Drug Prevention Network of Canada

ONE

The battle over Insite’s future
Vancouver Observer- Jenny Uechi

Tomorrow, the Supreme Court will begin hearing the case for continued operation of Insite, Vancouver’s safe injection site. Proponents call it a life-saving health facility, while critics view it as a dangerous facilitator of criminal activity. Whatever the court’s decision, Vancouver will be deeply affected by the decision.
Doctors, nurses and recovering drug addicts gathered at the Insite safe injection site on Wednesday morning to speak in support of the facility.
Vancouver Coastal Health’s chief medical officer, Dr. Patricia Daly, said that studies show supervised injection to be a “legitimate public health project that saves lives”.
Nicola Keate, a recovering addict, said that Insite helped her overcome her long-term drug addiction. “If they hadn’t come down and stepped in to get me up here and get me some help, I’d be dead today,” she said.
Speaking with a slight British accent, Keate reminded people how drug addicts don’t always conform to social stereotypes of poverty and abusive households.
“I’m kind of an oddity because I come from excellent parents and had an extremely good upbringing,” she explained.
Keate said her main problem was shyness, and that being teased as a child for over her accent caused her to become more withdrawn. After being introduced to drugs by a man “twice her age”, she spent a large part of her young adulthood addicted to hard drugs.
Keate is currently receiving treatment at OnSite, the drug recovery centre on the second floor of Insite, and says she has been clean for the last three months.
So far, public health officials and drug users have praised Insite as a life-saving facility that provides a necessary service within the Downtown Eastside, with its estimated population of 5,000 intravenous drug users its high concentration of drug users. A recent UBC study in the peer-reviewed medical journal, The Lancet, reported a 35 per cent drop in overdose deaths in the immediate vicinity of Insite since the facility opened in 2003. As for political support, Mayor Gregor Robertson and previous mayors have called on the federal government to keep Insite open.
Still, Prime Minister Stephen Harper and the Conservative Party have long opposed Insite have asked Canada’s top court to consider giving them power to shut it down. The question is, why?
A health issue, or a criminal activity?
One of the major points of contention over Insite is whether it is a health facility, or a judicial twilight zone where users can freely inject drugs banned by federal law.
For Hugh Lempick, a board member of Vancouver Area Network of Drug Users (VANDU), Insite is clearly the former.
“It’s a health facility,” he said. “If it weren’t a health facility, they wouldn’t have nurses there, it wouldn’t be supervised, it wouldn’t have saved over a thousand lives a year. It saves lives … the federal government, with their law-and-order argument, it’s bullshit.”
Lempick said that many of VANDU’s members rely on Insite, and that he knows “about a dozen” users who have managed to recover from drug use as a result of being introduced to treatment through Insite. Monika Stein, a manager of harm reduction programs at Insite, affirms that drug users at Insite are three times as likely to seek treatment than those who don’t.
In Lempick’s view, drug use is only a visible part of deeper problems. He said many drug addictions are caused by personal traumas such as child abuse and death of family members. Adding that it’s “no excuse” for becoming drug-addicted, Lempick insists that drug users often decide to take steps to break their habit through interaction with Insite’s staff.
Critics, however, are not convinced that Insite helps drug users seek treatment. Simon Fraser University criminology professor Garth Davies expressed doubt over Insite’s effectiveness, writing in a 2007 paper that Insite produced only one referral for every 112 visits.
Al Arsenault, a retired police officer who spent much of his 27-year career in the Downtown Eastside, said some people who use Insite’s services are not interested in stopping their substance abuse.
“Some people are incorrigible,” he said. “They will never, ever quit drugs, as long as we give them a place to shoot up … All they’re doing (at Insite) is facilitating, enabling and condoning destructive, illegal, unhealthy behavior.”
Arsenault, who is director/producer at Odd Squad Productions, a filmmaking company that produces documentaries to prevent youth from criminal activity, has worked on production such asThrough a Blue Lens and Tears for April, which show the devastating effects of drugs on people in the Downtown Eastside.
He argues that Insite “puts the cart before the horse” by helping drug users pursue their habit, and that funding should be directed more toward people seeking treatment. He believes that the $3 million annual budget for Insite should be used for other detox programs, such as Harbour Light, run by the Salvation Army, and the Welcome Home Society in Surrey.
“Support the people who are trying to get off drugs, help them get treatment, then if there’s money left over, deal with the other people who are addicted,” he said.
“At the end of 20 years of treatment, you have a most-likely healthy, productive adult. After 20 years of harm reduction, the person may or may not be alive, almost certainly diseased, and unproductive because they’re putting poison into their bodies. So you wonder where your money should go.”
Gloria Kieler, a pastor from Living Waters Mission, a faith-based outreach program for drug users, agrees that Insite is funded at the expense of detox services in Vancouver.
“People have to wait weeks to get into detox, and by then they’ve changed their mind,” she said. “It’s very difficult — harm reduction is great, but first of all, we should have enough beds for people to go straight into detox. They shouldn’t have to wait weeks. I don’t even feel free to talk to people about going to recovery because they’ll get disappointed trying to get in.”
Referring to documentary Streets of Plenty, Arsenault criticizes nurses at Insite for teaching new users how to shoot illegal drugs like heroin, and believes that the safe injection site does not provide the right setting for people seeking treatment to end their habit.
“You’re sitting with a public health nurse and you’ve got a needle full of drugs in front of you. Is that the best time to ask for treatment? Before you fix? Or, just after you fix, and you’ve added drugs in your brain? It’s nonsense.”
Treatment versus harm reduction
Sammy Mullaly, a nurse who has been working at Insite for three years, explains that staff ‘teach’ users to inject drugs in order to prevent them from injury and overdosing. It’s part of the “harm reduction” model, which is aimed at minimizing adverse consequences of drug use without forcing outright abstinence.
“A lot of people who come in come in with misconceptions, so we teach people how to inject more safely,” she said, noting that nurses help protect users’ health by providing clean needles and managing overdoses, which happen at a frequency of about “five a week”.
While many of the clients at Insite don’t go with the intention of quitting drugs, Mullaly explained that ongoing interaction between staff helps create the conditions for users to seek help.
“A huge part of our job is relationship building,” she said. “We find out all their stories and histories, and we refer them to treatment.”
Daly believes that Insite’s critics and supporters have “common ground” and agree on major points about addiction.
“I support prevention treatment,” she said. “Where the federal government is wrong that harm reduction is another option. You can’t have treatment without harm reduction. Treatment is complex and can take many years and many attempts.”
In Daly’s view, harm reduction and treatment go “hand-in-hand”, and one cannot work effectively without the other.
One issue of contention is that if the Supreme court rules in favour of Insite, there will be more facilities that will be opened in urban centres across Canada.
Dr. Thomas Kerr, director of the urban health research program at the B.C. Centre of Excellence in HIV/AIDS, said that other cities have already been considering opening up a safe injection site, and that Vancouver will be a litmus test of whether they will go through with it.
“There’s been good research undertaken in several cities including Toronto, Montreal and Victoria, showing that these facilities could help reduce public disorder problems related to drug use,” said Dr. Thomas Kerr, director of the urban health research program at the B.C. Centre of Excellence in HIV/AIDS. “But this court case is holding everything up.”
His concern is not that there will be too many safe injection sites in the future, but that there will be too little: when there are long lineups outside Insite, he said, people end up shooting up in alleyways or at home, increasing the risk of overdose and infection.
Colin Ross, a recovering addict who is receiving treatment at Onsite, described the safe injection site as being beneficial both to drug users and the city at large.
“We’re human beings — we deserve it, and you deserve it,” he said, pointing to reporters. “You deserve to have communities cleaner, safer. You deserve to have people being treated, and not leaving needles on your front lawn … The numbers are in, (Insite) works.”

http://www.vancouverobserver.com/

TWO

Listen to Al’s interview with CBC’s Stephen Quinn recorded May 11/11:

http://www.cbc.ca/onthecoast/

THREE

Peer Reviews

Richard Horton, editor of the British medical journal The Lancet, has said that
The mistake, of course, is to have thought that peer review was any more than a crude means of discovering the acceptability — not the validity — of a new finding. Editors and scientists alike insist on the pivotal importance of peer review. We portray peer review to the public as a quasi-sacred process that helps to make science our most objective truth teller. But we know that the system of peer review is biased, unjust, unaccountable, incomplete, easily fixed [skewed], often insulting, usually ignorant, occasionally foolish, and frequently wrong.[27]

Finally, this and other recent public health scares have focused attention on the validity of the precautionary principle. This principle states that, where there are significant risks of damage to the public health, we should be prepared to take action to limit those risks, even when scientific knowledge is not conclusive, if the balance of likely costs and benefits justifies it.

27. Horton, Richard (2000). “Genetically modified food: consternation, confusion, and crack-up”. MJA 172 (4): 148–9. PMID 10772580. http://www.mja.com.au/public/issues/172_04_210200/horton/horton.html.
http://en.wikipedia.org/wiki/Peer_review

This letter from our President, Gwen Landolt, was sent, as well, to the Globe and Mail.

Letter to the Editor
Ottawa Citizen
1101 Baxter Road
Box 5020
Ottawa, ON K2C 3M4

Your editorial in support of the Vancouver drug injection site (May 7, 2011) appears to be based on the advocacy research provided by the B.C. Centre for Excellence in HIV/AIDS rather than on an objective appraisal of the site.

The B.C. Centre for Excellence in HIV/AIDS has authored two dozen research papers on the site with every one showing positive results. These studies have long been criticized for methodological and analytical problems.

That organization’s most recent study, referred to in your editorial, claims that the overdose deaths in the immediate area of the site has declined by 35% since it opened in 2003. This is contradicted by the statistics released by the British Columbia Selected Vital Statistics and Health Status Indicators, Annual Reports, which state that the number of deaths from drug overdose in Vancouver’s Downtown Eastside has increased each year (with one exception) since the site opened in 2003 in relation to drug overdose results in the rest of the province.

An objective appraisal of the site was carried out by the Expert Advisory Panel which stated in it’s report released in March 2008, that only 5% of addicts use the site and that even of those who do use it, less than 10% use it for all their injections. It also stated that the site refers only 2.7% of its clients for treatment – the latter being the only way the addict can recover from the addiction. This approach is preferable to that offered by the site which only deepens the terrors of addiction.

Yours truly

C. Gwendolyn Landolt
President
Drug Prevention Network of Canada

Burnaby recovery centre doesn’t compromise with addiction: By Gerry Bellett, Vancouver Sun May 5, 2011

Theologians will advise you can’t parley with the Devil and remain unscathed and neither, according to the operators of Burnaby’s Charlford House, can you trifle with addiction.
So in this 15-bed Stabilization and Transitional Living Residence for women — the mouthful Fraser Health bureaucrats invented to avoid calling it a recovery centre — there are no compromises with drugs or booze, no softer, gentler way, no harm-reduction cop-outs, just the blood, sweat and tears of abstinence.
And for that, Trish LaNauze, executive director of Charlford House, makes no apologies.
“Our program is traditionally based, rooted in the 12-Step program [of Alcoholics Anonymous] which is 76-years old this year. And there’s a reason it’s successful,” she said.
It’s a philosophy that separates Charlford House from programs that aren’t as demanding on those they seek to help.
Tara Hamilton — three years drug-free, the previous 25 anything but — said the first three weeks in Charlford are known as boot-camp because “it’s so regimented and tough.”
“But it saved my life,” she says.
She had tried all the half-measures, made numerous deals with herself, but years of alcohol, crack and heroin abuse brought her to a night — and it wouldn’t be the last — she had to choose between her daughter and cocaine.
“I chose cocaine.”
She had had bouts of staying clean since her daughter was born in 2002 but they never lasted. Now after a prolonged spell of being drug free she was convinced she could drink.
“I didn’t understand addiction. I started drinking then doing weed and one night I left my daughter with a babysitter, went out and never came back.”
The babysitter called the ministry, the ministry apprehended the baby while its mother was drifting homeless and drug-addled through the Downtown Eastside.
Eventually, she would return, get her child back, promise she’d stay clean but by May 2007, she was in her bedroom doing cocaine while her five-year-old was as the door crying, “Mommy, mommy what are you doing?”
A girlfriend called the ministry and the cycle was repeated.
On Oct. 10 that year, she entered the Salvation Army’s Harbour Light Detox Centre and on Nov. 2, 2007, went to Charlford.
“I went in with a really bad attitude. I hated myself and everyone else,” says Hamilton.
“The first 21 days is like a retreat. You are cut off from everything. There’re no cellphones, no boyfriends. You don’t read newspapers, watch movies. You’re in a bubble.
“We had chores and group [meetings] to go to. I couldn’t get away with manipulating the women there because they’d call me out on all my lies. In other places they’d let me out at weekends but here if you went out it was together and if you were in a public place and had to go to the bathroom, another woman went with you.”
“It’s a good thing it was like that or I would have called someone to come and get me,” she says.
She was there six months and would have stayed longer.
Relieved of 25 years of drug-induced chaos, she was afraid to leave.
“I remember watching the news on TV [in her first week out] and getting nauseous because I hadn’t been exposed to that,” she says.
“Charlford House saved me. I needed structure and rules because I was a master con and could get around anyone. They taught me how to feel. I couldn’t cry when I first went there. But now I cry all the time — they thawed me out.
“I believed I was morally deficient because I’d choose drugs and alcohol over my child but I learned I have a disease, not a moral deficiency.”
With the help of Charlford House she found accommodation, had her daughter, then six, returned, and began to be a mother.
That was three years ago. Since then she has returned to the home as a volunteer and is waiting admission to Douglas College’s two-year community social services worker program at the end of which she will be qualified to work in a number of outreach programs, detox centres or women’s care centres.
She wants to get away from poverty, welfare and food-bank lineups.
“I’d like to be paying taxes,” she says.
Charlford House was founded 41 years ago by Thelma McPherson, who was undergoing her own recovery. She had started by bringing women suffering from addiction and living on the street into her own home.
Then she rented a small house on Charlford Ave., later moving to the present location on Kitchener in North Burnaby. More than 1,500 women have been helped since.
But the demand for its services are growing and staff are seeing more older women, 55 and up, needing help, said LaNauze.
“We’ve had one lady in here who was 70.”
It is time for the society to consider building its own home, she said.
“We need to stabilize; renting is not a long-term solution and it’s been a dream of ours to own our own place,” she says.
“We don’t want to get any bigger here because that would institutionalize the model and we’d lose what we have. We should be replicating this somewhere else.”
But it’s not four walls and a roof that brings about recovery, it’s the relationship that develops between the women and the support they give each other.
“There’s a spiritual bond between 15 people who otherwise would never be friends. They are each other’s best support because when they first come here the only thing they have to change is everything.”
gb******@**********un.com
© Copyright (c) The Vancouver Sun

Here is the link to watch DPNC Executive Director, David Berner, on Alberta Prime Time TV, discussing the possibility of opening “safe” injection sites in Edmonton and Calgary:

http://www.albertaprimetime.com/SearchResults.aspx?sr=safe%20injection%20sites

FROM DPNC BOARD MEMBER, AL ARSENAULT

Portugal is hardly the resounding success that the drugs liberalising lobby would have us believe

Sir, That fewer young people are trying drugs in Portugal may be the case (“Radical drug law could be imported to Britain”, April 22). But this simply reflects a Europe-wide trend, nowhere more evident than in the United Kingdom. The alarming Europe-wide increase in young people’s illicit drug use between 1995 and 2003 has come to a halt and is decreasing — in Portugal by rather less than the European average.

The picture painted by your report is less rosy overall when the data is examined fully. For according to Portugal’s Special Registry of the National Institute of Forensic Medicine, there has actually been an increase in Portugal’s drug-related deaths since decriminalisation was enacted, from 280 in 2001 to 314 in 2007. In well over half of these cases, opiates or opiates in combination with other substances (mainly cocaine or alcohol) were cited as the main substance involved.

Furthermore Portugal has been the only European country to show a significant increase in [drug-related] homicides between 2001 and 2006, by 40 per cent over a five-year period (2009 UNODC World Drug Report).

Finally, Portugal’s Instituto da Droga e da Toxicodependência reports that the overall prevalence of life time drug use increased from 7.8 per cent to 12.0 per cent in the period from 2001 to 2007, cocaine more than doubling and ecstasy close to doubling, with the prevalence of heroin abuse up from 0.7 per cent of the adult population to 1.1 per cent in the same period.

As to the decreases in new cases of HIV/Aids, not only is this also in line with a Western European trend but it is just as, if not more, plausible to associate this with Portugal’s annual increases in funding for treatment, detox and harm reduction than with the act of decriminalisation per se.

Portugal is hardly the resounding success that the drugs liberalising lobby would have us believe. And if it is what they are relying on to convert politicians and public to their cause it makes for a poor case.

Kathy Gyngell
Research Fellow, Centre for Policy Studies

Neil McKeganey
Professor of Drug Misuse, Centre for Drug Misuse Research, University of Glasgow

Mary Brett
Trustee, Cannabis Skunk Sense

THE IDENTICAL LETTER WAS SENT AS WELL TO THE GLOBE AND MAL
April 18, 2011

Letter to the Editor
The National Post
300 – 1450 Don Mills Road
Don Mills, Ontario M3B 3R5
Fax 416-383-2305

Dear Sir,

The leaders of the harm reduction movement, psychologists Dr. Thomas Kerr and Dr. Julio Montaner and Dr. Evan Wood, a health specialist, have written yet another advocacy study in promotion of the Vancouver drug injection site (National Post, April 18, 2011).

None of these individuals are drug treatment specialists. They are, however, the authors of over two dozen advocacy research papers on the site – with everyone showing positive results.

Their studies have long been criticized for the methodological and analytical problems.

Consequently, it is not surprising that the Government of British Columbia Selected Vital Statistics and Health Status Indicators, Annual Reports, states that the number of deaths from drug overdose in Vancouver’s Downtown Eastside has increased each year (with one exception) since the site opened in 2003 in relation to drug overdose results in the rest of the province. There were 28 deaths in 2003, 32 in 2004, 37 in 2005, 38 in 2006, 46 in 2007, 24 in 2008 and 40 in 2009. In fact, according to the Canadian Community Epidemiology Network in Drug Use, Downtown Eastside residents in 2006 experienced a 33% higher death rate than the rest of the province.

It is far more compassionate and just to provide drug addicts with treatment and hope, rather than to deepen their addiction by a drug injection site which leads only to their inevitable and unenviable deaths.

Yours truly,

C. Gwendolyn Landolt
President
Drug Prevention Network of Canada
905-787-0348 – Office
905-889-1993 – Residence
F: 905-770-1117
Email: re******@******og.com

From the desk of DPNC Board member, Andy Bigras

When Nick Bala started chemotherapy, he asked his doctor for something to help with the nausea and vomiting that followed each treatment.

After about four months, Bala asked his doctor for a prescription for medicinal marijuana.

“I found that it made a huge difference to the nausea,” Bala said Wednesday. “For me and many other people, it made chemotherapy much more bearable. It’s very important this be made available to people who are suffering.”

An Ontario court ruling this week may make that reality sooner rather than later.

An Ontario Superior Court judge found marijuana cultivation and usage laws unconstitutional and gave the federal government three months to respond to the decision.

But Bala isn’t leaping for joy yet, knowing that the government may appeal the ruling.

“This could be before the courts for years,” said Bala, a law professor at Queen’s University.

On Monday, the Ontario Superior Court declared the rules that govern medical marijuana access and the prohibitions laid out in sections 4 and 7 of the Controlled Drugs and Substances Act “constitutionally invalid and of no force and effect,” effectively paving the way for legalization. If the government does not respond within 90 days with a successful delay or re-regulation of marijuana, the drug will be legal to possess and produce in Ontario, where the decision is binding.

The ruling stemmed from the constitutional challenge of Matthew Mernagh, a man who relies on medical marijuana to ease pain brought on by fibromyalgia, scoliosis, seizures and depression.

© Copyright (c) The Ottawa Citizen

Thanks to Board member, Al Arsenault

Published: Saturday, April 09, 2011, Press and Guide – Dearborn, MI

The city’s chief judge last month made a ruling that could have big implications for the state’s two-year-old medical marijuana law.

In an order denying a motion to dismiss a possession of marijuana case, Judge Mark Somers wrote, “This court finds that in consequence of the lawful designation of marijuana as a Schedule I narcotic under the Controlled Substances Act, the Michigan Medical Marihuana Act is rendered unconstitutional and void in its entirety by operation of the Supremacy Clause of the United States Constitution.”

The Controlled Substance Act is a federal statute that classifies drugs into five categories, known as schedules, based on their potential for abuse. Schedule I drugs, such as marijuana, cocaine and LSD, are considered to be the most addictive and are not legal to prescribe.

The case stems from a traffic stop in January 2010. Dearborn police cited the defendant, Robert Brandon, for illegal possession of marijuana and contributing to the delinquency of a minor, according to court documents.

Brandon tried to have the case dismissed four months later based on the grounds that, after he was ticketed, he saw a doctor who issued him a “physician’s certification” for medical marijuana to treat chronic back pain. Doctor’s can’t legally prescribe medical marijuana so, under the Michigan law, a physician’s certification is the terminology used.

Somers questioned the legitimacy of the claim, however, noting that Brandon’s doctor only met with Brandon for about 20 minutes before writing the certification, did not perform any physical examination, and had no previous patient-doctor relationship, which is part of the criteria for medical marijuana certification.

Moreover, Somers wrote, Brandon’s certification came after the traffic stop, meaning that it couldn’t be used as a defense.

But what was most significant in the order was that Somers, an outspoken critic of marijuana and skeptic of the medical marijuana law, declared the medical marijuana law void. The case is scheduled for a pretrial conference April 12.

Somers declined comment Thursday because the case remains pending. The city’s chief judge last month made a ruling that could have big implications for the state’s two-year-old medical marijuana law.

In an order denying a motion to dismiss a possession of marijuana case, Judge Mark Somers wrote, “This court finds that in consequence of the lawful designation of marijuana as a Schedule I narcotic under the Controlled Substances Act, the Michigan Medical Marihuana Act is rendered unconstitutional and void in its entirety by operation of the Supremacy Clause of the United States Constitution.”

The medical marijuana law has been a legal quagmire since Michigan voters adopted it in 2008. Because marijuana remains illegal under federal law, local governmental bodies in Michigan have been forced to interpret how to apply it.

Somers’ ruling doesn’t mandate Dearborn’s two other district judges to take the same view.

Insite
A Chair Missing Three of Its Legs

By a 15-year Old Girl
November 8, 2009

Outline
I. Introduction
Thesis- The Safe Injection Site (Insite) in Vancouver uses money to supply a clean and safe environment for drug addicts to inject themselves with illegal substances. The money used to run this facility would be better spent on treatment.
II. Downtown East Side
A. History
B. Why Downtown East Side?
i) The Addictions
III. The Health of Drug Addicts
A. Physical Effects
i) Internal Damage
ii) Tolerance Building
B. Emotional Effects
i) Brain Chemical Imbalances
ii) Emotional Cycles
IV. Criticisms of Insite
A. What is Insite?
B. Unsuitable Way of Treatment
C. The Failed Four Pillars Approach
D. The Budget for Insite
V. Conclusion
Most people pay taxes, and others have jobs. Most people are responsible, contributing citizens of society. Drug addicts however, are not like most people. They have addictions that are so strong that it consumes their entire life. It does not matter if they once had jobs or have families. All that matters is the drug that is slowly killing them. Every waking second is about their next fix. Drugs are poisons that are derived from plant defence mechanisms called psychoactive alkaloids. These were used to ward off the herbivores. When the herbivore eats the plant, they experience the “high” and stay away from it. Yet addicts want this feeling, they need it to dull the pain and the loneliness they feel. It is illogical and unnatural, but it is an issue around the world, especially in the Downtown East Side in Vancouver. The Safe Injection Site (Insite) in Vancouver uses money to supply a clean and safe environment for drug addicts to inject themselves with illegal substances. The money used to run this facility would be better spent on treatment.
Originally, Gastown was a thriving industrial community complete with sawmills, great transportation, a main library, a city hall, banks, hotels and theatres. But, like all good things, it came to an end: in the late 60’s businesses re-located, decreasing the economy’s productivity. When less and less people walked through the Downtown East Side, the other community centers like the library and the theatres followed suit. The following decade, most people with mental health issues could not afford housing anywhere else but the Downtown East Side due to supply and demand. Soon after, many drug addicts and dealers called the Downtown East Side their home. In the late 80’s heroin, the drug of choice at the time, changed to cocaine, a highly addictive drug. Drug addicts living in the Downtown East Side had to support their habit somehow, and they did this by stealing. Due to the increase in robberies, the only businesses that made a profit were second hand shops that bought the stolen items. This made legitimate businesses hard to come by. In the 90`s, almost all of the businesses had moved elsewhere, leaving a poor, poverty-stricken, highly unemployed, and addicted Downtown East Side behind.
The problems in downtown Vancouver did not get any better, nor did the health of the drug addicts residing there. The health of drug addicts who use cocaine and methamphetamines ranges from ear, nose and throat problems such as bronchitis, bleeding, sinusitis and coughing up mucus and blood to unhealthy weight loss due to higher than normal metabolisms, and everything in between. Drug addicts either sleep too much or too little, have periods when they feel they have extreme strength which could cause injuries, teeth problems, vomiting, seizures, irregular breathing, haemorrhaging (bleeding of the brain), and the list goes on. What makes the addictions maintain in severity is tolerance building. This occurs as an addict needs more and more of their drug of choice to feel `normal`. However, drugs do not limit themselves to destroying the physical health of the user, they affect the mental health as well.
Drugs change responses of brain chemicals called nero-transmitters. They do this by causing the brain to release too much or too little of these chemicals. Vital nero- transmitters that are affected by drugs are as follows; norepinephrine, dopamine, serotonin, and acetylcholine. Norepinephrine and dopamine is adrenaline, and too much of it that is released can result in a more violent behaviour. Serotonin, also called 5-hydroxytryptamine is responsible for the high. This nero- transmitter constricts the blood vessels, making the user feel ‘happy’. Acetylcholine or ACH relays information between nerve cells in the brain, effecting the physical movement. Drugs that take a shorter time to affect the brain do so because they are similar size and shape to the normal brain`s nero-transmitters. The ingested drugs take about twenty to thirty minutes, whereas injected drugs take only fifteen to thirty seconds. A marijuana high can last up to several hours, whereas a cocaine high, lasts about an hour. While all of the brain chemical changes are taking place, the drug addict feels euphoric. He or she thinks that they are on top of the world, can do anything they want. Any pain or loneliness they feel, diminishes. Unfortunately for the addict, that joy comes to an end, and is followed by extreme depression. Wanting to feel that sense of euphoria again, the addict buys more drugs and shoots up. This vicious cycle continues to occur until the addict can get their next fix, until he/she can feel happy again, until he/she walks across the street, opens the door the Safe Injection Site, sits in a comfortable cubby, is supplied a clean needle, and is able to shoot up while a nurse is watching him to make sure he is safe so he/she can do it all over again the next day.
The Safe Injection Site opened its doors in June of 2003, when Health Canada granted Vancouver Coastal Health an exemption from section 56 of the Controlled Drugs and Substances Act (CDSA). This led to North America`s first Supervised Injection Site, otherwise known as Insite. It is located on 139 Hastings Street in the Downtown East Side. Insite is open from ten in the morning to four in the afternoon, seven days a week. Around 650 drug addicts use Insite each day. This means 650 human beings who desperately need support and help continue to shoot up, easily forgetting about what they really need, which is treatment. The high they experience is more important than anything else; it makes them feel good, so why should they stop? They are getting what they want, which is their drug of choice and the ability to use it. Insite only provides the ability to use the drugs safely.
Insite is only focussed on harm reduction. It is quite clear that Insite does not provide the four pillars approach. It has failed to supply the other three key pillars; prevention, treatment, and enforcement. Insite itself is the complete opposite of prevention. By letting addicts shoot up, they are allowing this behaviour. As for enforcement, making it legal to use drugs in Insite is most definitely not enforcing the law. As for treatment, that`s a big one. Drug specialists say that the best way for someone to get clean is to take the temptation away. Again, Insite is doing the exact opposite by enabling drug addicts to use without any consequences or second guesses.
Tony Cement, Canada`s former Health Minister is against Insite. He said “Advocates have given an overly rosy picture of the Vancouver facility, which focuses on `harm reduction` by letting addicts shoot up and receive medical help in a safe, clean environment.“ He said that treatment is key in the solving the issue. Clement continued by saying “The best way to reduce harm is to get addicts off drugs and to provide supports for that addict.“ Due to the fact that Insite was so controversial, Tony Clement had a committee issue a study. This committee found that Insite only had five percent of the Downtown East Side`s addicts actually using it. This concludes that Insite is not helping most of the addicts living in the Downtown East Side to kick their habit.
Addicts can have a moment of wanting treatment, but when they hear it can take anywhere from one week to four weeks for a detox bed, the moment often vanishes. It does not make any sense that while an addict has to wait for treatment, they can go shoot up at Insite any time. Insite makes it easier for addicts to continue to use because if they were caught on the streets using drugs, then they would be either fined or arrested, whereas in the safety of Insite, drug addicts are free to use without any consequences. The whole point of making something illegal is to make people not want to do it, or at least make it harder for them to do it. The drug addict using Insite may not think of his/her addiction as big a deal that needs fixing, but instead a normal way of life.
If the four pillars approach clearly states that treatment is part of it, then why would a drug addict have to wait for treatment? Because most of the funding is being put towards Insite, leaving little for treatment facilities and detox beds. So little in fact, that British Columbia, with 8,000 addicts, has only one hundred detox beds. Patti Smith, a worker at Vancouver Native Health said; “We need to be able to respond to these people the minute there is a window. They`re taking responsibility and we need to acknowledge it right away.“ So, prevention, enforcement, and especially treatment are not receiving the attention they deserve. Let`s compare Insite; a clean, chic setting complete with a coffee bar and background music to one of the very few detox beds; a dingy, unwelcoming facility that you have to wait for days to enter. As a drug addict, which would you rather be in? People do what is easiest for them. Why wouldn’t they continue to do something that makes them feel euphoric, at least part of the time, when the alternative would be a dull and boring place? Treatment must be appealing to use. John Turvey, a founder of a needle exchange noted “They`re jumping all over this Safe Injection Site and forgetting about the treatment programs that were supposed to go with it. What about abstinence and the 12-steps?“
Not only does Insite fail the four pillars approach, but it costs a lot of tax dollars to do it. The budget for Insite is three-point-five to four million dollars a year. This tax money should not go towards allowing and enabling drug addicts to use, but rather to treatment centers. Wasn’t that the whole point of Insite? Once informed of ‘treatment options’ addicts are supposed to go to treatment. But they don’t because there are not many treatment beds available. Insite is giving no hope to those who desperately want to overcome their addiction, but cannot because of the lack of funding. The main purpose of Insite is to decrease the amount of sharing needles. Yet 40% of regular Insite users who have AIDS still share needles. Money being put towards Insite for that purpose is being wasted, because the addicts who are informed about the dangers of needle-sharing do not get the message.
It is very surprising that despite Insite`s many problems, it continues to run to this day. Giving needles to drug addicts is like putting out a forest fire with a garden hose. It just will not work. The prioritizing of the four pillars approach is all wrong, and shows that we as a community accept drug use. Insite seems to be more about sustaining the addicts’ lifestyle, than about ending their addictions. Addicts will not own up or admit they need help, especially when a neighbourhood sets up a place where they can shoot up. These addicts need help, but it should not come in the form of a free needle. Some addicts will continue to use this debilitating program until they die. Mahatma Gandhi put it well when he said; “ Recall the face of the poorest and most helpless man who you may have seen and ask yourself if the step you contemplate is going to be of any use to him. Will he be able to gain anything by it? Will it restore him to a control over his own life and destiny?“ This quote can be applied to drug addicts. They are some of the poorest and most helpless of people, due to their overwhelming and negatively life-altering addictions. We offer Insite, but users will not gain anything by continuing to use drugs, and supplying them with needles to do so will not give them control over their life. The bottom line is that no matter how clean a needle is, it is still a needle that injects drugs into a person, continuing a deadly cycle that keeps their addiction, an addiction. Isn’t that exactly the opposite of what everyone wants for these people?

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8. Munoz, Mercedes and Courtwright, David. What Causes Addiction? California: Thomson Gale, 2005.
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12. “RE; Injection Site gets Extension:.” Letter to Editor of the Vancouver Sun,. 02 Sept. 2006. MS.
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16. http://vancouver.ca/COMMSVCS/PLANNING/dtes/communityhistory.htm
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FROM DPNC BOARD MEMBER, AL ARSENAULT

SAN DIEGO — The ease in which local teens are obtaining pot is being blamed on medical marijuana cards, and both sides of the marijuana dispensary debate acknowledge it is a growing problem.

Read the full story and watch the video: http://www.10news.com/news/27378646/detail.html