TORONTO - Drug addicts who visit Vancouver's embattled safe injection site are more likely to enter detox programs, more likely to start methadone therapy and reduce their number of monthly visits to the facility, a new study reports.
One of the authors, leading AIDS researcher Dr. Julio Montaner, said the study provides clear evidence the facility is steering some injection drug users toward treatment for their addictions, with a 30 per cent increase in detox enrolments among Insite users in the year after the safe injection site opened.
He said it also furnishes the federal government with the proof it asked for last August when it deferred a decision on extending Insite's licence on the grounds there wasn't enough evidence it was meeting its goals.
At the time, Health Minister Tony Clement said the government believed breaking the cycle of dependency should be the primary goal of a harm reduction program like Insite.
But Montaner said he doesn't expect the governing Conservatives to be satisfied now that there is evidence Insite is playing that role for some of the people who use it.
"The difficulty is that whatever we say, if you don't really like this (program), if you hate it - whether it's because of your preconceived notions, moral objections, religious issues, whatever . . . the goal post is going to be moved to something else," he said from Vancouver.
"We started this (research) to find out whether or not we were going to do harm to the people who are participating in this SIS (safer injection site). We found that not only don't we do any harm to them or those around it . . . we found that we're doing some good.
"(But) it's no longer about evidence. It's about . . . somebody continuously changing the parameters of, the definition of success," said Montaner, who is director of the B.C. Centre for Excellence in HIV-AIDS and president-elect of the International AIDS Society.
The study, published Friday in the journal Addiction, is the latest in a string of 28 or so scientific publications that have found the facility has had a positive impact on both the addicts who inject there and the community in which it is located, Vancouver's troubled Downtown Eastside. Earlier studies have been published in such prestigious publications as the New England Journal of Medicine and the Lancet.
But the Conservatives continue to argue that there isn't enough evidence on the efficacy of the program.
Health Canada recently issued a call asking Canada's addiction research community to submit proposals for studies it will fund looking into the facility's impact on public order and safety, on the risk behaviour of users and other issues.
The projects, which would be funded to the tune of $260,000 in total, must be completed and submitted to the department by the end of October.
On Thursday, a group of prominent addiction researchers released a letter they wrote to Health Canada in which they outlined why they would not be applying to do the work.
The researchers said the time frame is too short and the funding too small to do legitimate studies. And they are concerned about a provision that would bar researchers from speaking publicly about their findings for six months after they submit their work to Health Canada.
That provision would mean that researchers would be unable to comment publicly when the government announced its decision on the future of Insite, even if the government pointed to their work to shore up whatever decision is made. The government has said it will decide on the fate of Insite by Dec. 31.
Benedikt Fischer, director of the illicit drugs, public health and policy unit at the University of Victoria, was one of the signatories to the letter. Fischer said it is questionable whether a university ethics review board would even allow a researcher to agree to that kind of a provision.
"I think what we need in the debate here is a lot more straightforward honesty about it, that this is politics. And this will lead to political decisions and ideological decisions. And what's going right now is a process to try and veil that and gloss it over with science," Fischer said.
"There's a lot of positive, supportive evidence that this thing does certainly more good than harm. And this (evidence) is published in very, very, very high level - among the best medical research journals we can find . . . . And what you can't do, certainly, is just on the cheap produce evidence that will outweigh that."
Erik Waddell, a spokesperson for Health Minister Clement, said the government doesn't comment on correspondence it receives. And he reiterated that more research is needed because the government is not satisfied there is enough evidence to show that Insite is meeting its goals.
The latest study showed that in addition to increased enrolments in detoxification programs, Insite users were more 56 per cent more likely to start methodone treatment. As well, drug users who went into detox reduced their future use of Insite, visiting on average 19 times a month after detox versus 24 times a month before.
