strong commitment and passion for. My only disappointment is that the MSIC continues to operate on a trial basis," says Dr van Beek. The Kings Cross service received a four-year trial extension by the NSW Government in June last year, making it a ten and a half year scientific trial. "It's important the MSIC is judged on its health outcomes and it is now well-established the MSIC has been effective in reducing the various drug-related harms associated with street-based injecting to both individual drug users and the greater community," says Dr van Beek. The statistics speak for themselves: - 80 per cent of long term local Kings Cross residents and 68 percent of local business managers support the MSIC. - Over 10,000 injecting drug users have registered to use the MSIC to date. - More than 200 injecting episodes occur at MSIC every day i.e. in a clinical setting where in the event of a medical emergency eg overdose, specially trained registered nurses provide prompt and effective resuscitation. These injecting episodes would have otherwise occurred in unsupervised, often public and squalid circumstances in the local environs where timely help is in the lap of the gods. - 2,458 drug overdoses have been successfully treated onsite in the past seven years. - Ambulance callouts to heroin overdoses in the area have decreased by 80 percent thereby freeing Ambulance services to attend other medical emergencies in the area. - MSIC staff have referred drug users to other services including drug treatment and rehabilitation programs on more than 7,000 occasions to date. "One of the highlights of my time spent at the MSIC is seeing first hand staff helping drug dependent users who are often in desperate personal circumstances and leading socially isolated lives. I am humbled to know we have helped these people get their lives back on track." says Dr van Beek. "My one hope is that the MSIC's trial status is revisited prior to the next State election. The MSIC's apparently endless trial status is a barrier to its integration with the rest of the public health system affecting continuity of care, workforce development and staff morale, especially as the end of each trial period draws near. It also ensures that the service remains politicised; the work we do is too important to be subject to partisan politics," says Dr van Beek. Rev. Harry Herbert, Executive Director, UnitingCare NSW says without the insight, personal dedication, political acumen, tenacity and determination of Dr van Beek, the MSIC would not have succeeded as it has. "Ingrid made the dream a reality. She played an integral part in establishing the MSIC. She has been an inspiration to the staff, clients, businesses and community members associated with the MSIC." "Ingrid is congratulated and should be recognised and admired for her work in preventing and reducing drug-related harm and communicable diseases amongst one of society's most marginalised groups - injecting drug users," says Rev Herbert. Dr van Beek was recently inducted into the National Drug and Alcohol Awards Honour Roll for her tireless and significant contribution to the drug and alcohol field over many years. The Awards are a collaborative effort of the Ted Noffs Foundation, The Australian Drug Foundation, The Alcohol and Other Drugs Council of Australia and the Australian National Council on Drugs. Dr van Beek is returning to her original post as the full time Director of the Kirketon Road Centre in Kings Cross. Dr Marianne Jauncey, a public health physician, will take over as the Medical Director of the MSIC in the coming weeks. Dr Jauncey started her public health career working at the clinical coalface at the nearby Kirketon Road Centre, so she is well placed to take on this important role.
Location: 
NSW
Australia

Feature: Amsterdam, Connecticut? Drug Reformer With Bold Vision Seeks State Office, Radical Change

Like the rest of inner city America, Bridgeport, Connecticut's 130th District has for decades been ground zero in the war on drugs. Mostly black and Latino, like other majority minority neighborhoods across the land, it has suffered the twin ravages of drug abuse and drug prohibition. Now, a former drug-fighting Navy officer turned drug reformer is seeking to change all that with a bold vision and an upstart bid for the state House of Representatives.

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Sylvester Salcedo (2nd from right)
In late May, Bridgeport attorney Sylvester Salcedo announced he was seeking the Democratic Party nomination for November's House race in the 130th. Salcedo is best known in drug reform circles for being the first and only former military officer to protest the drug war by sending back his Navy and Marine Corps Achievement medal to then President Bill Clinton.

"Narcotics use and abuse is our problem here at home," he wrote at the time in a letter sent to Clinton. "The solutions should be applied here and not in Colombia or elsewhere. To spend this additional amount of money overseas is wasteful and counterproductive."

Fast forward eight years and little has changed. The war on drugs continues apace, drug arrests and drug war prisoners reach new highs every year. The violence associated with drug prohibition continues to plague cities like Bridgeport. And Salcedo has had enough.

"The war on drugs is one of our nation's longest wars, at home and abroad," he said as he announced his candidacy May 29. "It is senseless, wasteful and counterproductive. It is highly discriminatory on a racial and economic basis. I said so on the steps of the US Congress in Washington, DC flanked and supported by Minnesota Republican Congressman Jim Ramstad and California Republican Congressman Tom Campbell in the summer of 2000," he said.

"Eight years later, the conditions are the same, if not worse, especially for the isolated and abandoned residents of ethnic minority enclaves and neighborhoods like the 130th District," Salcedo continued. "I want to win this State Representative seat to be a leader of change. I want to lead the way to peace, understanding and cooperation, not through the politics of fear, and racial and ethnic discord and conflict. This senseless war on the poor and the voiceless must end."

Salcedo is not one for half-measures. He is proposing turning the 130th District into a sort of mini-Amsterdam, a zone of drug tolerance replete with safe injection sites, opiate maintenance facilities, and taxed and regulated marijuana sales. "I'm floating around this idea of the Covenant of the 130th District, which is to declare the district as a zone of tolerance," he said.

"I want to borrow from models like Amsterdam or Frankfort," he elaborated. "I'm not pushing legalization legislation, but acknowledging the fact that the 130th is a high drug trafficking and consumption area, from marijuana to heroin to cocaine. I want to try those approaches here. If you live in the district and are a heroin addict, we would work with you, whether it's a treatment and rehabilitation regime or a maintenance regime. If you select maintenance, you get the level of pharmaceutical grade heroin you need. In either case, you get medical, psychological, and social services, an intake exam, a social worker and a drug counselor to work with you. But this won't be a coercive or punitive program; instead it will be designed to develop the relationship with the addict."

Citing Bridgeport's chronically under-funded schools, libraries, and other services, Salcedo also called for regulated marijuana sales as a revenue raiser. "I want to open up a number of marijuana coffee shops in this district," he said. "They could be city sponsored, or they could be a joint private-public project. If people want to come here and imbibe, we will welcome them, let them pay the market price, and tax their purchases. The profits can go to the city general fund, or, if it's a joint venture, a share to the entrepreneurs," he said. "We will follow the experience of Amsterdam, with the police working collaboratively, so they're not arresting people coming from the coffee shops."

Salcedo's will undoubtedly be an uphill battle against the entrenched Bridgeport Democratic Party political establishment and to convince skeptical voters that more of the drug war same old same old is not the solution. But he has already passed the first hurdle by getting 290 district residents to sign his nominating petitions. Now he has to raise $5,000 by August to show he is a viable candidate and qualify for another $20,000 in primary funding from the state of Connecticut. At least 150 Bridgeport residents must donate to his campaign for him to qualify. (That doesn't mean people from outside Bridgeport or Connecticut cannot donate -- they can.)

He can do it, Salcedo said. "The primaries are eight weeks away, and nobody expected me to even get the required signatures, but I did. And I met every person who signed my nomination papers. I think I can meet this challenge, too."

He's going to need some help, from the drug reform community at large and from Connecticut activists in particular if he is to have a chance. One prominent Connecticut drug reformer, Efficacy founder and 2006 Green Party gubernatorial candidate Cliff Thornton is among the first to step up.

"I'll definitely be going down there and doing a few things for Sylvester," said Thornton. "I have to help the reformer."

One thing he will advise Salcedo to do is put his drug reform message in the background. "We'll try to sharpen his message," Thornton said. "He doesn't have to lead with drug policy. He's already known as the drug reformer, and he won't have to talk about it because people are going to ask him about it.

Another thing Salcedo can do is try to tie drug reform into other issues facing the community, Thornton said. "We're spending somewhere between $600 million and $800 million on prisons in Connecticut every year," he said. "If we took that and put it toward health care, we could take care of everyone in the state. That's the kind of connection we need to be drawing."

It would be a good thing if national drug reform organizations provided more than token support, Thornton said, looking back at his 2006 campaign. "When it came to actually supporting that run, everybody disappeared," he said. "The flagship organizations sent a few bucks here and there, but not enough to make a difference. And that's a shame. We are starting to elect good drug reform politicians, like Roger Goodman in Washington state and Chris Murphy here in Connecticut. Their opponents attack them as soft on drug policy, and they go up in the polls. We can elect people, if we support them," Thornton said.

Salcedo could use the help, he said. "Right now this is basically a one-man campaign, and I have a full-time job."

Still, he said, he may be able to pull off a surprise victory. "This is going to be a low turnout election, no other issues on the ballot here, and the only reason people are likely to go to the ballot box is to vote for me for change or because they're tied to one of the establishment candidates," he said. "In this district in this election, maybe 200 or 300 votes can win it. I'll be beating the bushes and talking face to face with people. I'll do everything I can, and then it's up to the voters.

(This blog post was published by StoptheDrugWar.org's lobbying arm, the Drug Reform Coordination Network, which also shares the cost of maintaining this web site. DRCNet Foundation takes no positions on candidates for public office, in compliance with section 501(c)(3) of the Internal Revenue Code, and does not pay for reporting that could be interpreted or misinterpreted as doing so.)

Europe: Scottish Parliament Think-Tank Calls for Prescription Heroin, Safe Injection Sites, Legalized Marijuana

A think-tank established by the Scottish parliament and tasked with looking at new approaches to drug policy has issued a report calling for radical changes in the way Scotland deals with the damage of drug and alcohol use. Parliament asked the think-tank, the Scottish Futures Forum, to determine how the country could cut the damage in half by 2025.

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Urquhart Castle on Loch Ness, Scotland (photo from Sam Fentress via Wikimedia)
The forum's report, Approaches to Drugs and Alcohol in Scotland: A Question of Architecture, landed like a stink-bomb in the middle of the ongoing Scottish debate over drug policy, which in recent months has been dominated by calls for a renewed "tough" approach to drug use and trafficking. It recommended that all substance use, including legal drugs like alcohol and tobacco, should be subsumed under a single policy dominated by a public health approach and was harshly critical of over-reliance on the criminal justice system to reduce the harms caused by substance use.

"Historically, we have seen, in particular, drug use mainly as a justice issue," the report noted. "This is mistaken and alcohol and drugs should be seen predominantly as a health, lifestyle and social issue to be considered along with smoking, obesity and other lifestyle challenges. The current level of enforcement activity tackling low level use of illegal drugs may not be the most effective deployment of enforcement resources and is likely to fail in reducing drug and alcohol related damage by half by 2025. It should be recognized that sending people to prison for low-level alcohol and drug-related crime is unproductive and probably unsustainable."

Instead of current policies, Scotland should shift to evidence-based policies emphasizing a public health approach, the forum said. Such policies would include consideration of safe injection sites to reduce the spread of infectious disease, prescribing of heroin to addicts, and the taxation and regulation of marijuana. More resources should go to prevention and treatment of substance abuse, as opposed to law enforcement, the forum said.

The Scottish government was not pleased, and a spokesman ruled out any quick establishment of safe injection sites. "There are complex legal and ethical issues around consumption rooms that cannot be easily resolved," the spokesman said. As for prescribing heroin, Scotland will "wait and see" how pilot programs in England are working out, he said.

Scottish Conservatives were appalled, with Tory leader Annabel Goldie calling safe injection sites "shooting galleries" and saying they and marijuana legalization were ideas out of the past.

But Liberal Democrats were more open. Their spokeswoman, Margaret Smith, said: "Drugs misuse is a global problem and if other countries have developed new and radical solutions, then it is sensible to consider them for use in Scotland."

Feature: BC Supreme Court Rules Vancouver Safe Injection Site to Stay Open, Federal Drug Law Controlling It Unconstitutional

In a ruling that stunned and very pleasantly surprised advocates for Vancouver's Insite safe injection site, the British Columbia Supreme Court Tuesday held that Insite can stay open indefinitely. Canada's federal drug law is unconstitutional when applied to Insite because it conflicts with the Charter of Rights and Freedoms and health matters that are a provincial responsibility, the court held.

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InSite (courtesy Vancouver Coastal Health)
The future of Insite has been a bitter political battle between the Conservative federal government of Prime Minister Stephen Harper and harm reductionists, scientists, academic specialists, and broad swathes of the Vancouver community, including Mayor Sam Sullivan and BC Health, the provincial health agency. Begun in 2003, under Harper, Insite has limped along on a series of temporary exemptions from Canada's drug law. The latest was set to expire June 30, and a campaign to save it was in full swing when the court made matters moot.

While the political fight was brewing, some actors sought recourse in the courts. Represented by Vancouver attorney John Conroy, the Portland Hotel Society, which operates Insite for BC Health, and the Vancouver Area Network of Drug Users (VANDU) filed suit in the provincial courts seeking protection for the site, and in particular, for workers at the site who might be at risk under the federal drug law. By imposing an absolute, unqualified prohibition on the possession of controlled substances, the law prevented access to Insite and its health services. That was an improper expansion of the federal government into what should be a provincial sphere, they argued. It was this lawsuit that brought Tuesday's victory.

In his ruling in PHS Community Services Society v. Attorney General of Canada, Justice Ian Pitfield declared part of the Controlled Drugs and Substances Act unconstitutional and null and void, and gave Ottawa one year to rectify the law so it does not interfere with medical treatment. In the meantime, Pitsfield declared, Insite is constitutionally exempt from the drug law.

"In my opinion," Pitfield wrote, "section 4(1) of the CDSA, which applies to possession for every purpose without discrimination or differentiation in its effect, is arbitrary. In particular it prohibits the management of addiction and its associated risks at Insite. It treats all consumption of controlled substances, whether addictive or not, and whether by an addict or not, in the same manner. Instead of being rationally connected to a reasonable apprehension of harm, the blanket prohibition contributes to the very harm it seeks to prevent. It is inconsistent with the state's interest in fostering individual and community health, and preventing death and disease."

The drug law blocks addicts from receiving health care that could reduce their chances of overdose or death by infectious disease, and that violates their rights under the Charter, Pitsfield wrote. "While users do not use Insite to directly treat their addiction, they receive services and assistance at Insite which reduce the risk of overdose that is a feature of their illness, they avoid the risk of being infected or of infecting others by injection, and they gain access to counseling and consultation that may lead to abstinence and rehabilitation," he said. "All of this is health care."

He pointed out that people who drink alcohol or smoke tobacco to excess aren't denied treatment. "I do not see any rational or logical reason why the approach should be different when dealing with the addiction to narcotics," he wrote. "Simply stated, I cannot agree with Canada's submission that an addict must feed his addiction in an unsafe environment when a safe environment that may lead to rehabilitation is the alternative."

Advocates for Insite, who fought for years to create it, then again to keep it going in the face of the ideological opposition of the Conservatives, wavered between ecstasy and disbelief. "I just want to cry, I'm so ecstatic," Liz Evans, one of the directors of PHS, told the Vancouver Sun.

"This is a significant victory for the people in our community," said New Democratic Party provincial parliamentarian Jenny Kwan, in whose district Insite is located.

NDP Member of Parliament Libby Davies, who represents the district at the federal level, went on the offensive in Ottawa Wednesday. "Mr. Speaker, yesterday BC's Supreme Court decision makes it abundantly clear that Insite, the supervised injection facility in east Vancouver, is a health facility," she said during parliamentary questions. "The ruling also makes it clear that closing Insite would be 'inconsistent with the state's interest in fostering individual and community health and preventing death and disease.' Can the Minister of Health assure the House today that his Conservative government will abide by the court's decision and not appeal this important case?"

While Health Minister Tony Clement denied any responsibility for any decision on an appeal, he let it be known his government was not happy. "We are disappointed with the judgment," he responded. "We disagree with the judgment. We are, of course, examining our options and I would say to the House that we on this side of the House care about treating drug addicts who need our help. We care about preventing people, especially our young people, from becoming drug addicts in the first place. That is our way to reduce harm in our society and we are proud of taking that message to the people of Canada."

"If the Minister of Health claims that he cares about people who use drugs and the issues they face, then he will respect the decision of the court," Davies retorted. "The medical, scientific and now legal conclusions just could not be any clearer. Insite is a life-saving facility and harm reduction is an essential component of Canada's drug strategy. When will the minister put aside his personal ideological position, respect the court's decision and get to work on changing Canada's drug laws to allow access to health facilities such as Insite? When is he going to do that? He is taking too long."

Clement did not respond, except to say, "We are here to help our kids, prevent them from getting on drugs in the first place. We are here to help addicts."

If he wants to help addicts, Clement should quit opposing the safe injection site, said the Canadian HIV/AIDS Legal Network. "The court has recognized that criminalizing drugs and drug users cannot be allowed to deny people the benefits of a health facility such as Insite, and that to do so would violate the constitutional rights of some of those who are most vulnerable and in need of such health services," said Richard Elliott, the network's executive director.

"It's time to end the waffling and misdirection that we've seen so far," said Elliott. "The evidence is extensive and shows the benefits of such health facilities, including reducing injecting behavior that risks transmitting HIV and hepatitis C. Ideology cannot be allowed to block the delivery of health services and perpetuate a public health crisis."

Update: Late Thursday the government announced it would appeal the decision.

Feature: Vancouver's Safe Injection Site Fights for Its Life -- Again

The only officially-sanctioned safe injection site in North America, Vancouver's InSite will have to close its doors June 30 if the Canadian federal government does not extend its exemption from Canada's Controlled Drugs and Substances Act. But while the Conservative government of Prime Minister Stephen Harper has made no secret of its distaste for the program, it has very strong community, local, provincial, and international support, and its supporters are now engaged in a strong campaign to ensure its continued existence.

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InSite (courtesy Vancouver Coastal Health)
Situated on Hastings Street in Vancouver's Downtown Eastside, home to one of the hemisphere's largest concentrations of hard drug users, InSite has operated since 2003, when it was granted a three-year exemption by the then Liberal government. With the advent of Conservative government, with its ideological opposition to programs that "encourage" or "facilitate" drug use, InSite's continued existence has been shaky. Twice, the Conservatives have granted the program temporary 18-month exemptions, saying that more research on its efficacy was needed.

But now, after five years of monitoring and evaluation, the results are in: According to peer-reviewed scientific studies, InSite increased the use of addiction treatment services, increased the use of detox services, reduced needle sharing, led to improvement in neighborhood public order and quality of life, resulted in no increase in drug-related crime, prevented overdose deaths, and helped reduce the spread of HIV/AIDS among drug injectors.

As if the nearly two-dozen studies of InSite were not enough, the Conservative government last year commissioned its own study, "Vancouver's INSITE service and other Supervised injection sites: What has been learned from research?," which was released in early April. According to Simon Fraser University criminologist Neil Boyd, who was hired by the government to advise the committee overseeing the study, the research shows that InSite has no apparent negative impacts, has resulted in "modest decreases" in drug use, and has not disturbed public order.

In fact, said Boyd at a press conference announcing his findings, InSite should not only be continued, but the program should be expanded to other locations. "I think our data suggests... the building of additional facilities of a similar kind in neighborhoods where they are needed would yield benefits much in excess of the costs required for such projects," he said.

That's unlikely under the Harper government, which is ideologically opposed to such harm reduction practices and in fact removed funding for them from its anti-drug budget. As Harper put it last October: "Because if you remain an addict, I don't care how much harm you reduce, you're going to have a short and miserable life."

Harper has also scoffed at empirical evidence when it conflicts with his agenda. In a January speech to party faithful, he mocked opponents who cited falling crime statistics in challenging his emphasis on law and order. "They try to pacify Canadians with statistics," said the prime minister. "Your personal experiences and impressions are wrong, they say; crime is really not a problem."

More recently, Health Minister Tony Clement and his underlings have sounded similar themes. Science would not be the only factor in determining whether to continue InSite's exemption, Clement's undersecretary, Winnipeg MP Steven Fletcher told The Canadian Press earlier this month. While the government would make a "rational and thoughtful decision based on science," it must also take into account "the realities of the situation," Fletcher explained. "There's multiple sides to this and they all have to be taken into consideration," said Fletcher.

When pressed in parliament by Vancouver East MP Libby Davies, a staunch InSite supporter, Clement vowed to make a decision before June 30 and responded to her criticism about rejecting the science supporting the program: "We are the government that actually wants more research, that actually commissioned more research because we want to make sure this decision is the right decision for Canada, for addicts and for the community in Vancouver," he said. "That is the decision we have made, more research and more consideration. That is because we are open-minded and we want to make the best decision for Canada and Canadians."

Now, as the June 30 deadline looms, InSite's supporters have mobilized. Already this month, the International Journal of Drug Policy published articles by scientists from around the world condemning the federal government for interfering politically with the site's research, Boyd held his Ottawa press conference, advocates held a rally in a Downtown Eastside park featuring 1,000 white crosses to symbolize the people who didn't die from drug overdoses while injecting at InSite, Vancouver street nurses picketed the office of the Vancouver Police Union, whose president is a leading critic of the site, BC Nurses Association president Debra MacPherson held a press conference to tout the health benefits of InSite, and all three BC civic parties have signaled their joint support of the program.

"We're fully behind the effort to keep InSite open," said David Hurford, director of communications for Vancouver Mayor Sam Sullivan. "It is part of the solution, not part of the problem, and it is a bottom-up solution from the grassroots. The federal government has said it supports grassroots decision-making, so why should bureaucrats from 3,000 miles away be making decisions for us here?" he asked.

The mayor's office is "working with local stakeholders to help communicate the benefits of InSite," said Hurford. "We wrote to the health minister last week asking him to keep the site open, and at a minimum, to extend the permits until all pending legal issues are heard."

Hurford is referring to a lawsuit pending in the BC courts that challenges Health Canada's jurisdiction over InSite. That suit argues that since under Canadian law, health care is the domain of the provinces, the federal government should not have control over InSite. But that lawsuit will not be settled by the end of next month.

Opposition politicians have also joined the fight. "This government chooses to view harm reduction as nothing more than dirty words, at the expense of protecting the safety and health of Canadians," said Liberal Party public health spokesperson Dr. Carolyn Bennett.

"The results from the InSite project show measurable evidence that it saves lives," said Liberal MP Dr. Hedy Fry, who played a key role in bringing the agreement that allowed InSite to open. "This has won it widespread support not only from experts in Canada but from the international scientific community, from the Vancouver police and from residents of the Downtown Eastside," said Dr. Fry. "It is simply irresponsible to ignore scientifically-based proof of the efficacy of harm reduction programs like this, and base public policy on ideology alone because real people suffer the consequences."

"The Conservative government must stop its unconscionable interference in scientific research on Vancouver's safe injection site," added New Democratic Party MP Libby Davies, who represents the Downtown Eastside. "Medical researchers from the University of British Columbia have revealed that Harper and his team have been suppressing evidence and denying funding to scientists who are looking objectively at the merits of Insite," she said.

"More than 20 medical and academic studies have been published showing the health and social benefits of InSite. We now have both scientific fact and evidence from users in our community that this facility is helping, not hurting the people of our city. The research record shows that Insite saves lives and increases public safety," Davies continued. "Harper doesn't understand that you can't just hide the facts whenever they don't suit your political agenda. We need a change in direction. It's time for this government to make decisions based on evidence instead of ideology -- InSite needs to be kept open."

"What we want is a 3 ½ year renewal of the exemption from the Controlled Substances Act," said Nathan Allen of InSite for Community Safety. "The fact that the Harper government has not granted this renewal shows they are very reluctant to support the community."

While the Harper government has previously said it needed more research to evaluate InSite's efficacy, that dog won't hunt anymore, said Allen. "They've already spent more than $1.5 million studying InSite, they've produced two dozen academic papers, and they've concluded that it has all kinds of positive impacts. We're wondering what questions the government has left to ask," he scoffed. "InSite has undergone the most thorough and well-funded scrutiny of any health clinic in the country."

In the event the government refuses to grant another exemption, Allen said he hoped it would respect provincial authority and local autonomy. "This has been a regional response to a local crisis here in Vancouver. We need to let the people here on the ground do what they need to do. If not, people will die," he predicted bluntly.

The clock is ticking for InSite, but the pressure is mounting on the Harper government. The next few weeks will determine if that pressure is sufficient to overcome the government's ideological opposition to the safe injection site.

If You Oppose Harm Reduction, You Support AIDS and Death

The Drug Czar's blog has been very concerned about harm reduction lately. They've taken the counterintuitive position of opposing efforts to save the lives of drug users, which seems like a strange choice. Now I understand why: they think harm reduction is the opposite of what it actually is.
These so-called "harm reduction" strategies are poor public policy because their underlying philosophy involves giving up on those who can successfully recover from drug addiction. [PushingBack.com]
This is wrong for a very simple reason: you cannot recover from addiction if you're dead. Harm reduction programs are not an alternative to treatment, rather they go hand in hand. Harm reduction keeps people healthy and alive, thereby creating opportunities for them to subsequently recover from addiction.

We could do nothing. That would be "giving up." We could ask drug addicts to either quit or die. That would be "giving up." Instead, harm reduction activists have taken to the streets and attacked this problem directly. They've studied the leading causes of death among drug users and created programs to reduce those casualties. That's the opposite of giving up.

Just pretend for a moment that you're cruel and you want drug users to die in large numbers. How would you go about it? Well, you would begin by eliminating regulated distribution so that users are forced to obtain unsafe products from criminals on the street. You would reduce access to clean needles in order to spread AIDS. You would enforce criminal sanctions against users so that they're afraid to seek help. And you would lobby aggressively against anyone who's studied the problem and proposed programs to reduce AIDS and overdoses.

Now I'm not saying the Drug Czar wants to kill people. I'm just saying he presides over a policy that is perfectly tailored to achieve that outcome. And he dares to suggest that the people out there working with addicts and saving lives are the ones who've given up.
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Sign-on letter to San Francisco officials in Support of a Safer Injection Facility

[Courtesy of the Harm Reduction Coalition] By changing San Francisco, we change the world A major part of addressing the expanding HIV/AIDS and overdose mortality rates in the United States is good public policy. The legacy of democracy is that when elected officials falter on implementing public policies that save lives, the public itself must step forward and urge those officials to take a stand. We need 200 signatures by December from organizations and individuals living or working in San Francisco on a petition that will be delivered to the desk of Mayor Gavin Newsom, the San Francisco Board of Supervisors, and the San Francisco Department of Health Director Mitchell Katz demanding that our city create a legal safer injection facility to reduce the number of deaths by overdose and to curb the transmission of HIV and Hepatitis C. Your activism does make a difference. With your support we were able to beat back an amendment in Congress by conservative South Carolina senator Jim DeMint that sought to ban all federal funding from any city that chose to slow the spread of HIV/AIDS and save lives through the creation of a safe injection center. Join our petition to Mayor Newsom and help to save lives. Visit our website and sign our online petition today. http://www.democracyinaction.org/dia/organizations/HRC/petition.jsp?peti... Other nations around the world have built 65-safer injection facilities in twenty-seven cities and eight nation, let's make San Francisco the first city in the U.S. to create one and begin a national trend that starts putting lives above politics. Hilary McQuie, Western Regional Director Harm Reduction Coalition www.harmreduction.org mcquie@harmreduction.org
Location: 
San Francisco, CA
United States

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