Sunday, August 23, 2009

You'd almost think they were on crack

In early August I was invited to be part of a focus group session for the "Toronto and Ottawa Supervised Consumption Assessment". Our focus group was one of many being held in Toronto and Ottawa, interviewing over 300 different stakeholders (community members, drug users, health providers, etc.), about eight at a time. Here's the backgrounder attached with the invitation (click to enlarge):
There are a couple important points to note:

1. Ottawa has the highest new rate of HIV infections amongst injection drug users in the province.
Just because Ottawa doesn't look like Vancouver's infamous Downtown East Side, we certainly do have social problems that stem from drug abuse. Unlike Vancouver's, however, our problem isn't with drug users and paraphernalia littering the streets, but rather a health problem that is next to invisible.

2. Nobody is proposing a Supervised Consumption Site for Ottawa at this time.
They're simply investigating what effect, if any, such a site would likely have on Ottawa's drug situation (and HIV infection rates) in the event one were installed.

3. The researchers don't suggest that drug use is "safe."
While I thankfully haven't seen this argument made in the current flurry, it's common among boneheads to accuse proponents of whitewashing by incorporating the word "Safe" in the facility name. It came up frequently in the Safe Inhalation (crack pipe) program discussion, and did much to distract from the discussion on the merits of the program itself. The term used in this study is "Supervised Consumption Site," not "Safe Injection Site," and certainly not "Shooting Gallery," which the Sun has likened to calling them. The effect is that the consumption of drugs (be it through injection or inhalation, as with a crack pipe) is supervised, so that the drug user doesn't contract diseases from dirty materials, and so that they don't overdose.

4. The City of Ottawa is not funding this study.
I saw a few comments on one of the news stories or blogs criticizing City Council for wasting money on this study, that Council should tackle some other newsworthy story, or some such comment (it's always the same wags every time and it's never relevant to the discussion at hand). The backgrounder explains that the study is being funded by the Ontario HIV Treatment Network, an arms-length non-profit funded by the Ontario Ministry of Health and Long Term Care that works in various ways to attack HIV problems.

Since this was a research study, we participants signed confidentiality documents. I can't speak for the others, but it made me more uncomfortable than a "we'll make all your comments public" clause: Since we were all there as Community Association representatives, I'd assume we are used to having our opinions being public, and reporting back to our respective associations. We're also not used to being reimbursed for our input (I personally think it to be a conflict of interest), and since they didn't let me refuse the reimbursement, I decided to pass it along to the association as a donation.

I think this closed format is the reason it didn't make the papers until a week later, in this Ottawa Sun story.

Already in that story, Ottawa Police Chief Vern White begins spreading some FUD: Since Vancouver Police received $6 million when Vancouver's Insite opened, his department would need that much, too, and that's not a good way to spend money on reducing crack use, right? But as described earlier, Ottawa's drug problem is primarily a health problem, as there's little public disorder requiring Police intervention. The Sun should have interviewed Ottawa's Medical Officer of Health, Dr. Isra Levy, not the Chief of Police.

But once the story hit the papers, the Blogosphere soon followed. On the same day the Sun story came out, River Ward blogger Blake Batson blogged:
The premise was that [Supervised Injection Facilities] allow drug users to safely exchange needles thereby reducing the incidents of Hepatitis and HIV. I am not going to argue the point that these blood diseases actually reduced because of SIFs but I am going to focus on the “collateral damage” inflicted on the cities involved.
Essentially, drugs are illegal because they are harmful. Even if these sites mitigate the harm, the drugs are still illegal, so Blake is against them. This is the same ideology behind the argument that Graffiti murals should not be allowed because they encourage graffiti elsewhere even though they successfully eliminate unwanted graffiti on the mural walls.

To his credit, Blake says he'd support the study if it proves these sites reduce drug use (as opposed to only reducing infections that follow from drug use), but he requires that information to come from "unbiased" researchers. When you say 'I only support the study if it says what I want to hear,' you miss the point about being unbiased. So forgive me for being skeptical of Blake's claim of open-mindedness.

Eric Darwin, who was at the meeting, also blogged it on his blog, West Side Action, once the story came out in the media. He garnered from the discussion, as I did, that
I do not think that there is an "open" or public shooting-up problem in either neighborhood, which was supported by data showing fewer and fewer pipes and needles being found...
From several hours of discussion, guided by questions from the facilitators, I learned about the nature of the problem, that it is largely "indoors" in our neighborhood, that DTE [Vancouver's Downtown East Side] solutions are not transferrable to here as our problem is very different.
While he talks about the problem, Eric falls short of describing what the problem is: the high incidence of HIV.

Ken Gray linked to Eric's post, as usual, without adding any substance (I hate how journalists these days always leech off us hardworking bloggers). David Reevely does so too but with commentary and an opener mind, suggesting it's worthwhile to at least study it. Unfortunately, because of Eric's omission of the HIV problem, the only comparison Reevely has to go by is the "visible" drug problem, which isn't nearly as big in Ottawa (specifically in Lowertown) as in Vancouver.

I believe the researchers said they were doing another consultation on the East side of the canal, for Byward Market and Lowertown representatives. There must have been one, because the cover story on the Ottawa Sun the next day was "SPLIT OVER SAFE DRUG SITE":

So not only is a Supervised Consumption Facility being proposed for Ottawa (as far as the Sun cares to suggest to you), but there's apparently a battle between East and West side community associations as to whose neighbourhood to put it in. Since there's no one spot where drug use is really problematic, I had suggested at the meeting that they use a mobile site, in the way the crack pipe and needle exchange is done with mobile vehicles, and not unlike how the bloodmobile acts as a mobile blood donor clinic. This would prevent any one neighbourhood from attracting crack users around a permanent site (though the methadone clinic in Centretown doesn't have such a problem).

But we still need someone to defend our City from the lefty druggies. In swoops suburban College Ward Councillor Rick Chiarelli with some wholesale fear for the Sun to monger you at retail: Even though the article says the study's results won't be out until next Spring, Chiarelli asserts that a Supervised Consumption Facility would be a bad for Ottawa, and it wouldn't do anything. Who needs research, anyway?

There are a lot of myths about a Safe Consumption Site in Ottawa, a lot of them pretty farfetched. I don't know exactly who started them, but you'd almost think they were on crack.

- RG>


XUP said...

We keep approaching all drug issues (like sex trade issues) from very narrow and short-sighted angles. Yes, of course a supervised site would be a good thing and would probably address one aspect of the overall problem, but when is the overall problem going to be addressed? The whole "war on drugs" thing is hopeless and ridiculous. Finding a way to get the criminals and criminality out of drugs and the sex trade is the only thing that makes sense to me.

Erigami said...

Thanks for the post. It's interesting to read a broad survey of media, as well as hear from someone who is actually involved in these studies (kinda/sorta).