Monday, 24 December 2012

Some Insight into InSite (from last year)


Place yourself in the shoes of a chronic addict for the duration of this essay. The old, ripped and tattered shoes of someone viewed  by the rest of society as nothing more than a stray dog; avoided, ignored, and out of touch with any form of their life pre-addiction. To many residents of the downtown eastside of Vancouver, BC, this is their current situation. Life on death-row, with nothing more than the narcotic contents of a syringe to provide any relief from life’s right hook. Yet, those contents are simultaneously clenching life’s left fist.
Heroin addiction is so much more than just a need for that perfect high. Needle sharing and the spread of HIV go hand in hand, and society’s rejection of addicts as suitable human beings can prevent many people from offering help to an addict on the long road to recovery. Insite, a safe injection site in Vancouver’s downtown eastside was created to provide clean needles to addicts in an effort to reduce the spread of HIV, to help addicts develop healthy relationships and access health care and treatment for their addictions. Insite is not only a place where safe injections can be performed, but the relationships the patients build with the nurses at the site may well open doors to their recovery. Having some vague sense of relational consistency in a lifestyle riddled with homelessness, lack of nourishment, emotional trauma and crime can only be a positive when it comes to getting one’s life back on track.
Not surprisingly, this program has a large number of opponents. For them, getting over the fact that there is an organization that is, in their mind, enabling the usage of an illegal and addictive substance is the biggest hurdle. Why is there funding for a program that seemingly promotes drug abuse? Should we not be focused on stopping this activity? This seems like a valid question and one that, in a perfect world, should have an answer. Yet as history illustrates, there will always be a drug market.
Supporters of the Insite program believe that drug addiction is a symptom of earlier trauma.  For example, Gabor Mate, a doctor who has worked for many years with addicts in Vancouver’s Downtown east side, believes users are seeking a means to bear pain that many of us can never comprehend (pain from childhood abuse, neglect or intergenerational trauma) (Mate, In the Realm of Hungry Ghosts, 3). Understanding that addiction may not be a choice but rather a source of relief, is a step that the general public (and politicians) do not consider. We need to begin looking at these people as people, not as problems.    
According to Insite’s web page, Vancouver is home to approximately 12,000 injection drug users. This is not an activity that will simply cease to exist. A focus on stopping drug use is a hopeless cause for the simple fact that so many people choose to use them. Insite’s focus on providing a safe place for the users to use clean needles provides security against some very devastating aspects of drug addiction. It keeps the activity of injecting off the streets and out of the hands of the untrained. From 2004 to 2010 there have been 1418 overdoses within Insite, and every single one has been treated by the on staff nurses (“Insite-Supervised Injection Site”). Sure, as an opponent would point out, they may live to inject another day. But by not re-using that syringe, by not improperly performing an injection for a “friend”, the dangerous addiction that cripples them is just a little bit safer. And what more can we ask from a situation that is so dangerous in the first place?
I’d like to compare the initiative taking place in Vancouver to that which is happening in Toronto. A proposal to have a safe injection site in Ontario’s capital has been rejected, thus birthing COUNTERfit, an organization that gives clean syringes to drug dealers in the hope that they will deliver it to their customers (“The Grey Zone”). May I ask you, with the understanding that stopping drug use altogether is an impossible task, which method would you prefer? Actually placing more power and control in the hands of street dealers and gangs (COUNTERfit pays these criminals with hopes that they deliver the proper safety equipment to users). Or having an actual site for users to go to, where trained professionals ensure safe syringes are used and proper injection happens, and takes the activity of injecting off the street.
Research into Insite has revealed a number of benefits. First and foremost the sharing of syringes had been reduced as well as public injection has been on the decline. More importantly, more individuals are accessing detoxification services and addiction treatment is on the rise. Public support is also very strong for Insite. The Final Report of the Expert Advisory Committee for Tony Clement has stated that “letters of support and surveys show that health professionals, local police, the local community and the general public have positive or neutral views of INSITE services and the majority wish to see the site continue (“Vancouver's INSITE service and other Supervised injection sites: What has been learned from research?”)
The fact that Insite provides not only a safe needle exchange program, but health, detox, and addiction treatment allows this to make the drug community, one that will always be in present in society, a much safer one. Insite also provides the first step in the lengthy ladder to recovery. The positives brought forth by Insite vastly outweigh the negatives, and by not introducing similar programs to other cities, our government is just allowing the current issues with the injection-drug culture to magnify and continue.

To all you beautiful humans, I remain
-John F. Johansen

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