Harm reduction saves lives and tax dollars

Nestled in the heart of Vancouver's drug-ravaged Downtown Eastside is an inconspicuous facility where an activity that is illegal everywhere else in the country carries on without the intervention of police. 

Nestled in the heart of Vancouver’s drug-ravaged Downtown Eastside is an inconspicuous facility where an activity that is illegal everywhere else in the country carries on without the intervention of police.

The facility is Insite. It provides heroin addicts with clean needles and a trained staff nearby, ready to provide assistance if the user begins to overdose.

Insite is also at the centre of one of Stephen Harper’s many losses in front of the Supreme Court of Canada.

Even though health care is provincial jurisdiction in Canada and Insite has the blessing of the B.C. government, possession of heroin remains illegal under Canada’s criminal code. As such, the facility can only operate with an exemption granted by the federal justice minister.

When the Conservative government came to power with its mantra of “tough on crime” it tried to revoke Insite’s exemption. That attempt was slapped down by the Supreme Court, which ruled that the justice minister did not give due regard to the lives and health of the addicts using the facility.

The Conservatives are not taking matters lying down. New legislation recently passed by Parliament – quietly under the radar of many big news organizations – aims to exploit a loophole in the court’s decision that could potentially allow the government to shut Insite down entirely or at least prevent the opening of new sites. This move sets the country up for another showdown between the Harper Conservatives and our highest court.

Immediately after the legislation was passed the government extended Insite’s exemption by a year – a move the cynics would note punts the issue until safely after the next election.

Advocates of harm reduction – who see some level of drug use in society as an inevitability – believe we are better served as a society by mitigating the harms that drug use causes, rather focusing solely on the hopeless battle of stamping it out.

Insite, for example, operates on the notion that heroin users will be heroin users, so until they are ready to get off the drug it is better to focus on keeping them alive long enough to do so by preventing an overdose or exposure to Hepatitis C or HIV.

Other examples of harm reduction include needle exchanges, and safe crack pipes. Some countries even provide recognized addicts with the drugs themselves to ensure purity, dosage and that the addicts do not engage in property crimes or prostitution to actually buy the drugs.

Harm reduction is obviously controversial. In a culture where the focus has always been on enforcement, it forces people to think “outside the box” about drugs – a box many are simply not willing or able to think outside of.

The idea of allowing and even facilitating the use of potentially dangerous drugs with the use of taxpayers’ money grates on the moral sensibilities of more than a few Canadians. The only good addict is a reformed addict, so if they aren’t willing to get help then force them, the thinking goes. If only it were that easy.

I have no qualms with harm reduction and would take the philosophy much further than Insite.

As nasty as drug use can be, it is clear that many of the harmful effects of addiction – both personal to the drug user and social – can be mitigated.

Contrary to widespread belief, which sees addiction as a one-way trip down a steep cliff, the reality is that with help a drug user can live a somewhat productive, meaningful life. Clearly the threat of prison, infectious disease and death are insufficient to motivate people off of drugs or we would have beaten this scourge long time ago.

Not only is harm reduction the compassionate approach, it makes financial sense as well. Many understandably object to the idea of our tax dollars being used to facilitate drug use, but that objection must be weighed against the financial cost of, for example, a round of treatment for Hepatitis C, or the liver cancer it can cause. Several analyses have shown that Insite actually saves public funds in the long term.

The Vancouver Police Department and some residents in the Downtown Eastside were initially icy to the idea of such a facility in their community but have warmed over when they actually saw it in operation. Studies have found a reduction of overdoses in the community after the opening of Insite. The facility enjoys the support of both the municipal and provincial government.

The federal government’s dogged insistence on shutting Insite isn’t surprising, given its unenlightened approach to drug use in general. The federal Conservatives seem to believe that the only solution to drug use is tougher sentences, more prisons and more moralizing to teenagers. That is too bad.

This isn’t to say that every city in the country needs a safe injection site. What makes sense in downtown Vancouver might not make sense in a place like, say, Whitehorse. But this city clearly has its own serious issues with alcohol and other drugs. The philosophy of harm reduction – in compliment to our byzantine liquor regulations and enforcement – might do us some good and is already employed in some respects.

Thankfully, alcohol being legal and all, we don’t have to deal with an obstinate federal government thwarting our efforts.

Kyle Carruthers is a born and raised Yukoner who lives and practises law in Whitehorse.

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