Readers know that I favor drug legalization (even the ‘dangerous’ ones). This libertarian philosophy has practical underpinnings. I calculate (although I must admit this a very soft calculation, because I have no data on which to base the calculations) that the harm from our current prohibition exceeds the harm that would occur from legalization.
This Canadian program makes sense to me – Canadian drug policy seeks a fix
Throughout the country, officials are considering radical changes in Canada?s approach to drugs, rejecting the tendency in the United States to push for law enforcement solutions. In so doing, officials are taking up the stance of several other countries, including Germany, the Netherlands, Switzerland and Australia, where there are various programs for decriminalization, clean needles and free methadone clinics.
The Vancouver-based Harm Reduction Action Society, which advocates changes in drug laws, reported that drug overdoses in Frankfurt, Germany, decreased from 147 in 1991 to 26 in 1997 with the creation of safe injection sites. In Switzerland, the organization said, drug overdoses also decreased, and there was a marked increase in the number of people registering for methadone and other treatment programs.
U.S. officials have angrily criticized the Canadian policy of harm reduction.
“The very name is a lie,” John Walters, the White House drug policy director, said in a telephone interview. “There are no safe injection sites.” Walter said the United States would continue to treat drug abuse as a “deadly disease that shortens lives.”
“It can’t be made safe,” Walters said. “We believe the only moral responsibility is to treat drug users. It is reprehensible to allow people and encourage people to continue suffering. That is why we don’t make this choice and we don’t believe we ever will.”
Canada also faced criticism from the United States in May when it proposed decriminalizing possession of small amounts of marijuana.
Canadian officials said their approach is intended to combat HIV – rampant among drug users-and to decrease overdoses. Officials in Canada?s largest cities, Toronto, Montreal and Vancouver, are also debating whether supplying heroin to addicts will save lives and combat criminal behavior.
So why is Canada approaching this problem so differently from the United States? I believe the problem is perspective. We (the United States) have elected a government which sees drug use as a moral problem. Thus, we easily condemn this immorality and stop all discussion. Canada has started to look at the overal implications of drug abuse. They are willing to weigh the pros and cons of any program (decriminalizing marijuana, providing a safe place of IV drug abusers to inject their drugs). As they dispassionately evaluate drug abuse, they conclude that the laws impede overall health, respect for the law, and encourage other criminal behavior.
“?Somebody said, “Why are we helping addicts?” ” said Viviana Zanocco, a spokeswoman for the Vancouver Coastal Health Authority. “The question is: Why shouldn’t we? Are we only supposed to help heart patients?”
The program also makes good economic sense, Zanocco said. “When we get somebody with HIV, it costs $150,000 Canadian [about $107,000] to treat over a lifetime. Some people say you are enabling addicts, but you can point also to the health care system. If we can prevent 10 people from contracting HIV, the safe injection site pays for itself.”
We need this logical approach. The political hysteria over drug abuse in this country has too many adverse consequences. While these are unintended consequences, they are consequences nonetheless. We need politicians and leaders with the courage to look at drug abuse as a societal problem which needs societal answers. We should neither demonize the abusers nor the drugs. We should put the pushers out of business the old fashioned way, using capitalism. We should provide legal safe drugs – even those which we know will harm the users. As we sell the drugs, we can then invest money (the money which we are saving on law enforcement and HIV care) on user education and drug treatment programs.
We already sell drugs that we know harm people – cigarettes and alcohol. While I lecture every patient why they should stop smoking, I would not try to make cigarettes illegal. Most people who drink have no problems – and the data even suggest that moderate drinking is good for one’s health! I suspect that we would find the same with many illegal drugs (especially marijuana).
I can only hope that we will approach this problem logically in the future. Perhaps Canada will teach us important lessons. But do we have receptors for such knowledge?
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4 Responses to Canada providing safe sites of IV drug users
DB's Medical Rants » On drug legalization
June 2nd, 2004 at 1:23 am
[...] is take – Paternalism In Medicine – Part III: The War On Drugs and one of my many posts – Canada providing safe sites of IV drug users First a quote [...]
Frances
August 4th, 2003 at 8:17 pm
Vancouver has proven so problematic in arguments favouring Safe Injection Facilities (SIFs) because of the numerous social factors that have plagued the city in recent years. (I’m going to oversimplify here for a second) Due to a warmer climate, an incredibly badly run mental health program, and a long standing teenage myth of hippie paradise, Vancouver has had a terrible problem with homelessness, drug abuse and IDU-related HIV infection (Vancouver has the highest IDU-related HIV infection rate in North America – 23%). These problems are regularly cited as evidence of the inefficacy of Vancouver’s drug programs, but in reality these problems have actually prompted Vancouver to develop numerous (and – as shown in studies – effective) groudbreaking drug and HIV programs that are thankfully begining to spill over into the rest of Canada.
Jeremy
November 19th, 2003 at 8:12 pm
Re: Frances’ comment
I can’t speak for the rest of Canada’s perception of Vancouver, but rest assured no Vancouver teenager fancies his/her city a “hippie paradise”. Quite the opposite, in fact, when you cannot walk a single downtown city block without being begged/harassed for money by the homeless addicts.
With their changed perceptions of Vancouverites, the vast majority of whom will NOT give money to panhandlers, I hear that the homeless will now first approach people they consider to be foreigners.
And yeah, its warmer here but it rains like the Amazon which has a desultory effect on any attempt at insulation for someone on the street.
Jeremy
November 19th, 2003 at 8:12 pm
Re: Frances’ comment
I can’t speak for the rest of Canada’s perception of Vancouver, but rest assured no Vancouver teenager fancies his/her city a “hippie paradise”. Quite the opposite, in fact, when you cannot walk a single downtown city block without being begged/harassed for money by the homeless addicts.
With their changed perceptions of Vancouverites, the vast majority of whom will NOT give money to panhandlers, I hear that the homeless will now first approach people they consider to be foreigners.
And yeah, its warmer here but it rains like the Amazon, which has a desultory effect on any attempt at insulation for someone on the street.