Thus far, Vancouver is the only Canadian city that has implemented a federal program to open safe injection sites in its notoriously heroin-infested east end. The program has been successful in getting addicts off the streets, due in part to a government-approved amnesty from drug-related prosecution for users and care-givers alike, though whether the sites have led to reduced drug use is open to debate.
Toronto has mulled over the idea of safe injection sites at various times over the last five years, but with the city’s drug problem nowhere near as bad as Vancouver’s, and with the lack of a central neighbourhood known for overt heroin use, the program has never been implemented here. David Miller has never formally endorsed the approach, though he does favour “harm reduction” as one of the four pillars of the strategy to combat drugs. Though she has not commented publicly on the issue, it is unlikely that Jane Pitfield would support a service that caters to the homeless on the streets.
Empirical evidence from the West Coast is making it increasingly difficult for those opposed to safe-injection sites to maintain their scientific footing. A study conducted by UBC last year indicates that Vancouver’s program has caused a significant reduction in syringe-sharing, which is the main source of HIV and Hepatitis C infection among intravenous drug users.
Safe injection sites foster contact between addicts and health care workers who can provide addiction counseling and treatment referrals. Added to this is the mitigating effect use of the sites has on the marginalization of users, a factor that has been identified in studies as significantly contributing to the cycle of addiction.
Without robust scientific support for their position, those opposed to safe injection sites cling desperately to outdated, erroneous assumptions about substance abuse. They continue to tout criminalization and abstinence-based treatment as the most effective tools for fighting the “war on drugs,” despite overwhelming evidence to the contrary. Indeed, the creation of a black market drug trade responsible for many of the social ills associated with addiction, such as violent crime, poverty, and the transmission of HIV can be attributed to these misguided policies.
These assumptions merely cloak a racist, class-based view of intravenous drug use. It is no secret that the majority of addicts hail from disadvantaged segments of the population, and that a disproportionate number of users are Aboriginal.
A drug policy that emphasizes criminalization and outdated treatments does little to address the pathology of addiction, and instead works to reinforce the status quo. Conversely, approaches aimed at reducing the harm associated with drug use may help to alleviate pre-existing social disadvantages by giiving addicts a much-needed sense of dignity.
- Anji Samarasekera
By refusing to provide Canadian drug addicts with government resources, we are in effect turning our back on some of society’s most vulnerable people. It’s about time we stop treating substance abusers as though they were second-class citizens. There are alarming rates of death and contraction of HIV/AIDS amongst drug users across Canada, and regardless of their lifestyle they too are entitled to health care and compassion.
Safe injection sites would not promote drug use. Rather, they would help reduce the rate of infection and provide resources for Toronto’s addicted. At the proposed clinics, there would be safe needle exchange programs in which medical professionals could monitor the injection of intravenous drugs and be on hand in case any complications occurred.
Vancouver health officials have reported that since their initiation in 2003, the safe injection sites boast a zero overdose rate.
In a July 2006 letter, the Canadian HIV/AIDS Legal Network claimed that shutting down already existing Canadian sites would be “a huge step backwards in Canada’s response to HIV/AIDS.” Moreover, a recent report in the New England Journal of Medicine stated that drug users who frequent such clinics are more likely to get into detox.
Injection sites will be able to provide life-saving services and support for Toronto’s most at-risk population-homeless drug users. Without safe injection sites, the homeless use dirty, infected needles and resort to shooting up in back alleyways, abandoned parking lots, and, what’s worse, schoolyards. Why unnecessarily expose our children to the problems of drug use when the solution is so simple and effective?
- Aisha Ansari
On the surface, safe injection sites seem loaded with benefits. They provide intravenous drug users with a place to inject their drugs under supervision by clinical staff. They decrease HIV rates and clean up the streets. They reduce the drug problem and lead to happier, healthier communities.
Unfortunately, the reality is not so rosy. While proponents of safe injection sites often cite encouraging data from Vancouver’s Insite, North America’s only legal safe injection site, not all the results have been positive. Several studies have shown that most users do not visit the site each time they require their drug fix. They may go when it is convenient for them, but they would be just as likely to inject their drugs (likely with dirty needles) on the street if they are not near the facility. Having addicts casually frequent the safe injection site while continuing to inject drugs elsewhere is clearly counterproductive and translates into a waste of government resources.
It also must be noted that Vancouver is sometimes notoriously referred to as the “heroin capital of North America” because of its extremely high rates of heroin addiction. Translating results from Insite to the city of Toronto, where the drug problem is not as great, should only be done with great discretion.
Perhaps the most compelling argument against safe injection sites is that they do not address the key issues behind drug addiction. For as long as users remain addicted, they cannot contribute to society in a meaningful way. As such, the harm reduction concept is merely an inconsistent ‘band-aid solution’ to a much bigger problem.
On the contrary, many addicts receiving treatments such as methadone (a long-acting synthetic heroin substitute) have been able to return to “normal” life. They have been able to gain employment, reconnect with family, and, most importantly, free themselves from the destructive cycle of drug addiction.
- Mayce Al-Sukhni