Pubdate: Thu, 25 Jul 2013
Source: Vancouver Sun (CN BC)
Copyright: 2013 The Vancouver Sun
Contact: http://www.canada.com/vancouversun/letters.html
Website: http://www.canada.com/vancouversun/
Details: http://www.mapinc.org/media/477
Authors: Thomas Kerr and Julio Montaner
Note: Dr. Thomas Kerr is the is the co-director of the Urban Health 
Research Initiative at the British Columbia Centre for Excellence in 
HIV/AIDS and associate professor in the Department of Medicine at the 
University of British Columbia. Dr. Julio Montaner is the director of 
the British Columbia Centre for Excellence in HIV/AIDS, the chair in 
AIDS Research and head of division of AIDS in the Faculty of 
Medicine, University of British Columbia, and the past-president of 
the International AIDS Society.

EVIDENCE TRUMPS IDEOLOGY OVER PUBLIC HEALTH BENEFITS OF INSITE

It has been nearly 10 years since Insite, Vancouver's supervised 
injection site opened and two years since the Supreme Court of Canada 
unanimously determined that it should remain open to protect public health.

A large body of scientific evidence demonstrates that Insite and 
other harm reduction programs, such as needle exchanges, are 
effective in reducing the harms associated with illicit drug use. 
Sadly, ideological debate about harm reduction continues, despite 
widespread agreement among health authorities, including the World 
Health Organization, that such programs are essential to the fight 
against HIV/ AIDS and other drug-related harms.

A recently released report summarizing 15 years of data on the drug 
situation in Vancouver provides further evidence that harm reduction 
programs have helped reduce illicit drug use and improve public 
health: fewer people are injecting drugs; more are accessing 
addiction treatment; and HIV transmission related to injection drug 
use has plummeted.

Likewise, a large body of scientific evidence shows that Insite is 
meeting its objectives. Peer-reviewed studies involving dozens of 
researchers from Canada, Australia, Britain and the U. S. demonstrate 
clearly that Insite does not increase crime or perpetuate active drug 
use. More than 30 peer-reviewed studies show that Insite saves lives 
and health care dollars, reduces disease transmission, and promotes 
entry into addiction treatment.

The program now has the support of leading national health 
organizations such as the Canadian Medical Association, the Canadian 
Association of Nurses, and the Canadian Public Health Association. 
Health organizations in other parts of Canada are now advocating for 
similar programs in their jurisdictions.

Still, critics continue to launch personal attacks against 
scientists, misrepresent existing research, and cite bogus reports 
that have never been subjected to scientific scrutiny or published in 
recognized journals, reducing public discourse about harm reduction 
to the same level as past debates about global warming and the harm 
of cigarette smoking.

The most vocal of those arguing against Insite is the Drug Prevention 
Network of Canada ( DPNC). This is an organization that covertly 
accepted RCMP funding to produce pseudo-scientific reports on Insite. 
Ultimately the RCMP acknowledged their wrongdoing and distanced 
themselves from the reports, admitting the reports were commissioned 
to "provide an alternative analysis" to existing research and "did 
not meet conventional academic standards." Ironically, when a Supreme 
Court justice asked lawyers representing the federal government if 
they had any scientific evidence indicating that Insite was not 
meeting its objectives, they did not offer one of the DPNC reports - 
they offered nothing.

David Berner and the DPNC continue to get the facts all wrong. Anyone 
who has spent any time in Vancouver's Downtown Eastside knows that 
Insite was opened and continues to be operated by the Portland Hotel 
Society and Vancouver Coastal Health. It was not created or ever 
operated by the B. C. Centre for Excellence in HIV/ AIDS. Rather, our 
centre was contracted, through an open and competitive process, to 
conduct an arm's-length scientific evaluation of Insite.

Recently, the DPNC has repeated claims that drug overdose deaths in 
Vancouver's Downtown Eastside have increased since the facility 
opened. This is not only false, but in citing data from the B. C. 
Vital Statistics agency, they continue to recklessly lump all drug- 
related deaths together, including many causes of death that bear no 
relevance to Insite.

The claim stands in stark contrast to a 2011 study published in the 
prestigious medical journal, The Lancet, which showed overdose deaths 
around Insite had declined by 35 per cent. The Lancet study 
systematically reviewed each recorded death and involved the use of 
appropriate statistical methods. Dr. Chris Beyrer, a professor at 
Johns Hopkins School of Public Health who was invited by The Lancet 
to write a commentary to accompany the article, stated: "Supervised 
injection facilities clearly have an important part to play in 
communities affected by injection drug use. They should be expanded 
to other affected sites ... on the basis of the life-saving effects."

Harm reduction programs should remain essential components of our 
response to illicit drug use. Still, we must do more to further 
reduce drug related harm.

In doing so we must recognize that we have an ethical duty to base 
our responses to drug-related harm on the best available evidence.

By now, that evidence should be resoundingly clear: Harm reduction - 
including Insite - saves lives.
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MAP posted-by: Jay Bergstrom