Gary Christian, Research Coordinator of Drug Free Australia and Dr. Colin Mangham, Director of Research DPNC, expose the bad science and faulty research methods in the Lancet study of drug overdoses around Insite.
To read the full analysis, please see this document.
We are pleased to tell you that the new DRUG PREVENTION NETWORK OF CANADA BLOG is up and running. You can find it here or under the menu heading LINKS.
In coming days, you will find entries and posts, including photos and videos from our AFFILIATE MEMBER organizations and individuals.
Dear Friends & Colleagues,
We have a new sub-page on our web site menu.
If you click NEWS, you can check the latest news and updates.
But you can also click a new sub-page called AL’S ALERTS.
DPNC Director Al Arsenault is a former Vancouver Police Officer and one of the principals behind Odd Squad Productions, an award-winning film & video house. Al is also a great collector and sharer of news, information and press releases on all things drug-related.
In fact, he sends us so many pieces on such a regular basis, we thought we’d give him his own page.
All that follows on that page flows from the watchful eye of Al Arsenault.
Thank you Ms Landolt for your interview on the radio and your article
in today’s National Post. As a resident of downtown Toronto I have
been involved in arguing against The Toronto Drug Strategy and a safe
use site in Toronto for all of the reasons you mentioned today! Most
people in the general public do not understand that the drugs are
still purchased on the street and that there are no questions asked
when a user presents themselves at a safe use site, consequently these
facilities only enable drug use. The other galling fact is that many
of the people who are there to help in the administering of the drugs
have been or still are users themselves providing a blind leading the
blind scenario. Here in Toronto we have offices set up in the city
which will hand out drug paraphernalia to anyone, no questions asked
under the guise of needle exchange programs. Let me be clear there is
no needle exchange taking place, consequently, these used needles,
crack pipes and condoms find there way into our parks, schoolyards and
back lane ways. As ordinary citizens we have been powerless to get the
city to pick up this mess or to take responsibility for it! You were
also right to point out that most of the studies that have been
released in support of Harm Reduction programs do not follow a true 4
pillar approach nor are Abstinance based organizations involved in the
studies, therefore skewing the results to more harm reduction
programs. Thank you for your work!
Maureen Gilroy
May 30, 2011
Letter to the Editor
The National Post
300 – 1450 Don Mills Road
Don Mills, Ontario M3B 3R5
Fax 416-383-2305
Dear Sir:
Thomas Kerr, author of the article on the Vancouver Drug Injection facility (May 30, 2011) is not an objective observer of the site.
He lobbied for the establishment of the drug injection site a decade ago, and he and his co-researchers have published over two dozen studies on the facility – all positive. It is no coincidence that all these studies have been peer reviewed only by those (as is Mr. Kerr) who support a harm reduction policy i.e. a policy that presupposes that the addict will continue to use drugs and the only solution is to reduce the “harm” to the drug addict. Significantly, Mr. Kerr and his co-researchers have refused to release any data to other researchers so that they can be verified.
Most recently, Mr. Kerr and his co-researchers released a study strategically timed during the week that the Supreme Court of Canada heard arguments on the validity of the site. In this study, it was stated, that the researchers had observed that overdose deaths in the immediate area of the site, had declined by 35% since it opened in 2003. However, the federal government’s Expert Advisory Committee which released a report on the site in March 2008 found that only 5% of the drug addicts in the area used the drug injection site. The claim that Insite resulted in a 35% decrease in overdose deaths, in the area is, therefore, questionable.
In his article. Mr. Kerr attempts to discredit the annual reports of the Government of British Columbia Selected Vital Statistics and Health Status Indicators, which state that the drug induced deaths have increased each year in the site area (with one exception) since the site opened in 2003 by claiming that many of these deaths surrounding Insite were from other causes. This is not so. The B.C. government report definitively states that the deaths are from drug overdose in the area.
Mr. Kerr also attempts in his article to discredit a study by Dr. Colin Mangham who has raised concerns about the methodological deficiencies in Mr. Kerr’s studies.
Mr. Kerr, however, ignores the fact that other researchers have also questioned his studies including Dr. Garth Davies, from Simon Fraser University. Other studies, for example, from the University of Glasgow, have also questioned the validity of drug injection sites. It is with good reason, that two dozen major European cities who have experimented with drug injection sites, signed a declaration in 1994 opposing such sites and want them permanently banned.
2
Well off individuals such are airline pilots, doctors and lawyers, can afford to receive treatment for their addiction. The drug injection site, however, serves to shuffle the poor off to its premises so that they increase the injection of drugs in their bodies which leads only to their inevitable and terrifying deaths. The injection site refers only 3% of its users for treatment.
Treatment is the only solution to drug addiction. Surely, as a civilized society, we can offer this to our suffering drug addicts. They are human beings who deserve better than a drug injection site, supported, not for compassionate reasons, but for reasons of personal, professional or financial bias for its continuation.
Yours truly,
C. Gwendolyn Landolt
President, Drug Prevention Network of Canada
Excellent local CTV video and print story on Insite: http://bit.ly/iUXqLz
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.”
gbellett@vancouversun.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
