• Hot Off The 'Net

    Harm Reduction or Mixed Messages?

    By J.T. Junig, MD, PhD

    I’m curious what readers think about needle exchange programs, dosing rooms, and other means of harm reduction. Should we provide clean syringes and needles for drug addicts at taxpayer expense? Should the needles incorporate filters to protect people who dissolve and inject Suboxone—at the same time when many patients wait in line to get into a buprenorphine program in order to use the medication properly?

    I would also appreciate comments from anyone who is making use of needle exchange or similar programs—and from any readers who are diverting Suboxone. Set up a free, anonymous e-mail account and let me know why you are doing what you are doing—instead of using the medication properly and leaving the using days behind. If you are nervous about leaving an I.P. address on the Psych Central site, send me an e-mail—to [email protected] .

  • Drug Policy - Hot Off The 'Net

    Vancouver Injection Site Becomes Election Issue

    Vancouver’s controversial safe injection site became an election issue Monday after yet another published study showed it has saved lives, prompting the study’s author to say Conservative policy on the site has no basis in fact.

    Critics demanded Prime Minister Stephen Harper drop his government’s opposition to the clinic and abandon efforts to have it shut down.

    Harper was in Yellowknife on Monday where he touted his government’s national drug strategy, saying it is based on prevention and treatment.

    But the Conservative government has said in the past that it doesn’t condone the safe injection site and claims it fosters addiction.

    The latest study was published this week in the influential medical journal The Lancet. It was written by Dr. Thomas Kerr, along with his colleagues from the Urban Health Research Initiative at Vancouver’s St. Paul’s Hospital.

    “Canadians should be concerned about how the federal government is approaching problems like drug addiction — that they’re really not basing their decision on science, they’re basing it on ideology,” Kerr said.

    Marc Townsend, manager of the Portland Hotel Society, enters Insite

  • Drug Policy

    Harm Reduction Advocates Target Addicts And Critics

    On the heels of
    yet another study     which found that supervised injection sites encourage patrons to seek treatment, the Drug Prevention Network of Canada, an organization funded by the Drug Free America Foundation, whose mission is, among other things, “To advocate no use of illegal drugs and no abuse of legal drugs” and “To oppose legalization of drugs” is complaining to sympathetic media that they are being bullied by harm reduction advocates.

    Specifically, the DPNOC’s “Director of Research,” Colin Mangham is upset that his reputation is being damaged by a lawsuit filed against him for “publishing” lies and distortions about InSite, Vancouver’s supervised injection facility, and harm reduction in general, in an online “journal” owned by the DFAF.

    I am reminded of Ben Stein’s move “Expelled: No Intelligence Allowed,” in which Stein whined that proponents of “intelligent design” and critics of evolution are being discriminated against in colleges, universities and anywhere else empirical evidence and the scientific method are still respected. At least we know we have them on the back foot for a change.

    Supervised injection site epitomizes warped philosophy in Downtown Eastside

    By Mark Hasiuk, Vancouver Courier September 15, 2010

    [snip]

    “The best thing you can say about harm reduction advocates is that they are reductionists–they are reducing a complex human problem to a simple thing,” said David Berner, the newly appointed executive director of the Drug Prevention Network of Canada, an abstinence-based organization (soon-to-be headquartered in Vancouver) founded by former Conservative MP Randy White. “We need to get money and human energy back into prevention, education and treatment.”

    [snip]

    But criticizing Insite can come with a price. In the high stakes world of harm reduction, where government grants provide vital lifeblood, reputations are brutally defended. Critics targeted and bullied.

    Just ask Colin Mangham.

    Last September, the Portland Hotel Society, co-operators of Insite, slapped a defamation and slander lawsuit on Mangham, a 60-year-old research scientist and addictions expert whose 2007 RCMP-funded report published in the Journal of Global Drug Policy and Practice questioned the findings of Insite researchers. “Statements made about improving public order, saving lives and getting people into detox are misleading and based on data that just isn’t there,” said Mangham, during a recent phone interview from his home in Langley.

    [snip]

    Where are the transitional fossils? The evidence for common ancestry and decent with modification just isn’t there.

    Ten years in, Vancouver’s great harm reduction experiment keeps rolling along, leaving rows of victims in its wake. Addicts get sicker, critics assailed, while an entire neighbourhood rots from the inside out.

    Wonder if this is what Philip Owen had in mind?

  • Drug Policy

    CMA Journal Article Backs Drug Injection Site

    Federal government accused of ignoring addicts by opposing Vancouver site

    An article in the Canadian Medical Association Journal slams the federal government for its efforts to shut down Insite in downtown Vancouver, Canada’s only safe injection site for drug addicts.

    Injection booths at Insite in Vancouver. Insite is the first legal supervised injection site in North America and is located in Vancouver’s east side. Injection booths at Insite in Vancouver. Insite is the first legal supervised injection site in North America and is located in Vancouver’s east side. (Jonathan Hayward/Canadian Press)A co-author of the paper has told CBC News he believes the federal government should stand aside, allow the centre to operate, and abandon an appeal to the Supreme Court

    “We’ve concluded after reviewing the evidence that Insite is doing what it’s supposed to be doing, and furthermore that we’re very concerned that the federal government has misled on the science,” said Dr. Michael Rachlis, a professor of health policy at the University of Toronto.

    Insite was established in 2003, when there was a Liberal government in Ottawa, but has been fighting for its survival since the Conservatives came to power in 2006.

    ‘We’re calling on the federal government to drop the current action they have in the Supreme Court.’ — Michael Rachlis, University of Toronto

  • Hot Off The 'Net - International

    HIV Shoots Up

    British Medical Journal On Harm Reduction

    Strict laws on the criminalisation of drug use and drug users are fuelling the spread of HIV and other serious harms associated with the criminal market and should be reviewed, say experts. In this video, epidemiologist Elizabeth Pisani and other leading commentators describe which countries are leading the way in tackling HIV infection among injecting drug users.

  • Drug Policy - Question of the Week

    Can heroin be used to treat heroin addiction?

    Drug Policy Question of the Week – 6-9-10

    As answered by Mary Jane Borden, Editor of Drug War Facts for the Drug Truth Network on 6-6-10. http://www.drugtruth.net/cms/node/2930

    Question of the Week: Can heroin be used to treat heroin addiction?

    First, a look at the numbers finds that there were approximately 213,000 current users of heroin in the United States in 2008, with current users defined as those who had used the drug in the last month. This kind of use is medically defined as chronic.

    The two physicians looked into heroin addiction in the 2004 Archives of Internal Medicine article entitled, “Treating Opioid Dependence.” They pointed to a scientific basis for heroin addiction by postulating,

    “Chronic heroin abusers end up with an endogenous opioid deficiency because of down-regulation of opioid production. This creates an overwhelming craving.”

    Three synthetic opiates — Methadone, Levomethadyl, and Buprenorphine – have been developed as chronic maintenance therapies to overcome this down regulation and the consequent cravings.

    Very recently – in fact just last week – the prestigious British medical journal, The Lancet, contained an article and commentary concerning the

    “scientific evidence base [that] is emerging to support the effectiveness of maintenance treatment with directly supervised medicinal heroin as a secondline treatment for chronic heroin addiction.”

    Heroin maintenance is targeted toward the

    “5-10% of heroin addicts who fail to benefit from established conventional treatments.”

    Moreover, studies have shown that,

    “treatment with supervised injectable heroin leads to significantly lower use of street heroin than does supervised injectable methadone or optimised oral methadone.”

    Commenting on heroin maintenance, The Lancet concluded,

    “The existing interference and non-evidence-based opposition from politicians and care providers, who refuse to acknowledge the limitations of methadone maintenance and the superiority of prescribed heroin in selected populations, is arguably unethical. Denying effective second-line therapy to those in need ultimately serves to condemn many users of illicit heroin to the all too common outcomes of untreated heroin addiction, including HIV infection or death from overdose.”

    These facts and others like them come from the Heroin and Heroin Maintenance chapters of Drug War Facts.

    Questions concerning these or other facts concerning drug policy can be e-mailed to [email protected].