[homeles_ot-l] Why Ottawa needs some Insite Ottawa Citizen

[Rob Boyd]

Why Ottawa needs some Insite
A comprehensive harm reduction program would reduce drug use and make
Ottawa safer
By Dr. Mark Tyndall, The Ottawa CitizenOctober 4, 2011

 
Insite workers and supporters celebrate the Supreme Court of Canada
decision on the future of the safe injection site. Vancouver police, the
municipal government and the local business community initially opposed
the facility, but now support it. Dr. Mark Tyndall writes that Ottawa
would benefit from a similar harm reduction program.


Last week’s unanimous Supreme Court decision that allows Vancouver to
operate Insite, North America’s first supervised injection site, was a
victory for harm reduction and a ringing endorsement for a more sensible
approach to illicit drug use in Canada. The court battle essentially
pitted a highly successful evidence-based program that saves lives,
reduces drug use, and connects drug users to health care services
against our federal government’s commitment to stopping drug use
through criminal deterrents.

In the spirit of full disclosure it should be stated that I am firmly
on the side of harm reduction. Over the past 12 years I have been
working as a physician and researcher on projects aimed to reduce the
devastating effects of illicit drug use, including studies at Insite.
During that time I have witnessed first-hand all of the serious health
consequences of drug use including death from HIV, Hepatitis C,
overdoses, and an encyclopedic list of infectious diseases. I have seen
people inject drugs into their arms, legs, groins, neck, fingers and
toes. I have seen people use filthy puddle water to mix their drugs and
pick up used needles in hopes of finding the tiniest residue of heroin
stuck to the side of a syringe. I have seen people lie, cheat, steal,
and beat their friends for drugs. I have known women who have gone
missing and were later found murdered as a consequence of drug addiction
and prostitution. In short, I have seen the very worst of drug use and
the physical, mental and social harms endured by individuals, their
families and communities.

There are many misconceptions surrounding harm reduction that cloud the
issue and confuse the debate. Simply put, harm reduction is a very
pragmatic approach to problem drug use and offers support, care and
treatment to people who are either not able or not willing to stop using
drugs. The underlying principle is that people who use drugs have enough
life challenges already and should not be sentenced to a life of
homelessness, disease, and intermittent imprisonment because of the
illegal drugs that they use. Harm reduction offers people the
opportunity to connect with health and social services while recognizing
that most addicted people will continue to use drugs.

Critics of harm reduction have used a number of arguments to undermine
programs. However, there is not a shred of evidence that harm reduction
interventions promote drug use, create new drug users, increase danger
to the public, encourage criminal behaviours, or make it easy for
organized crime or pimps to exploit the weak and the vulnerable. In
fact, harm reduction has the opposite effect. On the other hand, the law
enforcement approach to reducing illicit drug use has directly
contributed to these problems. Even the most ardent supporters of this
law enforcement admit that things are getting worse and cycling drug
addicts through the criminal justice system is neither effective or
sustainable.

In addition to criminalization, the federal government has stated their
priorities are also aimed at prevention and treatment. On the surface it
is hard to argue against these goals. However, there is a major
difference between prevention of drug addiction in our society and
preventing drug use among people who are already addicted. Preventing
people from initiating drug use should indeed be a key component of our
drug strategy and programs that are directed at the drivers o
f drug
addiction should be addressed. But we cannot wait for eliminate childhood poverty, build affordable housing, develop mental
health programs, enhance youth employment opportunities, support
single-parent families, and build strong communities. All of these could
help in the future but will be too late for people who are currently
addicted.

Addiction treatment is also important and the opportunities for
street-entrenched drug users are woefully inadequate across Canada. The
government should certainly be providing more resources for short-term
detoxification, medium-term outpatient treatment and long-term
residential facilities. There are many people who could be helped if
treatment programs were available. However, there can be no treatment
without the engagement of the very people who need treatment and there
can be no engagement without low threshold, non-judgmental, and
long-term facilities that can work with drug users. This is exactly what
a supervised injection site provides.

Opponents of harm reduction also use an economic argument to deny
services, stating that programs are too expensive in times of government
cutbacks. However, the real concern should be directed at the costs of
not initiating harm reduction programs. Who pays for ambulance calls,
emergency room visits, hospital admissions, ICU care, and surgery to
drain abscesses? Who pays for police calls, court costs, and jail time?
Who pays the $250,000 lifetime cost of HIV care and treatment? If a
supervised injection site could prevent just four cases of HIV per year,
it would pay for itself. It is hard to think of more cost-effective
health interventions than needle/syringe programs, methadone maintenance
therapy, and supervised injection sites.

There are many lessons that can be learned from the Insite experience
in Vancouver and it would be a serious mistake to start the debate from
scratch in Ottawa. Although the drug situation in the downtown eastside
of Vancouver is on a larger scale, everything else is much the same. In
2003 when Insite opened its doors, the municipal government, the police,
and the local business community were all against the facility. Now they
enthusiastically support it. Even public opinion polls that were
overwhelmingly opposed to harm reduction have been transformed into a
type of civic pride at the accomplishments of Insite.

Ottawa has many talented and committed community workers, nurses,
physicians, and advocates who could really make a difference to our
city. Although not a magic bullet, a comprehensive harm reduction
program in Ottawa would reduce problem drug use, improve health
outcomes, make our communities safer, connect the addicted to treatment,
and stop the transmission of HIV among the cities drug users. The time
is now to switch direction and treat addiction as a health issue and
give hope to some of the most vulnerable people in our city.

Dr. Mark Tyndall is a professor of medicine at the University of Ottawa
and chief of infectious diseases at the Ottawa Hospital.

© Copyright (c) The Ottawa Citizen

Rob Boyd
Oasis Program Director
Sandy Hill Community Health Centre
613 569-3488 xt. 2112
 
 
Confidentiality Notice:
 

This email message, including any attachments, is for the sole use of
the
intended recipient(s) and may contain confidential and privileged
information. Any unauthorized review, use, disclosure or distribution
is
prohibited. If you are not the intended recipient, please contact the
sender by reply e-mail and destroy all copies of the original message.
 

Avis de confidentialité
 

Les informations contenues à l’intérieur de ce courriel, y compris
tous les
documents qui y sont attachés, sont pour l'usage exclusif du/des
destinataire(s) désignés ; car elles peuvent être de nature
confidentielle
et privilégiée. N'importe quelles revue, utilisation, divulgation ou
distribution non autorisée est interdite. Si vous n'êtes pas le ou les
destinataire(s) désignés, veuillez immédiatement en aviser l
'expéditeur
par
courriel et assurer vous d’avoir détruit toutes les copies du
message
original.
 


Confidentiality Notice:
This email message, including any attachments, is for the sole use 
of the intended recipient(s) and may contain confidential and 
privileged information.  Any unauthorized review, use, disclosure 
or distribution is prohibited.  If you are not the intended recipient, 
please contact the sender by reply e-mail and destroy all copies 
of the original message.  

Avis de confidentialité
Les informations contenues à l’intérieur de ce courriel, y compris 
tous les documents qui y sont attachés, sont pour l'usage exclusif 
du/des destinataire(s) désignés ; car elles peuvent être de nature  
confidentielle et privilégiée.  N'importe quelles revue, utilisation, 
divulgation ou distribution non autorisée est interdite. Si vous n'êtes 
pas le ou les destinataire(s) désignés, veuillez immédiatement en 
aviser l'expéditeur par courriel et assurer vous d’avoir détruit 
toutes les copies du message original.
-------------- next part --------------
An embedded message was scrubbed...
From: rboyd at sandyhillchc.on.ca
Subject: I just saw this on Ottawa Citizen
Date: Tue, 04 Oct 2011 14:37:49 -0400
Size: 1697
URL: <http://list.web.net/lists/private/homeles_ot-l/attachments/20111004/a07a5bde/attachment.eml>