Spreading human misery

Barbara Kay, National Post · May 18, 2011 | Last Updated: May 18, 2011 3:16 AM ET

Insite, in Vancouver's Downtown Eastside is the only "safe-injection site" (SIS) in North America where addicts can legally inject hard drugs under medical supervision. If the Supreme Court, now in deliberation, rules the federal government has no right to shut it down, Insite clones will spring up all over Canada.

Insite is the brainchild of a concept called "Harm Reduction" (HR), supposedly one of four pillars in Canada's National Anti-Drug Strategy. But because HR militants are also in favour of legalizing all drugs, the other pillars -prevention, treatment and enforcement -are of little interest to them.

Supporters always speak of the numerous "studies" that show success for Insite. But how scientific are they? In a 2007 evidence-based critique of Insite, for example, Colin Maugham, Director of Research for the Drug Prevention Network of Canada, noted the most-cited studies' lack of control groups, and concluded that Insite's evaluations overstated its positive findings, and omitted or understated the negative findings. For example, while studies claim that Insite's presence saves lives, the Government of British Columbia Selected Vital Statistics and Health Status Indicators states in its annual report that the number of deaths from drug overdose in Vancouver's Downtown Eastside has increased in most years since the site opened in 2003.

Insite is often touted as the "compassionate" response to drug addiction by its promoters. Addiction enablement is not true compassion. True compassion is animated by the belief that people can change, that they have moral agency. Insite-type compassion is the soft bigotry of low expectations. It is politically correct timidity around "judging" (certain) uncontrolled human appetites. Curiously, sometimes the same "compassionate" romanticizers of drug addiction -call them the Addictionally Correct (AC) -have no problem judging smokers or the obese for their poor health choices.

From the discourse of the AC, you would never know that it is actually quite difficult to become addicted to drugs like heroin. It takes months of steady usage. The AC have convinced themselves, too, that weaning oneself from a hard drug is nigh impossible. In fact, detoxing from heroin, according to those who supervise it, is no more stressful than a transient illness -and (unlike alcohol withdrawal, a far more pernicious addiction), nobody has ever died from heroin withdrawal. Motivation is all. Indeed many heroin addicts, like returning Vietnam soldiers, have withdrawn from heroin use without incident.

Long-term rehab works, even in cases where addicts are forced into programs. A 2008 longitudinal study by Portage, since 1970 Canada's foremost practitioner of the therapeutic-community approach to rehabilitation, found that 18 months after completion of rehab, the study cohort's hallucinogen, amphetamine and cocaine use had decreased by a stunning 85% overall.

Sidebar results, with significant implications for reduced burdens on the public purse, were equally impressive. Hospitalizations and contact with the justice system decreased by 86.8% and 92% respectively, while full-time employment increased by 55%.

If safe injection sites (SISs) are so wonderful, then why have three dozen European cities, including Berlin, Stockholm, London and Oslo signed a declaration against SISs? Because they learned that SISs lead to increased drug use and crime. Sweden, for example, has had remarkable success with a program of compulsory drug treatment for addicts. As a result, Sweden's rates for crime, disease, medical and social problems stemming from drug addiction are lower than other European countries.

Almost nobody is beyond redemption from drug addiction, but you wouldn't know it from the deep-throated baying for addiction enablement that dominates debate on the issue. And oh, the hypocrisy: There isn't a single AC pundit in this country militating for Insite who would passively allow his or her own child to use their services. Each and every one of them would move Heaven and Earth to ensure that their loved ones got intervention and treatment. As retired Vancouver policeman Al Arsenault, who patrolled the "chemical gulag" of Downtown Eastside Vancouver for 27 years and who calls Insite an "abject and utter failure," put it: "The rich get treatment, the poor get [Insite]."

Nobody has ever died of an overdose at Insite, a key argument for its supporters. That is true, but so what? No depressed people would ever die from stepping off the Golden Gate Bridge if there were a safety net below it. The net would do nothing to solve the depression of those jumping into the net, or help the many thousands of others who continued to jump from other high places in plain sight of the net. It would only give the impression that society is "doing something" to reduce the harm.

Just like Insite. Yes, 1,400 people use it, but Insite does not protect them from the health risks of direct-to-vein injection. They don't die from a sudden overdose, but they do die from their behaviour. There are better ways than Insite to spend public money. It is puzzling and rather shameful that the federal government has not found its tongue in making its own case on this file.