#READ The War on Harm Reduction by Jason Tan de Bibiana: VIA @papakelt
Posted on 12 April 2011
The Four Pillars Drug Strategy, as the name suggests, has four components for addressing problematic substance use: Treatment, Prevention, Harm Reduction, and Enforcement. This comprehensive approach was adopted by the City of Vancouver in 2001 and a number of other Canadian cities since then, but does not reflect Canada's current national drug strategy, which largely ignores Harm Reduction. Recently, Dr. Gabor Mate described its implementation as a "one pillar and three toothpicks" strategy – by which he meant that Enforcement still gets the majority of resources and support in Canada. Billions of dollars from Ottawa have been pledged for prison expansion, federal legislation has been proposed to impose mandatory-minimum sentences for drug-related offences, and the Conservative government is currently running for re-election on a tough-on-crime platform that promises to enforce mandatory drug testing of all federal inmates once per year, and lay additional charges on prisoners in possession of illicit drugs.
Seemingly, the current logic is to lock up all the drug users and then keep them in there until prison life beats the addiction out of them.
In contrast to an Enforcement-heavy approach, Harm Reduction is a crucial component of a balanced and pragmatic drug strategy. People use drugs for complicated reasons, in spite of knowing about all the risks they pose. Harm Reduction proposes that the negative consequences of drug use can be mitigated. Harm Reduction underlies clean needle-exchange and crackpipe mouthpiece programs, supervised injection and drug consumption sites, managed alcohol programs, and even providing taxi-rides home, water, and condoms at bars and clubs. A successful Harm Reduction program prevents overdose deaths and the spread of infectious diseases, and can complement Treatment and Prevention. These programs pay off in the long-run by averting future costs to the health care and social system from serious consequences such as HIV-infection, and give people the opportunity to stay alive and stay healthy.
The Conservative government is still strongly opposed to the idea of Harm Reduction and has been particularly hostile towards Vancouver's InSite, which remains the only legal supervised injection site in North America.
A few years ago, Dr. Stephen Hwang asked in an editorial:
What if a new treatment for diabetes was developed? It doesn't cure diabetes but it reduces many of the complications associated with the disease. The treatment is evaluated favourably by a highly-respected group of health scientists and findings are published in the leading peer-reviewed medical journals. The studies even suggest that the treatment is a cost-effective use of health care resources! Yet, the federal government calls the research inconclusive and says it will only support treatments that either prevent diabetes or cure it completely. Other health care providers are forbidden from providing the new treatment and the government even tries to ban it altogether.
Sounds bizarre, right? Well, Hwang reminds us that this is exactly what has happened to InSite.
The opposition to Harm Reduction is based on differences in ideology, not a lack of research and evidence. More than 30+ research studies have been published in peer-reviewed medical journals that describe the positive impacts of InSite, which include decreases in public injecting, syringe sharing and overdoses, and increases in uptake of addiction treatment and detoxification services. The researchers looked for evidence of negative impacts from InSite's operation, such as increases in crime rates in the Vancouver's downtown Eastside neighbourhood, and found none. Critics of InSite continue to declare that supervised injection sites and other Harm Reduction initiatives send the message that injection drug use is safe and will encourage people to use drugs. However, there is no empirical evidence to support this hypothesis – InSite isn't trying to corrupt our society, just to save some of the people who have been the most marginalized.
On May 12, 2011, the Conservatives will take another shot at shutting down InSite, in an appeal to the Supreme Court of Canada. InSite opened its doors in 2003, when the Liberals were in power, and has been allowed to operate since then under an exemption from Canada's drug laws. What began as an pilot project to evaluate whether a supervised injection site would improve health and result in other desirable outcomes, as well as whether it would be worth the money and resources, is now an important and established service. The experiment is over, at least by the consensus of the scientific community, and many others. But we're still waiting for government decision-makers that are willing to support policy informed by evidence and open to a balanced and comprehensive drug strategy that includes Harm Reduction as a valuable alternative to the "War on Drugs."
Comment: We all need to really comprehend the whole concept of harm reduction, that is, reducing harm done by street drugs; offer drug treatment and look at alternative therapies that will help us dig deeper into the true social-environmental-spiritual roots of drug addiction. The war on drugs is actually a war on drug addicts. Support Harm Reduction! @Peta_de_Aztlan
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