Supervised injection and alcohol intake sites

Stephen LaFrenie

Supervised injection and alcohol intake sites

When my brother was on the street as a psychiatric person, it was the network of people, shelters, soup kitchens, and social services that allowed him to eventually seek the help he needed. He is now taking medication faithfully and receives a disability pension. He is able to hold a part time job and is living in a communal home with other psychiatrics. Without this social network I am convinced he would still be on the streets or worse, wrongly in jail.

Supervised injection sites are needed in order to compassionately assist people in dealing with and eventually ending drug addiction. Forcing addicts into a back alley or derelict buildings increases the sense of hopelessness and despair. Addiction to alcohol and drugs is a condition that needs to be treated in the same manner, not traumatized further. These sites cut down on HIV infections, overdoses, and a host of other related problems. Supervised injection sites treat addicts. They are not hang outs for casual users. The same idea is being used for hard core alcoholics. This has led to fewer hospital visits and treatment by emergency services. They should be continued, made legal, and expand to include other chronic, dangerous addictions. People become well when they have support systems available to them and addiction is no exception. We cannot be a socially progressive party or society and not advocate for this. To his temporary credit Health Minister Tony Clement did not go through with the reprehensible election promise to shut down these programs. However he hasn’t endorsed them either and is merely extended the program another year for further consideration.

During the 2006 election I remember seeing Stephen Harper standing in front of a supervised injection site, vowing to shut them down and end the program. The problem with the ‘Regressive’ Conservative Party of Stephen Harper is that they can’t help but impose judgment followed by punishment on the poor and disadvantaged. Their societal goals are based on maintaining and enforcing a winner vs loser mentality. Drug addicts and alcoholics are losers, deserving every nasty thing that happens to them. They should be tossed aside until ‘divine intervention’ gives them the sign. The same applies to poverty with the poor as losers while the materially wealthy are winners. No matter how hard they try they just keep spinning their wheels, eventually moving backwards. This is why, even with the numbers crunched showing that these programs reduce the cost of police and emergency services, they can’t help themselves. The need to invoke moral judgment and punishment is too great.

InSite (Vancouver)

"Improving Access to Care
Drug users who live on the margins may have difficulty accessing health care. And without this care, the chances of improving health outcomes are slim. By visiting insite and being exposed to health care professionals in a non-threatening environment, many
clients willingly ask for referrals to other health and social services. Over a one-year period, insite made more than 2,000 referrals to other services, with about 40 percent of the referrals to addiction counseling. People using insite are more likely to enter withdrawal management (detox) programs, and people using insite who also talk with addiction counselors are even more likely to enter detox. In fact, one in five regular visitors to insite began a detox program, showing that insite is a proven entry-point for the Downtown Eastside’s highestrisk injection drug users. Detox programs are an important marker of addiction treatment system use, as most addiction treatment programs first require people to complete a detox program. Researchers also compared the rate of detox program use among people using insite – before and after insite opened – with the rate of detox use going up substantially after people had been using the facility. Research results show that insite is playing an important role in managing overdoses that occur at the site – overdoses that would, in all likelihood, be occurring on the streets if the facility didn’t exist, and could result in death. Overdoses have been common at insite, with almost 500 occurring over a two-year period, but none
resulted in a fatality. In fact, insite staff managed the majority of overdoses on their own, with only four in 10 needing ambulance support, and fewer than one in 10 resulting in a transfer to hospital."

Link to report on controlled alcohol distribution for chronic alcoholics.

"The client care workers interviewed all noted improved hygiene and nutrition for all participants during the program. Compliance with medication, defined as taking it as prescribed at least 80% of the time, was noted for 88% of subjects. The majority were reported to attend scheduled medical appointments. A cost analysis was performed (results not shown). Mean monthly direct cost of the program was $771 per client, with estimated per-client reductions in the costs of ED services of $96; hospital care, $150; and police services, $201.
This article describes the effect of providing supportive shelter for a subset of chronically homeless people with alcoholism and providing them with institutionally administered alcohol as a harm-reduction measure. The 17 participants enrolled in MAP drank heavily and had long drinking histories. They were regular users of nonbeverage alcohols such as mouthwash, had significant medical and psychiatric comorbidities, and were frequent users of emergency, hospital and police services. Within MAP they received housing, health care and treatment of their alcoholism with doses of alcohol that were modest in comparison with their previous levels of consumption. Police encounters decreased by 51% and ED visits by 36%, which, given the associated “unit encounter” costs ($93 and $270, respectively), offset a portion of the costs of MAP.
Finally, the option to detoxify from alcohol is always presented; once stabilized in the program, a few participants have successfully been medically detoxified and received housing, a formidable accomplishment considering the severity of an on-average 35-year addiction in which subjects drank daily to unconsciousness. This appears attributable to tempering alcohol consumption in a safe environment, which makes alterations of behaviour, including detoxification, possible."

The net cost of this program is actually $324.00 per client not $771.00. You can further reduce this net cost evaluation by adding into the equation the future opportunity of successfully detoxified clients obtaining jobs and paying taxes. The reduced cost to victims of any criminal activity related to client behaviour such as damage to property, assault, plus the increased ability of emergency and police services to respond to other incidences. For example, during the years I lived on Queen Street West in Toronto I regularly found old men lying on the street as the result of being drunk and falling. Often they would have head wounds as a result. When I called to report these incidents the response almost always included the arrival of ambulance, fire department and police. So even if you are motivated more by social cost factors than pure compassion these programs still make superior sense and produce better results than the present approach.

Social conservatives though don’t see this and will go to unintelligent, sometimes absurd lengths to argue against these programs. I watched a televised session at Toronto City Hall discussing the possibility of exploring these types of programs in the city. The study was presented and defended by Mayor David Miller and Councilor Kyle Rae. This was just the discussion of exploration not implementation. To my dismay both Councilors Ford and Nunziata stood to counter the proposal with ridiculous arguments. Councilor Rob Ford argued and interrogated Councilor Rae about whether he supported prostitution in the city. A line of questioning that had nothing to do with the subject. Councilor Nunziata started out on subject but waved pamphlets supplied by CAMH on safe use of drugs, stating that they were teaching people how to do drugs and was this what we wanted to do in Toronto. Teach young people how to do drugs. She also linked the program with endorsing prostitution basing it on the fact that junkies often use prostitution to pay for drugs. They are too morally blind to the realities of these problems. The need to judge and punish again supercedes the need to deal with and solve the problems of chronic addictions.

This blog reflects my personal opinion.
It is not official Green Party Policy.