The bells tolling opioid deaths in Canada incessantly ring. They toll for the nearly 14,000 individuals since 2016 who have died from opioid overdoses.  Prime Minister Trudeau’s response to this ongoing tragedy is to authorize the establishment of even more supervised drug injection sites (SIS).  This will not solve the problem.

Trudeau’s response is based on the well-orchestrated public relations campaign which claims that these sites are beneficial for drug addicts as they allegedly save their lives.  Evidence supporting this proposition is totally unreliable.

The establishment of a SIS is based on the concept that addicts cannot change, and therefore must be provided with clean facilities and medical supervision to repeatedly inject their drugs.  This assumption is contradicted by the thousands of former drug addicts who have sought treatment and now lead healthy, productive lives.  The fundamental need of a drug addict is abstinence-based treatment rather than easy access to facilities to continue to inject drugs.

Effect of Drug Injection Sites on Addicts

The problem with the SIS approach is that it deepens the addiction.  Well-off individuals can afford to obtain treatment for their addictions, but, it is the addicts without money or support who are shuffled off to a SIS, where they inject themselves continuously with street drugs.  Their addiction continues and leads to their further degradation and eventually, a difficult death.

Advocates of SIS also argue that these facilities provide opportunities for the addict to seek treatment.  The latter is not the priority for such facilities, as very few addicts take advantage of treatment offered them. The SIS employees do not exert pressure on addicts to seek other treatment since they believe the addicts must make their own independent decisions.  A drug addict, without support, is not able to do so.  In contrast, Sweden, a very liberal country, has strong law enforcement and mandatory treatment for addicts.  Treatment facilities are also widely available there.  As a result, Sweden has the lowest rate of drug use in Europe.  It is noteworthy that the effectiveness of treatment is the same whether it is voluntary or mandatory.

It is not in the best interest of the SIS to prioritize alternative treatment. Referrals for treatment are not a central part of SIS because they must rely on a continuous supply of addicts to maintain funding from federal and provincial governments. Life-long addiction insures a continue source of income for the SIS.

Regretfully, advocates for SIS have justified their use on research provided in thirty studies which purported to show that the Vancouver drug injection site, called Insite, established in 2003, had curtailed crime, disease, and led to a 35% reduction in deaths caused by drug overdose.  These studies, without exception, concluded that Insite’s operation had produced exemplary results.

These thirty studies on Insite, however, were all conducted by the same individuals who lobbied for the establishment of the drug injection site in the first place.  As a result, they had a personal interest, as well as a conflict of interest in ensuring that Insite be regarded as successful.  Their research papers violated prime directives of evaluation, in that they intermingled activism with positions of public and professional responsibility, without acknowledging their activity as activists. This raises valid questions of potential bias or conflict of interest.  Their research, in effect, was carried out for the purpose of supporting the political objective of continuing the operation of Insite, establishing that it was “successful” in treating addicts.  The studies were peer reviewed only by supporters of the drug injection facility.  Also, the researchers, contrary to standard scientific procedure, have refused to share their data with other researchers so that their studies cannot be replicated.  One such study on Insite was published in the British medical journal Lancet on April 18, 2011. This study was pivotal in the decision by the Supreme Court of Canada, handed down on September 20, 2011, to prevent the federal Minister of Health from closing down the Vancouver injection site.  This study purported to show there was a 35% reduction in overdoses in the 500 metre radius around Insite, while in the rest of Vancouver, the rate decreased by 9%.

The B.C. Coroner’s report, however, indicated that overdoses actually increased in that specific area by 14%, or 11% when population-adjusted, between 2002, the year before Insite opened, and 2005, the final year of the study period.  An international medical team of drug experts has exposed this egregious error in a Lancet article which was published in the journal on January 14, 2012.

Substitute Opioids Given to Addicts Do Not Solve Their Problems

Providing opioid-dependent patients with substitute opioids, such as methadone, hydromorphone, Dialudid, etc., do not help the addict in the long run.  The opioid methadone helps patients to manage their withdrawal symptoms and cravings without getting high or risking an overdose, however, its use still does not make much sense as the addict remains addicted to an opioid for life. Such treatment merely creates another opioid problem, which is the never-ending maintenance treatment.  Other approaches to stop addiction, such as detox centres and behaviour therapy treatment do not have this problem.

It is a tragic fact that many of these addicts have health, social, and mental problems for which they are not being given support or treatment.  Instead, they are offered only the maintenance therapy, which continues their addiction.  Drug abuse is not solved by enabling drug addicts to use substitute drugs, as it leaves the addict in a drugged state for the rest of his/her life.

Effect of Dug Injection Sites on Communities

Drug injection sites are destructive for the communities in which they are established.  They make the area neither safe nor passable for people living there.  They also gravely harm businesses located there.  Drug addicts around them scream abuse day and night, and engage in endless fighting. Drugged out and sometimes dead addicts litter the sidewalks, together with abandoned needles, condoms and crack pipes.  Addicts defecate anytime, anywhere in the area, making the vicinity almost unwalkable.  Those few individuals who dare walk near the sites are accosted by beggars, prostitutes and drug traffickers.  Consequently, those who reside in the vicinity are afraid to go out at night, and businesses in the area experience huge financial losses.

Federal Government Report on SIS

The Federal Government’s Report on SIS (March 31, 2008) found that there is no proof that drug injection sites decrease the spread of HIV and other blood-borne diseases.  Nor is there any proof that SIS decrease crime in the area.  In Vancouver, between 50 to 60 extra police are assigned to the 12 city blocks surrounding the drug injection site in order to limit criminal activity in the area.  Police officers are prohibited from charging the addict with possession and, instead, are obliged to escort the addict into the injection site.  The drug addict obtains illicit drugs, usually heroin or cocaine, of questionable purity, from a drug trafficker, which the addict brings into the site for injection purposes.  The drug injection site becomes a “honey pot” or meeting point for drug traffickers. According to the report by the federal Expert Advisory Committee on Supervised Drug Injection Sites, it is estimated that each addict causes $350,000 worth of crime each year in order to purchase drugs from a trafficker.

It is also a fiction that drug addicts using SIS cease casually disposing their used injection needles.  The federal Expert Advisory Committee report found that only 5% of drug addicts use SIS for injections, and of these, only 10% used the facility exclusively for their injections.  Many continued to inject their drugs on back streets, alleyways, and parks, leaving their contaminated needles behind.

Addicts Urgently Need Abstinence-Based Treatment

A compassionate society must not kill addicts by enabling their addiction by way of a SIS. Addicts should be provided with abstinence-based treatment facilities and other community support systems to deal with their myriad problems – social, economic, mental and/or physical health, in order to break their dangerous addiction.

This doesn’t happen when money is being funneled into self-serving supervised drug injection site.

March 17, 2020