Pure
Fiel a Verdad
- Joined
- Dec 20, 2001
- Posts
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Should a city provide, among other health services to addicts, a 'safe injection site'? At such a site the user can inject himself or herself, under medical supervision. Also included is "needle exchange": the addict turns in an old needle and gets a new, clean one. The city of Vancouver is debating the matter with the Canadian federal government; such sites have existed there for some time. Some other major world cities--San Francisco, in the US-- have such programs.
The philosophy is "harm reduction": No one is treated, but their risk of death and disease is reduced. SOME will then seek other treatments. In addition, community benefits are cited, e.g. addicts don't shoot up in parks and leave used hypodermics there.
Opponents say the money is wasted, since it's not treatment, and that such centres attract addicts; that such centres send the wrong message to addicts, implicitly encouraging the lifestyle. The Conservative Party of Canada, with a majority in parliament holds this view and a) wishes to withold funds, and b) remove the legal protections the site enjoys--i.e. that addicts there, with drugs, and/or shooting up, are not subject to arrest. In effect forcing a shut down, even if the centre was entirely financed by city and province.
http://www.sfaf.org/hpp [The San Francisco situation]
http://www.cdc.gov/IDU/facts/AED_IDU_SYR.pdf [Report to Congress re 'needle exchange']
http://en.wikipedia.org/wiki/Needle-exchange_programme [Wiki article on topic.]
===
http://www.theglobeandmail.com/servlet/story/RTGAM.20080530.wbcclinicisl30/BNStory/National/
Second safe injection site operating quietly in Vancouver since 2002
JEREMY NUTTALL
From Friday's Globe and Mail
May 30, 2008 at 5:52 AM EDT
VANCOUVER — A B.C. Supreme Court decision that closing Vancouver's supervised injection site is unconstitutional was a victory for the site's supporters.
But another safe injection site has been operating quietly in the city since 2002, and officials there say the federal government's plan to appeal Tuesday's ruling will not stop them - even if the Conservatives succeed in their appeal.
The site is part of the Dr. Peter Centre, an HIV/AIDS-specific care facility in the west end. It's much smaller than Insite, but offers the same service - a place for heroin users to inject drugs under the watchful eye of health-care workers.
Maxine Davis, executive director of the Dr. Peter Centre, said it makes sense to offer a supervised injection site to patients whose illnesses go hand in hand with drug addiction.
"Nurses working at the centre were witnessing rushed injections and a variety of health concerns," Ms. Davis said. "And they decided if they knew what to do to prevent such things, why not do it?"
And while Insite was seeking an exemption from criminal law, the centre took the position that it is upholding the law by providing a place where addicts can use drugs safely.
The centre's safe injection site has the blessing of the B.C. College of Nurses, the Vancouver Police Department and the provincial government. Unlike the high-profile Insite, the Dr. Peter Centre's facility has never been threatened with closing - the federal government has not even acknowledged it. As recently as last week, inquiries about the site were bounced from one ministry to another as none seemed to know it existed.
Tuesday's court decision, which proclaimed heroin addiction to be a health issue, specifically mentioned Insite. Health Minister Tony Clement said yesterday that the government will appeal the decision.
Ms. Davis said the court ruling would give the Dr. Peter Centre case law with which to argue for its existence. Whether the federal government wins or loses its appeal, Ms. Davis said the site will continue to operate.
"We were clear and firm in our position that we were carrying on regardless of the decision that was made by the court," she said. "So, if the federal government wants to appeal it, we maintain our position that it is a professional nurses' practice."
===
Ottawa wants safe-injection site shut down
GLORIA GALLOWAY
From Friday's Globe and Mail
May 29, 2008 at 10:18 PM EDT
OTTAWA — Ottawa moved Thursday to close Canada's only sanctioned safe-injection site, announcing it will appeal a B.C. court ruling that Vancouver's Insite should stay open because reducing the risk of drug overdoses is a vital health service.
“In my opinion, supervised injection is not medicine; it does not heal the person addicted to drugs,” Health Minister Tony Clement told the House of Commons health committee Thursday.
“Injection not only causes physical harm, it also deepens and prolongs the addiction. Programs to support supervised injection divert valuable dollars away from treatment. And government-sponsored supervised injection sends a very mixed message to young people who are contemplating the use of illicit drugs.”
Mr. Clement told the committee he will ask Justice Minister Rob Nicholson to appeal a British Columbia Supreme Court ruling that saved Insite, North America's only sanctioned safe-injection facility, from closing at the end of June when its exemption from Canada's drug laws expires.
Allowing addicts to inject themselves with illegal drugs at a supervised site in Vancouver prevents the death of one person a year, Mr. Clement said.
“The evidence is that Insite's injection program saves, at best, one life per year. A precious life, yes. I believe we can do better and we must,” Mr. Clement said, citing a report from an advisory committee he struck to investigate the merits of the site. “My job as Health Minister is to balance that one life against any possible negative effect of supervised injection that might take one life elsewhere.”
The advisory committee, which released its report in March, concluded that although Insite staff have intervened in more than 336 overdoses since 2006 and no overdose deaths have occurred at the site, “Insite saves about one life a year as a result of intervening in overdose events.”
The committee said long-term studies would be needed to verify that number, and the “mathematical modelling” may not be valid. On the whole, the panel found Insite to be cost effective and helpful to addicts looking for treatment.
“Over a million injections have taken place at the site,” said Liz Evans, a nurse who is executive director of the group that runs the site. “You don't have to be a rocket scientist to know that of the over 900 overdose incidents that have occurred since it's opened, probably more than four of them could have resulted in a death.”
The facility operates in the city's blighted Downtown Eastside on the strength of exemptions granted by Ottawa under a section of the Controlled Drugs and Substances Act.
“In this case, we have given it due process, we've looked at all the evidence, and our position is that the exemption should not be continued,” Mr. Clement said.
Removing the exemption will shut Insite down if an appeal court reverses the B.C. court's judgment.
In his ruling this week, Mr. Justice Ian Pitfield upheld arguments that Insite provided vital health services to addicts by reducing the possibility of drug overdoses, curbing the risk of transmitting infectious diseases and giving users access to counselling that may lead to abstinence.
As a result, Insite's injection-drug users have the right to protection from drug laws under Section 7 of the Canadian Charter of Rights and Freedoms that guarantees everyone “life, liberty and security of the person,” the judge found.
He gave the federal government until June 30, 2009, to redraft laws against possession and trafficking of illegal drugs to accommodate Insite's operation. Without that adjustment, those key sections of the law are unconstitutional, Judge Pitfield said.
If the ruling is allowed to stand, advocates will press for additional sites in Vancouver and across Canada, Mr. Clement said.
He stressed that he approves of many of the services offered at Insite, including needle exchanges and condom distribution, and would not want it closed entirely. But he does not agree with supervised injections.
The minister's rejection of the safe-injection site came after the health committee heard from a series of witnesses supporting its continuation.
One witness supporting the government's position refused to testify, saying he has been harassed by addicts. Most of the people who appeared before the committee spoke from their own experiences.
For Ms. Evans, it was about dealing with addicts in the Downtown Eastside.
Others, like Thomas Kerr, director of the urban health research program at the B.C. Centre of Excellence in HIV/AIDS, cited the more than 25 peer-reviewed scientific papers that have found, among other things, that the injection site reduces public disorder, overdoses and disease while connecting the users of illegal drugs with avenues for treatment.
But Mr. Clement discounted that research, saying many of the studies have been conducted by the same authors who “plow their ground with regularity.”
When asked when Mr. Nicholson will launch the appeal, his office referred calls to Health Canada, which would say only that it will ask the minister to do so at the earliest opportunity.
Mr. Clement's announcement that he will ask for an appeal of the court ruling was greeted by cheers from a large group of people in the committee room who had been organized to attend to back the government's position.
But opposition MPs sided in favour of Insite.
David Butler-Jones, Canada's chief public health officer, looked decidedly uncomfortable when asked whether he agreed with Mr. Clement.
“The science, I think, speaks for itself. The debate speaks for itself,” Dr. Butler-Jones replied. “We provide the best advice we can. Governments and jurisdictions, as appropriate, make their decisions and have the political context in which they make their decisions.”
The philosophy is "harm reduction": No one is treated, but their risk of death and disease is reduced. SOME will then seek other treatments. In addition, community benefits are cited, e.g. addicts don't shoot up in parks and leave used hypodermics there.
Opponents say the money is wasted, since it's not treatment, and that such centres attract addicts; that such centres send the wrong message to addicts, implicitly encouraging the lifestyle. The Conservative Party of Canada, with a majority in parliament holds this view and a) wishes to withold funds, and b) remove the legal protections the site enjoys--i.e. that addicts there, with drugs, and/or shooting up, are not subject to arrest. In effect forcing a shut down, even if the centre was entirely financed by city and province.
http://www.sfaf.org/hpp [The San Francisco situation]
http://www.cdc.gov/IDU/facts/AED_IDU_SYR.pdf [Report to Congress re 'needle exchange']
http://en.wikipedia.org/wiki/Needle-exchange_programme [Wiki article on topic.]
===
http://www.theglobeandmail.com/servlet/story/RTGAM.20080530.wbcclinicisl30/BNStory/National/
Second safe injection site operating quietly in Vancouver since 2002
JEREMY NUTTALL
From Friday's Globe and Mail
May 30, 2008 at 5:52 AM EDT
VANCOUVER — A B.C. Supreme Court decision that closing Vancouver's supervised injection site is unconstitutional was a victory for the site's supporters.
But another safe injection site has been operating quietly in the city since 2002, and officials there say the federal government's plan to appeal Tuesday's ruling will not stop them - even if the Conservatives succeed in their appeal.
The site is part of the Dr. Peter Centre, an HIV/AIDS-specific care facility in the west end. It's much smaller than Insite, but offers the same service - a place for heroin users to inject drugs under the watchful eye of health-care workers.
Maxine Davis, executive director of the Dr. Peter Centre, said it makes sense to offer a supervised injection site to patients whose illnesses go hand in hand with drug addiction.
"Nurses working at the centre were witnessing rushed injections and a variety of health concerns," Ms. Davis said. "And they decided if they knew what to do to prevent such things, why not do it?"
And while Insite was seeking an exemption from criminal law, the centre took the position that it is upholding the law by providing a place where addicts can use drugs safely.
The centre's safe injection site has the blessing of the B.C. College of Nurses, the Vancouver Police Department and the provincial government. Unlike the high-profile Insite, the Dr. Peter Centre's facility has never been threatened with closing - the federal government has not even acknowledged it. As recently as last week, inquiries about the site were bounced from one ministry to another as none seemed to know it existed.
Tuesday's court decision, which proclaimed heroin addiction to be a health issue, specifically mentioned Insite. Health Minister Tony Clement said yesterday that the government will appeal the decision.
Ms. Davis said the court ruling would give the Dr. Peter Centre case law with which to argue for its existence. Whether the federal government wins or loses its appeal, Ms. Davis said the site will continue to operate.
"We were clear and firm in our position that we were carrying on regardless of the decision that was made by the court," she said. "So, if the federal government wants to appeal it, we maintain our position that it is a professional nurses' practice."
===
Ottawa wants safe-injection site shut down
GLORIA GALLOWAY
From Friday's Globe and Mail
May 29, 2008 at 10:18 PM EDT
OTTAWA — Ottawa moved Thursday to close Canada's only sanctioned safe-injection site, announcing it will appeal a B.C. court ruling that Vancouver's Insite should stay open because reducing the risk of drug overdoses is a vital health service.
“In my opinion, supervised injection is not medicine; it does not heal the person addicted to drugs,” Health Minister Tony Clement told the House of Commons health committee Thursday.
“Injection not only causes physical harm, it also deepens and prolongs the addiction. Programs to support supervised injection divert valuable dollars away from treatment. And government-sponsored supervised injection sends a very mixed message to young people who are contemplating the use of illicit drugs.”
Mr. Clement told the committee he will ask Justice Minister Rob Nicholson to appeal a British Columbia Supreme Court ruling that saved Insite, North America's only sanctioned safe-injection facility, from closing at the end of June when its exemption from Canada's drug laws expires.
Allowing addicts to inject themselves with illegal drugs at a supervised site in Vancouver prevents the death of one person a year, Mr. Clement said.
“The evidence is that Insite's injection program saves, at best, one life per year. A precious life, yes. I believe we can do better and we must,” Mr. Clement said, citing a report from an advisory committee he struck to investigate the merits of the site. “My job as Health Minister is to balance that one life against any possible negative effect of supervised injection that might take one life elsewhere.”
The advisory committee, which released its report in March, concluded that although Insite staff have intervened in more than 336 overdoses since 2006 and no overdose deaths have occurred at the site, “Insite saves about one life a year as a result of intervening in overdose events.”
The committee said long-term studies would be needed to verify that number, and the “mathematical modelling” may not be valid. On the whole, the panel found Insite to be cost effective and helpful to addicts looking for treatment.
“Over a million injections have taken place at the site,” said Liz Evans, a nurse who is executive director of the group that runs the site. “You don't have to be a rocket scientist to know that of the over 900 overdose incidents that have occurred since it's opened, probably more than four of them could have resulted in a death.”
The facility operates in the city's blighted Downtown Eastside on the strength of exemptions granted by Ottawa under a section of the Controlled Drugs and Substances Act.
“In this case, we have given it due process, we've looked at all the evidence, and our position is that the exemption should not be continued,” Mr. Clement said.
Removing the exemption will shut Insite down if an appeal court reverses the B.C. court's judgment.
In his ruling this week, Mr. Justice Ian Pitfield upheld arguments that Insite provided vital health services to addicts by reducing the possibility of drug overdoses, curbing the risk of transmitting infectious diseases and giving users access to counselling that may lead to abstinence.
As a result, Insite's injection-drug users have the right to protection from drug laws under Section 7 of the Canadian Charter of Rights and Freedoms that guarantees everyone “life, liberty and security of the person,” the judge found.
He gave the federal government until June 30, 2009, to redraft laws against possession and trafficking of illegal drugs to accommodate Insite's operation. Without that adjustment, those key sections of the law are unconstitutional, Judge Pitfield said.
If the ruling is allowed to stand, advocates will press for additional sites in Vancouver and across Canada, Mr. Clement said.
He stressed that he approves of many of the services offered at Insite, including needle exchanges and condom distribution, and would not want it closed entirely. But he does not agree with supervised injections.
The minister's rejection of the safe-injection site came after the health committee heard from a series of witnesses supporting its continuation.
One witness supporting the government's position refused to testify, saying he has been harassed by addicts. Most of the people who appeared before the committee spoke from their own experiences.
For Ms. Evans, it was about dealing with addicts in the Downtown Eastside.
Others, like Thomas Kerr, director of the urban health research program at the B.C. Centre of Excellence in HIV/AIDS, cited the more than 25 peer-reviewed scientific papers that have found, among other things, that the injection site reduces public disorder, overdoses and disease while connecting the users of illegal drugs with avenues for treatment.
But Mr. Clement discounted that research, saying many of the studies have been conducted by the same authors who “plow their ground with regularity.”
When asked when Mr. Nicholson will launch the appeal, his office referred calls to Health Canada, which would say only that it will ask the minister to do so at the earliest opportunity.
Mr. Clement's announcement that he will ask for an appeal of the court ruling was greeted by cheers from a large group of people in the committee room who had been organized to attend to back the government's position.
But opposition MPs sided in favour of Insite.
David Butler-Jones, Canada's chief public health officer, looked decidedly uncomfortable when asked whether he agreed with Mr. Clement.
“The science, I think, speaks for itself. The debate speaks for itself,” Dr. Butler-Jones replied. “We provide the best advice we can. Governments and jurisdictions, as appropriate, make their decisions and have the political context in which they make their decisions.”
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