Sam Eifling: Drug Policy and Insite

As we define the human rights questions around Insite and similar safe injection sites, I'd like to pay special attention to the intersection of addiction and the law. Do the medical necessities that accompany addiction present governments with different considerations when treating addicts under the law? Can addiction be considered a compelling reason for a person to break local or federal statutes involving narcotics use, and should concerns about a greater societal good be weighed against the rights of an addict? For example, to what degree should the change in the rate of violent crime, for better or worse, be factored into the policy decision to allow or forbid drug use? And does a venue such as Insite – which in practice becomes a social center for intravenous drug users in addition to a purely medical facility – address a human rights concern that would fall outside the purview of other narcotics laws? 

In asking whether this facility should survive, and examining questions of similar facilities' potential viability in other cities in North America or beyond, we should ask whether Insite does address matters of human rights per se. The practicality of such a site of course depends on a host of other factors, but special attention should be paid to whether Insite alleviates for its customers the threats of bodily harm, psychological distress or death that accompany addiction, rehabilitation, narcotics use or everyday life in a high-drug-use urban area.

Further, do the issues that accompany addicts and addiction deserve to be seen as a public health concerns rather than criminal matters? 

Resources for this inquiry would include:

* Interviews with people who manage and use Insite; an examination of crime and overdose rates in Vancouver since Insite's founding in 2003; any data Insite can provide relating to the treatment or recovery of drug users Insite may track; 

* A review of the existing peer-reviewed literature on the efficacy of Insite, including recent publications by the Harm Reduction Journal, The Society for the Study of Addiction, Drug and Alcohol Dependence, the New England Journal of Medicine, the International Journal of Drug Policy, The Lancet, the Canadian Medical Association Journal, and the American Journal of Preventive Medicine. 

* An effort to suss out the influences in the Canadian law enforcement system that in the past have put Ottawa and the RCMP at odds with British Columbian policy regarding Insite – e.g., what Maclean's last month described as “dubious studies” that have justified to the federal government's ongoing opposition to the site. 

Comments

[Michael Byers]

The thing that excites me most about this draft proposal is the tension you've identified between the law (on drug use and related activities) and the rights of addicts (to life, to security of the person, etc.). This bears exploring, I think! How does one go about balancing different rules/laws/rights against each other? Does international law have anything in particular to say in this regard? (Check out the idea of peremptory norms, also called jus cogens, which absolutely prohibit the legalization of slavery, torture and genocide). I want you to say something new in your paper, and for that new thing to have an international dimension.

Great work so far!

[Dave Morgan]

There's a documentary called 'Through a Blue Lens' that you might want to check out. It was filmed by a group of policemen, who documented the day-to-day lives of some of the addicts they met during their patrols of the Downtown Eastside. It was filmed about 10 years ago (so pre-Insite), but it might give you an idea of the situation at that time, and how life / opportunities have changed since the opening of Insite.

[Pablo Antezana]

Here I copy the link to an interesting article published a couple of months ago in Maclean's about the controversy currently revolving around Insite. Contains interesting data. I hope it's useful.

http://www2.macleans.ca/2010/08/20/injecting-truth/

[Sam]

Dave, that's a fantastic suggestion. And Pablo, yes, it's hard to feel anything but embarrassment for a government so nakedly trying to manipulate reality. This follow-up was also strong, I thought: http://www2.macleans.ca/2010/08/23/the-harper-government-and-the-insite-flim-flam/

[Mo]

Hi,
I'll be sending an e-mail to Constable Jodyne Keller, the Vancouver PD's liaison to the homeless, and Ann Livingston, who started the Vancouver Area Network of Drug Users asking about water in the DTES. If you'd like to add questions or your contact details to that e-mail, let me know at mo-al-mehairbi@hotmail.com

(I'll also send this to the Prostitution project.)
Mo.

[Frank Halderman]

Here is an interesting bit of new regarding the refusal of French PM Francois Fillon's refusal to consider drug consumption rooms in France.I am very much in favour of Insite in Vancouver.

http://www.talkingdrugs.org/debates-over-consumption-rooms-in-france

[Scott Goosenberg]

Please find (below) an article from the Georgia Straight decrying any and all opposition to Insite as political in nature. Generally speaking, do you believe that initiatives and enterprises similar to Insite are viable or possible in the U.S., in liberal cities like San Francisco which has endemic drug issues of itself? If so, can drug rehabilitation in general as opposed to putative measures for drug addicts resonate with the general public? In California, there is recent news that constituents' interest in legalizing marijuana is faltering, no longer commanding a slim majority of the vote. If citizens are queasy about legalizing marijuana, do you think that even a pluralistic, liberal-democracy like the U.S. would be willing to take such a quantum leap? That is to say, if a generally open-minded nation like the US, whose willing -- under the Obama admin -- to ramp down the "war on drugs" while concomitantly retaining putative rather than rehabilitative policies towards drug addicts (despite more of an emphasis on the latter than the past), do you truly believe that at least a plurality of nations, let alone within Canada, are willing to recognize drug addicts as victims of a disease? To use a tennis term, drug addiction to many -- including, admittedly myself -- seems like an "unforced error." Sure, many people in bad situations become drug addicts as a result of socialization, but drug use/abuse is a choice, and it may be hard to argue that in the aggregate, tax dollars are worth being spent on what for all intents and purposes (in some cases at least) is an entitlement and even a rationalization that helps perpetuate such behavior?

Sorry for playing devil's advocate here, but I figured a counter-argument could be beneficial.

(http://www.straight.com/article-288521/vancouver/conservatives-continues-long-fight-against-insite-application-supreme-court)

[Chantelle]

Hey Scott, thanks for the feedback. Public attitudes towards addiction are a huge factor when making public policy decisions. I'm not sure how other countries frame/define addiction, but Canada does recognize addiction as a medical condition under the umbrella of 'disabilities'. e.g. There was a recent court case in Ontario ruling that two individuals with alcoholism were entitled to long-term disability benefits.

Couldn't get to the link you provided, but have been doing research into this Supreme court case re: insite.

Thank you for the link about France Frank! I was really curious to see which way this would go... I don't know a lot about French politics but was surprised that they decided against the safe injection sites.