Libby Davies: Insite anniversary coincides with Conservative attack on evidence-based medicine

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      It’s ironic, and typical, that as Insite celebrates its 10th anniversary of successful operation in Vancouver's Downtown Eastside, the Conservative government in Ottawa is still railing against safe-injection sites and no doubt has Bill C-65 ready to go when Parliament returns October 16.

      Bill C-65, An Act to amend the Controlled Drugs and Substances Act, was the last bill to be introduced before Parliament recessed in June. It’s a nasty bill, couched in anti-harm reduction rhetoric, full of misconceptions, and designed to shut down any attempt to open a safe-injection site in Canada.

      The bill is a shining example of Conservative ideology trumping evidence-based health and science.

      But try as hard as they can, Insite just won't go away and nor will public support for it. After numerous court rulings, including the Supreme Court of Canada, enormous public scrutiny, more than 24 peer-reviewed scientific studies, Insite will continue no matter what legislation the Conservative government throws at it.

      September 2003 marked the opening of Insite, but the struggle to get there began many years before that.

      The original application to Health Canada was subject to a run of hurdles that would have challenged an Olympic athlete. The then-Liberal government was wary and skeptical of approving the original Section 56 exemption under the Controlled Drug and Substances Act that was needed for Insite to operate.

      Mounting public pressure, particularly from Vancouver, forced the government into giving the exemption and Insite launched its critically needed services. Insite opened as part of a public-health plan after a 12-fold increase in overdose deaths in Vancouver between 1987 and 1993. At the time, the Vancouver area was also seeing drastic increases in communicable diseases among injection-drug users, including hepatitis A, B, and C and HIV/AIDS.

      What has been remarkable about Insite is its ability to overcome political challenges and retain strong community support.

      I vividly remember participating in a community action named "1,000 Crosses" in Oppenheimer Park. The crosses represented the people who had died needlessly from drug overdoses. I vowed to take the message for action to Ottawa, as a newly elected member of Parliament.

      I recall how opposed the local business community was at first when Insite was first raised as a needed health intervention and to save the lives of injection-drug users. I remember meeting with Allan Rock, then minister of health in in Ottawa in 1997, and later, with Bud Osborn, who came to a second meeting to convince the minister that Insite could turn the tide of preventable drug overdoses. Bud presented Allan Rock with a book of his powerful poetry that spoke the truth about the situation in the Downtown Eastside—poetry that became a rallying call for action, and this excerpt from Bud’s poem stays with me:

      “......but with these thousand crosses

      planted in oppenheimer park today

      who really see them

      feel sorrow

      feel loss

      feel rage

      our hearts shed bitter tears

      these thousand crosses are symbols

      of the social apartheid in our culture

      the segregation of those who deserve to live and those who are abandoned to die these thousand crosses represent the deaths of drug addicts these thousand crosses silently announce a social curse on the lives of the poorest of the poor in the downtown eastside...."

      Even in opposition the Conservatives wouldn't consider a shred of mounting evidence that Insite was part of the solution, not the problem. Prior to the 2006 election we invited Stephen Harper to visit the facility on East Hastings Street, to see for himself what important work was underway. Of course he refused. Conservatives don't like reality to confuse their "truth".

      Insite had to fight tooth and nail to get its permits to operate extended, while in Ottawa in 2007 the Conservative government eliminated "harm reduction" from Canada's drug strategy. But still Insite continued to garner positive international reviews and continued to save lives.

      Ten years marks a sustained commitment by the Vancouver Network of Drug Users (VANDU), the Portland Hotel Society, and many others who never shied away from the belief that drug users have human rights, dignity, and a right to access health care. 

      On my part, I'm proud to have been part of this struggle for Inite and what it stands for. I remain determined to defeat not only Bill C-65, but the architects of this absurd stance that public policy based on evidence is politically expendable.

      Libby Davies is the NDP MP for Vancouver East.



      Lee L

      Sep 20, 2013 at 1:37pm

      It doesn't take a degree in political or social science to understand the attitude of the public toward funding injection services for addicts who have had to scrounge, beg, prostitute and steal from the public to support their lifestyle, and I don't think the conservatives are at odds with that attitude.

      Oddly though, if INSITE works, it increases the supply of addicts and their associated behaviours by extending their lifetime while doing nothing to prevent new addicts. INSITE without an accompanying means of bringing individuals out of an addicted life is never going to be willingly funded on compassionate grounds.
      There is no unlimited source of funding for anything, and in a limited financial environment, I would fund prevention before safe injection.

      More practically, though, doing the math on the drain on the health care system by those that even if they do manage to extract themselves from addiction were at high risk of infection with diseases (such as AIDS or hepatitis C) which are tremendously expensive to treat or cure, could make a case for a more extensive program which would include INSITE.

      A presently available course of treatment to cure hepatitis C, acquired through injection drug use, for example, costs the system approximately $100,000 - $200,0000... IF it is successful. If it is not, then the consequent progression of the disease will eventually cost even more. INSITE will directly reduce those costs and even pay for itself to the degree that it prevents infection. Perhaps it should be funded through the health care system itself as a cost saving measure.

      Rick in Richmond

      Sep 20, 2013 at 3:50pm

      Insite is a suicide prevention bureau. To that limited extent, it is a very good thing. And it saves the taxpayers a great deal of money in inevitable charges down the road.

      As drug users die of their multiple addictions and diseases, the cost to the taxpayer is enormous. Even conservatives will agree that it's cheaper to supervise needle use than to supervise a slow death from AIDS. But both are dead ends.

      The only real answer lies in prevention, and in treatment of the underlying causes of drug addiction. Like cancer, there is no single cause, or cure.

      As long as anyone tries to rationalize these diseases as a "lifestyle choice", addicts will be pleased to continue in their slo-mo suicide. And that's the moral dilemma of Insite.

      We pay to keep drug addicts alive who are actually killing themselves, a little bit every day. That cycle needs to be broken. Any other approach is profoundly inhumane.


      Sep 22, 2013 at 7:16pm

      More bs from Libby. I have always supported the NDP at the ballot box and financially. I wish Mulcair would flush her down the toilet along with the other fringe characters in the party. Let the poverty pimps and junkie enablers form a new party.

      Barry William Teske

      Sep 23, 2013 at 5:55am

      And as usual nobody has the fortitude to take on the phameceutical lobbyists and the industries that maintain the creation and the supply of addiction inducing drugs.
      Not even me.