Insite, Evidence, and Stephen Harper
A scene that said much about Prime Minister Stephen Harper unfolded last week at the Supreme Court of Canada.
At a hearing about the legal status of Insite, the supervised injection site in Vancouver, a lawyer representing the federal government acknowledged the facility had been granted a federal exemption from drug laws under a clause that permits scientific study. Insite is an experiment, in other words.
“And it worked,” observed Chief Justice Beverley McLachlin.
A long list of scientific research papers published in prestigious peer-reviewed medical journals showed that Insite had done exactly what it was designed to do. Overdose deaths down. Rates of HIV and hepatitis C infection down.
“Lives are being saved, diseases are being prevented by this site, and are we putting too fine a point on it by saying the site has nothing to do with it?” McLachlin asked the federal lawyer.
“In the end, this program somehow, while not being perfect, works,” interjected Justice Louis LeBel. “Have you evidence that tends to demonstrate that this program doesn’t work?”
The lawyer’s stammered response: “I think that’s a fair observation.”
So to sum up, heaps of evidence suggests Insite saves lives, while the federal government has acknowledged before the Supreme Court of Canada that it hasn’t evidence to the contrary.
From the moment the Conservatives came to power in 2006, they insisted that the decision on Insite’s future would not be guided by politics or ideology. The evidence would settle it. But as the evidence of Insite’s effectiveness steadily mounted, the Conservatives’ hostility to the facility never wavered. They wanted to close it then. They want to close it now.
And so what we witnessed last week at the Supreme Court was nothing less than a naked admission that Stephen Harper’s government doesn’t give a damn about evidence.
That would be alarming enough. But to fully appreciate how hideously the government is behaving, bear in mind two things: the origins of Insite and the nature of the drug policies Stephen Harper does support.
Insite is an experiment born of endless failure. For years, even decades, the thick clot of social pathologies in Vancouver’s downtown eastside neighbourhood only grew. Police sweeps didn’t stop it. Neither did blockbuster trafficking busts, or the steady flow of money into social service agencies and countless publicly funded community groups.
In those circumstances, doing more of the same is madness. You have to try something new.
Insite was something new, and the idea behind it was simple and modest: Give addicts a safe, clean place to inject drugs and the damage can at least be minimized. With clean syringes, users won’t share dirty needles and spread blood-borne diseases. With a nurse present, overdoses won’t end in death. And when addicts come in off the street, social workers can engage them -and try to steer them to detox, rehab and, just maybe, getting off drugs for good.
It would be good for the community, too. Fewer needles in parks and playgrounds. Less hustling on the streets. Fewer corpses in back alleys.
Or so it was hoped. Similar facilities in Europe -where the “harm reduction” philosophy is widely accepted -had delivered excellent results. But so many efforts had failed before. This had to be done carefully. It had to be monitored. And rigorously studied by scientists.
It was. And the results are clear.
This makes Insite a textbook example of how to do social policy. Try something new -but be cautious. Don’t assume you have the answer. Set up a small experiment. Study the results carefully. If it fails, shut it down. And if it succeeds? Obviously, you should keep it going. And cautiously expand it to other sites and cities, while continuing to carefully monitor results.
Seems only reasonable, doesn’t it? But compare that to the drug policy Stephen Harper enthusiastically supports: more law enforcement and tougher punishment of drug crimes.
In the 1950s, rising rates of heroin addiction in Vancouver (stop me if you’ve heard this one before) prompted a national debate about drug policy. Doctors and public health officials argued that law enforcement had failed badly. They wanted to try different approaches -approaches which we today would call harm reduction.
The police disagreed, insisting that tougher laws would do the trick. They had little evidence to support that claim and they didn’t intend to study whether tough new laws actually did what they were supposed to. But they were sure they were right.
As usual, the police got their way. Harsh new laws -including a seven-year mandatory minimum sentence for importing drugs -came into force in the early 1960s. A few years later, rates of drug consumption and trafficking soared.
That pretty much sums up the long history of trying to deal with illicit drugs by ramping up law enforcement and punishment. In a paper published a few years ago, Peter Reuter, one of the world’s leading experts on drug policy, summarized the evidence: “Research has almost uniformly failed to show that intensified policing or sanctions have reduced either drug prevalence or drug-related harm.”
No matter. Every year, huge sums are spent trying to deal with illicit drugs and the vast majority of that money goes to law enforcement.
And Stephen Harper is fine with that. In fact, he wants more of the same. But that modest, inexpensive, rigorously studied, scientifically validated, life-saving program in Vancouver? He wants it closed.
Which says so much about Stephen Harper.