Dion wants more ‘safe injection’ sites
Notwithstanding inconclusive evaluations of its success, Liberal party leader Stephane Dion has praised Vancouver’s supervised drug injection facility and promised that as prime minister, he would support mayors of other cities who want to establish similar projects.
Relying on favourable information from the B.C. Centre for Excellence in HIV/AIDS – including a notable study from November 2006 – Dion made two specific positive claims about InSite, the “safe injection” site on Vancouver’s Downtown Eastside. But by the time Dion spoke in late January 2007, strong doubt had been cast on the “evidence” he used.
Dion’s first claim was that InSite had reduced the number of fatal overdoses among addicts. That assertion had already been questioned by B.C.’s Addictive Drug Information Council (ADIC), which made its own report last November.
ADIC pointed out that proper research into the impact of a facility would include baseline information from well before the startup and would show how contextual factors in the drug trade might be impacting services. Given that existing evaluations of InSite have lacked these essentials, ADIC could not be certain that InSite has actually lowered overdose deaths.
“It is for this same reason that too much should not be made of the fact that, during the first year of InSite’s operation in Vancouver, the number of overdose deaths rose 28 per cent, from 50 to 64 deaths,” said ADIC.
Dion’s second claim was that InSite had increased the number of injection-drug users willing to seek treatment for their addictions. Health Canada-funded research has shown that a minority of InSite clients do proceed to detoxification. Unfortunately, that step does not necessarily result in follow-through to treatment and abstinence. Longitudinal outcome studies have not yet been produced to demonstrate lasting results.
Further, ADIC examined InSite’s overall usage figures and found that “expressed as a ratio, InSite produces one referral for every 112 visits.” A “referral” could be to any one of eight types of services. Forty per cent are for “various forms of addiction treatment,” while 10 to 15 per cent of the referrals are for “hospital emergencies.”
ADIC concluded that InSite’s proponents have not demonstrated its results are any better than those that could be expected if its funds were invested elsewhere, towards prevention, detoxification and treatment.
The federal Conservative government remains unconvinced that the public should be co-operating in intravenous drug abuse. InSite has operated since September 2003 under an exemption to the Controlled Drugs and Substances Act. Other, unofficial sites operate illegally elsewhere in Canada.
The federal government contributed $1.5 million for research and the provincial government contributed $3.2 million.
InSite had applied for a three-year extension of its legal exemption, but last August, federal Health Minister Tony Clement declined to take that step. Instead, he authorized an extension only until Dec. 31, 2007 for the purpose of allowing more definitive research, provided that research is no longer funded by the federal government.
“Do safe injection sites contribute to lowering drug use and fighting addiction? Right now, the only thing the research to date has proven conclusively is drug addicts need more help to get off drugs,” Clement said then.
News reports at the time indicated that InSite has the support of the Vancouver police department. Subsequently, the Vancouver Sun learned that the RCMP takes a different view than its local counterpart. An RCMP internal report obtained though the Access to Information Act showed that the 2004-2005 Vancouver increase in overdose deaths came at a time when such deaths declined in the rest of the province. The report found “no evidence” that InSite’s clients were more likely to enter drug treatment or that they were less likely to inject themselves publicly.
The RCMP also worried “that when the perceived risks associated to drug use decreases, there is a corresponding increase in the number of people using drugs.”
Prime Minister Stephen Harper had previously indicated that his government’s position would be partly influenced by the RCMP view. While campaigning prior to the 2006 federal election, before the competing analyses were available, Harper vowed, “We as a government will not use taxpayers’ money to fund drug use.”