Pubdate: Fri, 12 Aug 2011 Source: Victoria Times-Colonist (CN BC) Copyright: 2011 Times Colonist Contact: http://www2.canada.com/victoriatimescolonist/letters.html Website: http://www.timescolonist.com/ Details: http://www.mapinc.org/media/481 Author: Elizabeth Payne, Times Colonist IDEOLOGY BEATS SCIENCE ON SAFE INJECTION SITES Dr. Mark Tyndall may not seem like a dangerous man to you. In fact, the recently installed head of infectious diseases at the Ottawa Hospital, who works one day a week at the Ottawa Mission treating people with HIV and recently returned from the international AIDS conference in Rome, may seem like the kind of medical professional the world needs more of. But to the Conservative government, the former co-lead investigator at Vancouver's controversial supervised injection site is a man with some dangerous, even abominable, ideas: Namely, that drug addiction is a health issue, not a political or criminal one. "Abomination," in fact, is the very word Tony Clement, federal health minister at the time, used to describe the philosophy governing the safeinjection site Insite in 2008, adding that "allowing and/or encouraging people to inject heroin into their veins is not harm reduction. It is a form of harm addition." The scientific and medical world disagreed and, unlike the federal government, had the science to back it up -- dozens of peer-reviewed studies, in fact, much of it based on research done by Tyndall and his colleagues. The Conservative government long ago made Insite a political cause, vowing to close it, despite research citing its benefits. Insite remains open, but the battle over it has gone all the way to the Supreme Court of Canada. Meanwhile, the government's ideological attack on North America's only supervised injection site has had a spillover effect, making it politically difficult, if not impossible, for other communities to consider something similar. Even when such harm reduction would make people safer and even save lives. Which brings us to Ottawa. This is a very different city than Vancouver. Ottawa does not have the heroin trade Vancouver does, nor is drug use as visible. But growing numbers of drug users are injecting opiates derived from prescription drugs such as oxycodone. Some die from overdoses, others become ill from using dirty needles. And the fact that Ottawa has one of the highest rates of new HIV infections in the country is one sign of the harm being done by unsafe injection drug use. New HIV cases were up by nearly 50 per cent in Ottawa during the first half of this year -- something that is raising alarm bells among the city's public health officials. In Vancouver, new HIV infection rates are way down, in part because of harm reduction. Ottawa has had various forms of harm-reduction programs in recent years, including a managed alcohol program, a crack pipe program and needle exchange. Does Ottawa need a safe injection site? A report on just that subject has been in the works for a number of years and is due to be released this fall, said its co-author, University of Toronto researcher Carol Strike. No word on whether it will conclude that a supervised injection site would make sense for Ottawa. Tyndall, who has seen the difference having some contact with addicts makes to their health, says there is no question Ottawa should ramp up its harm-reduction programs. But he is hesitant to lead the charge for a safeinjection site. "I want to work behind the scenes for a bit, I didn't come here to crusade for harm reduction." Tyndall has seen how doctors and health professionals who advocate for supervised injection sites are sometimes vilified and painted as prodrugs, even though, as he notes: "I have seen the worst that drugs can do." And Wendy Muckle, executive director of Ottawa Inner City Health, says politics around safe-injection sites make battling for one unpalatable. Her organization is currently involved with a Housing First program for addicts, another, longer term, form of harm reduction that helps transform lives. "If I had to choose between staying under the radar and doing more housing, I would rather do that any day of the week than battling with Stephen Harper over a safe-injection site," she says. It is frustrating to those who work with addicts that politics is part of the calculation when they consider the best ways to treat and improve the lives of addicts. "The frustrating thing is that our government is not swayed by any evidence, just by ideology that drugs are bad and people shouldn't use them," said Tyndall. The result is that, for communities like Ottawa, Vancouver, Toronto, Winnipeg and anywhere there are drug addicts, reducing the harm of addictions, the spread of diseases, the drain on emergency rooms and police and the negative social effects of drug use on the streets is more difficult than it needs to be because of a federal government with its eyes firmly closed when it comes to drug treatment. - --- MAP posted-by: Richard R Smith Jr.