Pubdate: Thu, 17 Aug 2006 Source: Ottawa Citizen (CN ON) Copyright: 2006 The Ottawa Citizen Contact: http://www.canada.com/ottawa/ottawacitizen/ Details: http://www.mapinc.org/media/326 Author: Margret Kopala Note: Margret Kopala is a longtime Conservative Party activist in the National Capital Region Cited: 16th International AIDS Conference http://www.aids2006.org Bookmark: http://www.mapinc.org/opinion.htm (Opinion) Bookmark: http://www.mapinc.org/topics/InSite Bookmark: http://www.mapinc.org/find?142 (Supervised Injection Sites) Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction) Bookmark: http://www.mapinc.org/people/Stephen+Harper Bookmark: http://www.mapinc.org/decrim.htm (Decrim/Legalization) AIDS 'A REAL DISEASE' Addiction, on the Other Hand Is Not, an Author Argues Prime Minister Stephen Harper didn't attend the AIDS conference and so far he's declined a visit to North America's first safe-injection site. Located in Vancouver's Downtown Eastside, the scientific research pilot project known as Insite will close on Sept. 12 if its mandate isn't extended. More important than Harper's absence will be the lack, in either locale, of discussion about human agency or personal responsibility. These, finally, may be humanity's best hopes in the wars against an AIDS virus and substance-abuse problem whose capacity to mutate, replicate and find new markets knows no bounds. To be sure, the efforts of science and law enforcement in these wars are considerable and cannot be diminished. But a startling new book by a British writer and psychiatrist experienced in general hospital and prison work shows we're seeking answers in the wrong places. While the central thesis of Romancing Opiates: Pharmacological Lies and the Addiction Bureaucracy by Theodore Dalrymple has implications for the AIDS war, its principal target is the thinking behind facilities such as Vancouver's Insite. Insite is Canada's poster organization for the provision of supervised facilities where addicts can inject their own drugs and access services. Its primary objective is "harm reduction," that is, the reduction of incidences of overdose, disease, crime, and shooting-up detritus. According to its advocates, Insite is a resounding success with peer reviewed, measurable data in all areas to support their case. But behind this sanitized picture a disturbing reality nags. Harm-reduction policy is inherently infantilizing, says Dalrymple, because it assumes the authorities ought to be responsible for the negative results of chosen behaviour. "If consequences are removed from enough actions, the very concept of human agency evaporates." If treating people as "inanimate objects rather than as agents of their own destiny" isn't bad enough, Dalrymple presents yet more disturbing arguments, among them that opiates have been dishonestly romanticized by writers such as Coleridge and De Quincy and that heroin use is a consequence, not a cause, of crime. His most eye-popping revelation? Heroin withdrawal is trivial compared with the real dangers of alcohol withdrawal. He says most addicts and most doctors know this. Progress is difficult because of the self-serving nature of bureaucracies but the general public is complicit too. The blamelessness of victim groups confers high moral standing and absolution for weaknesses while at the heart of the issue is an existential angst that afflicts everyone. "The temptation to obscure life's [difficulties] by means of chemically induced oblivion has always been, and will always be, great," writes Dalrymple, "at least until the meaning of life has been found." Most vulnerable are those believing that immediate satisfaction of personal desires is the only good, but with no prospects for its realization. Disaffected, they lack either interests or the consolation of intellectual, cultural or religious pursuits. "The addict has a problem," says Dalrymple, "but it is not a medical one: he does not know how to live." Instead, he pursues his daily fix, which at least keeps him busy. Arguments to legalize drugs merely suggest the cause of crime is the existence of laws, he says, while comparisons with the prohibition era are simply invalid. Subject to abuse to be sure, alcohol use is supported by established custom in a way that other substances are not. Is the war on drugs winnable? No, but neither is the war on death and no one's given up on that fight. But we should definitely close the clinics that institutionalize bad romantic ideas, and end the pretense addicts are ill and need treatment. Like the war on drugs, the war on AIDS must continue. Unlike addiction, AIDS is a real disease that humanitarians must address. Yet funding treatment that often results in the willful transmission of disease to multiple partners presents another challenge, and here Dalrymple's arguments warrant consideration. In Canada such behaviour is illegal but in Africa and India, where AIDS runs rampant, we apparently believe inhabitants are incapable of making responsible decisions about their behaviour and that drugs and condoms will solve the problem. Like safe injection harm-reduction policies, this denies human agency, insults human dignity and smacks ominously of a soft totalitarian entry by the western world into a new era of Third World colonialism. - --- MAP posted-by: Richard Lake