The Conservative 'Anti-drug Strategy': More harm than good

It's that time of year again. Time for the Conservative government to mull over whether or not to extend the exemption of Vancouver's supervised injection facility (SIF), Insite, under the Controlled Drugs and Substances Act. While they sit in caucus and ponder whether to finally show their true ideological colors and let narrow-minded social conservativism trump sound public policy, hundreds of people's lives hang in the balance.

Here's a little background. In September 2003 InSite opened its doors to injection drug users for the first time. It was the first SIF in North America and was modeled after several successful counterparts in Europe. As one of Canada's harm reduction initiatives, supported by the Portland Hotel Society, the Province of BC, and Health Canada, it targeted marginalized drug addicts on Vancouver's Downtown Eastside, who were going to inject drugs regardless. Instead of publicly injecting on the street, Insite allowed these people to use under healthcare workers’ supervision, making sure that they did not share needles, and attending to overdose events with immediate medical intervention.

InSite received an initial federal exemption for its first three years of operation, allowing users to bring their drugs to the SIF without fear of legal reprisal. In addition, the federal government granted 1.5 million dollars to an independent team of scientists tasked with evaluating the initiative. In that time, this preeminent group of addiction researchers produced approximately 30 peer-reviewed articles, documenting no increase in crime or drug use, a decrease in public injection and disorder, fewer publicly discarded syringes, a reduction in users' risk of contracting communicable diseases such as HIV/AIDS, and an increased rate of treatment-seeking amongst addicts.  These articles have been published in such influential scientific journals as the Lancet and the International Journal of Drug Policy. Currently, Insite has approximately 600 visits from people living with serious, life-threatening addictions each day.

In September 2006, the newly minted Harper government refused to renew InSite’s license for an additional three years beyond its pilot phase despite documented evidence of positive health outcomes and its contribution to restoring public order. Citing a report criticizing InSite (written by a known anti-harm-reduction activist), Canada’s Health Minister Tony Clement suggested it would be irresponsible to renew InSite’s exemption for a further three years. Interestingly, the report in question was funded by Canada’s federal police force, the RCMP, and was published by an anti-harm reduction lobby group (globaldrugpolicy.org). Clement’s comments indicate the willingness of the Canadian government to ignore dozens of peer-reviewed studies that have shown a range of benefits of the programme and an absence of any negative effects in favour of a single non-peer-reviewed prohibitionist publication. In addition, the government has placed a moratorium on any new supervised injection facilities and the Insite research programme has been halted. InSite has received only temporary exemptions since, and its latest is set to expire at the end of June 2008.

Currently, Clement and Harper are refusing to disclose whether Insite will receive another exemption. Out of frustration, the Portland Hotel Society and a group of drug users from Vancouver have taken the federal government to court. They are in BC Supreme Court, arguing that Insite should fall under provincial jurisdiction because it provides medical services. The government's lawyers are arguing that:

“The harm-reduction philosophy is not universally endorsed by experts on addiction. It may well have harms ..."

They are right. As someone very familiar with this field, I can honestly say that harm reduction is not universally endorsed. Indeed, a meagre 97% of addictions experts will testify to its benefits. Moreover, the government suggests:

"... the experts' report found no direct evidence Insite reduced drug overdose fatalities, curbed HIV infection or reduced public disorder... "

As someone who has read several of these peer-reviewed studies, I can tell you that either the federal interpretation of the word 'direct' is wrong or this is a bold-faced lie on behalf of the Harper government.

In summary, Insite saves lives. It reduces the risk of contracting hepatitis, HIV/AIDs, or dieing from drug overdoses.  It lets people's sons and daughters, brothers, sisters, parents, and friends live longer. Perhaps even long enough for  some of them to seek treatment and maybe even become reunited with family or friends. So why does a medical establishment have to take the federal government to court to continue its work? It's time for the federal government to stop toying with people lives, and give Insite a permanent exemption.