Empowerment the antidote to drug-related harm

A kick in the ass

The Insite safer-injection facility needs a shot in the arm. And the Tory government’s recently announced National Drug Strategy needs a good swift kick in the ass.

At Vancouver’s Insite, drug users can inject safely under the supervision of medical staff, reducing the risk of overdose or infection. Proof of the facility’s success at reducing unsafe needle disposal and increasing uptake of detox programs has been noted by the internationally respected medical journal The Lancet.

But evidence is not enough to convince Conservative health minister Tony Clement, who continues to string the centre along with short-term extensions — this time for only six months. During a recent CBC interview, he claimed that the government is lacking the necessary information to decide Insite’s permanent fate.

The Canadian HIV/AIDS Legal Network branded Clement’s Oct 2 extension announcement “an irresponsible decision on a public health program that has been proven to work.” Executive director Richard Elliott says “the evidence is unequivocal: Insite is saving lives and lowering the risk of HIV infection in one of the most marginalized communities in Canada, and increasing the chances of referring people who use drugs to addiction treatment services.”

Wait, it gets worse. A few days later, the Conservatives announced that Canada’s National Drug Strategy had been relaunched as the national “anti-drug” strategy. Big bucks were ponied up for law enforcement, as well as prevention and treatment. Conspicuously missing was any support for harm reduction, which jurisdictions across the country and around the world have deemed a key pillar of any successful approach to problems around drug use.

Harm reduction acknowledges that many people will use drugs whether or not they are legal, and that not all drug use is harmful to individuals or society. This approach encourages a compassionate and supportive attitude toward addicts’ attempts to move toward sobriety rather than the “lock ’em up” prohibition strategies that have proven unsuccessful to date.

Many of us have little interest in drug use — legal or illegal. But we all benefit from understanding the impact of drug laws, in terms of what they target — and what they ignore. After all, it can be argued that just as much — if not more — social harm is generated by legal highs.

According to the work of Dr Robert Gable, whose findings were reported last year in Scientific American, the harmful drug with the greatest likelihood of addictive potential is not methamphetamine — it’s tobacco, a legal but devastating carcinogen. And it’s widely held that, in vast majority of drug-related instances of unplanned unprotected sex, the culprit is alcohol.

Drug prohibition is not part of the solution — it’s part of the problem. The fact drugs are illegal means they are controlled by organized crime, and priced at unaffordable rates that mandate illegal activity in order for addicts to afford them. Stigma and fear of arrest deter people from seeking treatment. Many people use in dangerous places in unsafe ways to avoid being caught. The poor — whose safety net is the flimsiest — suffer the most. Bottom line: Criminalizing drugs causes harm.


But Minister Clement claims the opposite, telling the general council of the Canadian Medical Association (CMA) last month that “[law] enforcement is harm reduction.” This is little more than ideological double-speak.

Since the Tories came to power in 2006, arrests for marijuana possession have increased from 20 to 50 percent in Toronto, Vancouver, Ottawa and Halifax. And in a new move based on the much-assailed U.S. “War on Drugs,” the Tories have unveiled mandatory minimum prison sentences for some drug offences.

Everyone in our society loses when people are thrown in jail for drug use. If the experience in the U.S. is any indication, the prison system becomes inundated with young, non-violent offenders. According to the advocacy group Stop Prisoner Rape (SPR), these inmates are at the greatest risk of violence and sexual assault by hardened criminals — potentially leading to new infections with HIV and hepatitis C.

And a research paper by the Canadian HIV/AIDS Legal Network revealed that drug use in prison has far greater potential for harm than on the outside. In the absence of needle-exchange programs, sometimes a single syringe will be reused by 30 or 40 people. Bringing drug users into jail who wouldn’t have otherwise been there also leads other prisoners to take up drug injection for the first time while behind bars, generating new addicts. Almost all of these people are eventually released back into society.

The reaction to the Tory announcement from medical experts has been a resounding thumbs-down. In a release, Dr Isra Levy, a senior member of the CMA worried about the “shift to an ideological approach.” Levy added, “What we need is a comprehensive approach that includes harm reduction for those for whom prevention or treatment either fails or is inaccessible.”

It’s hard not to see the government’s decision on the Insite safer-injection centre as political maneuvering while the Tories bait the opposition parties on the question of another federal election. Why not hold off on attempting to axe the facility until the Conservatives have their hoped-for majority in the House?

This policy change doesn’t reflect shifts in our society or the needs of Canadians who are concerned about drug use and the real problems that sometimes come with it. It’s about a belief system being forcibly overlaid upon the facts, and the results will not be pretty.

Tony Clement has told reporters that the government’s initiative is “innovative” — but it flies in the face of science and evidence. After all, the people they arrested for puffing pot were charged for an activity that was almost decriminalized by the previous party in power.

First they came for the joint smokers. Who will be next?

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