03/05/08

Can Canada save its safe injecting experiment from the politicians’ axe?

Insite injection roomVancouver is the only city in North America that provides a safe place for addicts to shoot up in. The local government thinks it’s a good idea. The national government doesn’t. So they’re sticking their oar in to undermine the project, according to local researchers.

“Scientists accuse Tories of ‘despicable’ interference”, yells a headline in the Globe and Mail. “An article published in the International Journal of Drug Policy charges that the Conservative government interfered in the work of independent scientific bodies, attempted to muzzle scientists and deliberately misrepresented research findings because it is ideologically opposed to harm-reduction programs,” reports Andre Picard. (I’d love to provide you with a link to the original article; the IJDP is the official journal of the International Harm Reduction Association, but they’ve decided to limit their policy impact by publishing through a restricted access Elsevier journal.)

At issue, on the face of it, is funding for research and a continuation of an exemption from national law that allows the safe injecting site to operate as a research site. But the real issue is, as always, whether the conservative government wants science or political expediency to inform its drugs policy.

Last month, an independent committee published a very detailed report about the impact of the Insite safe injecting space, which serves around 600 people a day, has helped over 300 people stay alive after an overdose, and overseen 220,000 safe injections. Fans of the programme cherry-pick the positive findings: more hard-core users getting into treatment, fewer people shooting up in public, less needle sharing, while opponents of harm reduction highlight the downsides. They revolve mostly around our inability to prove the effect of the programme, the usual chestnut of public health prevention. They complain too about the limited impact of the programme — it reaches only five percent of injectors in Vancouver’s downtown east side. But that’s in part the tyranny of a “pilot” set-up. It seems to me that should be a reason to expand the programme, not to pull it.

We’re nowhere near the last word on this, but for today let it go to the eminently sensible Provincial Health Officer for British Columbia, “I’m a realist enough to know that public policy is not based solely on science, but you would hope that policy would be strongly swayed by science, particularly in health care,” he told the Globe and Mail. “”If there was a validated intervention for hernia repair would we accept that the government step in and say: ‘We don’t like hernia repair’? I don’t think so.”

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This post was published on 03/05/08 in War on drugs.

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  1. Comment by Lee Rudolph, 03/05/08, 06:22:

    “(I’d love to provide you with a link to the original article;
    the IJDP is the official journal of the International Harm Reduction Association, but they’ve decided to limit their policy impact by publishing through a restricted access Elsevier journal.)”

    (1) Assuming (which the Mop&Pail article doesn’t make clear) that “the original article” is _The Canadian government’s treatment of scientific process and evidence: Inside the evaluation of North America’s first supervised injecting facility_,
    the IJDP does at least make the abstract available for free, at
    www . ijdp . org/article/S0955-3959(07)00219-8/abstract (extra spaces inserted for safety).

    (2) It’s quite amazing — no matter how hard Springer-Verlag tries, Elsevier always finds a way to be even wretcheder. My most recently accepted article will soon appear in a Springer journal. When I was filling in the paperwork, including signing over the copyright, Springer actually gave me the choice of letting their online version of the article be open-access! The only catch was, it would have cost me $8,000. (I don’t know if that’s a flat fee or a per-page fee; the article is 8 pages in proof, so the latter hypothesis is not entirely paranoid.) I did not avail myself of their offer.

    On the other hand, Springer does allow me to keep a copy of the article freely available on my own website, without fee, so long as I acknowledge their publication, and that copy isn’t type-set so as to appear to be The Real Thing.

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