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Injection drug problems, infection rates skyrocket in the north

February 18th, 2009 · 12 Comments

I have a story in today’s Globe about a resolution from the Health Officers Council of BC that calls for supervised-injection sites in all B.C. communities that need them. The most interesting part of doing that story, for me, was talking to Dr. David Bowering in Prince George and hearing about the escalating drug problem there — a significant reason why medical health officers there support the concept of an SIS.

I wasn’t able to get any of the opponents of injection sites by the time my story was printed, but Colin Mangham did reach me after my deadline had passed. I append his comments here.

I am not at all surprised there would be no opposition to the call from Medical Health Officers. Most do not know a lot about or really follow the issue and all are very busy.  None I would think would be inclined to stick their neck out the least bit, if they did read up on the issue, or were not partners in the ideology of INSITE. The Provincial Health Officer has long advocated for outright legalization – the necessary partner to harm reduction. He is on record as being so and the MHOC, a separate group of which he is part, also advocates for harm reduction/legalization. Many others more involved with INSITE including some of the researchers, the city drug czar, Centres for Excellence, VCH civil servants dealing with the DTES, are also strong believers in harm reduction ideology and have spoken out for it on many occasions. While having such views and bias is perfectly fine, remember these are also the people responsible for drug policy and public drug program dollars. Their bias has become reality at our expense.  Along with this bias, we have seen treatment dwindle terribly, no primary prevention programs for schools or communities, and for want of a better word, mockery of police and enforcement.  Before INSITE was even planned, these people were calling for drug maintenance programs and injection sites to be a major part of drug policy in future. I for one am willing to state emphatically that not in Canada, nor anywhere else in the world, have these programs proven successful – just about every report one sees shows obvious fundamental problems in controlling behaviour while not dealing with the drug use and addiction themselves. I stand behind what I found when I reviewed the research reports on INSITE. Among all the correlations and suggested effects, I see no actual unique or attributable impact of INSITE on disease, treatment uptake, deaths, or crime. Such is not shown in any of the papers regardless of the journal they are in. Moreover the INSITE research is fundamentally lacking as it compares itself to nothing- there is not a second treatment to which it is being compared other than the status quo, largely created by the people pushing INSITE and its parent philosophy.
Most addiction MD’s you will talk to, if they are not concerned with reputation or job, will tell you treatment remains the only real hope for the addict.  Treatment works. Treatment reduces disease, crime, death. But instead of more treatment, we are being asked to support more INSITES.
I have found it ironic that I and other critics of INSITE have been labelled ideologues, who “trump science” with that ideology. Even though INSITE remains without an evidence base to justify its continuation, these people are willing to push for its replication and attack anyone who disagrees and seem so tied to the ideology of harm reduction that INSITE has become for them a hold at all costs beachhead.
While this is happening, many older institutions in the DTES who have done so much are being pushed aside because the harm reductionists don’t want ‘moral baggage.’   Give them a call.
INSITE is a classic “foot in the door” harm reduction measure. This is why it and its promoters are extolled by about every legalization lobby group on the web, and why if you Google my name you’d think I was a heretic worthy of burning at the stake. (Well maybe not quite burning – just censoring. The intent to permanently ensconce it along with drug maintenance programs – the next step – was made evident in federal discussions 10 years ago – before there was ANY evidence.  Now, with sketchy, weak evidence, and with significant evidence of weak or no actual impacts, it is being pushed ahead. if ever there was science trumped by ideology, this is it.
My heart aches at the hopelessness of a place that exists to provide a place for people to inject themselves with the drug that is killing them, and I feel real anger that supposedly intelligent people are pushing to replicate it at our, and the addicts’ expense. Especially at the addicts expense. I challenge these people’s real belief in the importance of getting people away from and off of drugs, and that doing so provides the only real hope for people, and the only manifestation that we really do care and consider them our brothers and sisters and of great worth.
Yes I am passionate and yes I am angry.
Colin Mangham

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