Sunday, June 08, 2008

Insite not the answer, but it helps
June 6, 2008

Perhaps you’re already familiar with that ancient fable about the six blind men and the elephant. I find it coming to mind a lot these days in the fight over Canada’s only supervised injection site.
The Indian fable, put into charming verse in 1873 by John Godfrey Saxe, tells the story of how the six men interpreted what an elephant looked like based on whatever part of the elephant’s anatomy they touched first. One touches the animal’s massive side and concludes it must resemble a wall; another grabs the trunk and presumes that elephants are shaped like snakes; and so on. (http://www.noogenesis.com/pineapple/blind_men_elephant.html if you’re curious).
The point I’ve always taken from the fable is that it’s impossible to reach the right conclusion if you presume that what you know is all there is to know. Problems are solved not by bickering over six different versions of an elephant but by bringing those viewpoints together to understand the whole.
It’s pretty clear from the battle shaping up around Vancouver’s supervised injection site that we’ve got an elephant on our hands. Blinkered by an ideological viewpoint that simply doesn’t allow for a fuller picture to emerge, the federal government has a tight grasp of the elephant’s tail and an equally firm conviction that its version is the only one that matters.
We can fight it out in court, I suppose, and that appears to be what we’re headed for. A win in B.C. Supreme Court last week that deemed the pending closure of Insite unconstitutional is headed for appeals court and no doubt the Supreme Court of Canada now that Ottawa has made it clear that its sole goal is to shut Insite down.
I suspect last week’s ruling will ultimately be upheld. But for the 8,000 users of Insite who face being hung out to dry for the next decade while we argue about what constitutes an elephant - not to mention tens of thousands of other Canadians who could benefit from similar sites in their own communities - I can only hope for a much quicker resolution than a court fight will ever bring us.
My personal view of places like Insite is that they’re a small but important component of an overall strategy for reducing the harms of drug and alcohol use.
They certainly don’t solve all of the problems around addiction, or even most of them. Nor are they universally supported by people with addictions in their own background, some of whom are every bit as adamantly opposed to injection sites as the Conservative government.
But supervised injection sites do keep people alive to fight another day. They bring a desperate and isolated population into contact with professionals who want to help them. They provide health care to a group of people who otherwise receive very little due to widespread stigmatization of their particular illness.
They reduce the spread of costly and difficult diseases. They provide a badly needed alternative to open drug use on our streets by those too addicted to hide their problems any more. Meanwhile, as has been proven at Insite, they don’t lead to increased street problems or higher rates of crime. That’s good enough for me.
The government questions whether the dire situation in the Downtown Eastside has improved at all since the site opened four years ago, and contends that Insite’s $3 million annual budget would be better spent on “treatment.”
Federal Health Minister Tony Clement is absolutely right when he says much more money needs to be put toward treatment for addictions. But for many of Vancouver’s most disadvantaged users, Insite is where treatment starts.
For some, a visit to the supervised site will be a first step toward recovery. I don’t know how Clement envisages people with severe addictions finding the help they need to begin that journey, but in my experience it starts with them getting support in a place where they’re accepted just as they are.
For others, recovery will be years in the making, perhaps even unachievable. But at the very least they will benefit from a safe, clean place to inject, and our communities will benefit from a reduction in the ferocious bacterial and viral infections spread through street-level injection drug use.
As for fears we’re sending a “poor message” to youth about drug use by allowing supervised injection sites, that’s just one of those fictions that lazy people dream up to create emotional heat around an unsound argument. Nothing says “Kids, don’t do drugs” better than the haunted visage of someone in late-stage addiction.
With as many as 125,000 Canadians thought to be injecting illicit drugs, the elephant is upon us. Time to open our eyes and see the beast for what it is.

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