Insite: does it incite insight?

And how do we decide whether something is working?


Brian Lilley’s latest piece criticizing Vancouver’s Insite safe-injection facility has been a source of continuing fascination to me since he posted it a couple of days ago. There is a certain courage about the thing, I think, that sets him apart from other Insite objectors. Let’s not get too caught up in the quarrel over the quantitative evidence from Insite, he suggests. This is convenient, to be sure, since the evidence is all against him; but I think he is right to say the question whether Insite should exist can’t quite be settled by means of numbers alone.

In designing a policy, we must always weigh many groups of what it has become trendy to call “stakeholders”, and many kinds of interests and possible consequences. “Just because something may work,” Lilley writes, “doesn’t mean we should do it.” This is a difficult statement to absorb, for those of us who’ve noticed that the drug war involves doing a whole lot of harmful things that obviously don’t, in any specifiable sense, “work”. But he is entitled to raise the prior question of how we decide whether something is working.

Which is, of course, is the point at which everything turns to porridge [emphasis mine]:

Helping junkies shoot poison into their veins and then putting them back on the street is wrong. Would I have as much of a problem if these drugs were administered as part of an ongoing treatment program to help wean addicts off of drugs? Probably not.

But that’s not what InSite does. InSite allows people to enter a government backed facility and use street drugs that they have purchased on the street, drugs that could have anything mixed in, and shoot those illegal drugs into their veins. The addict then leaves the facility and heads back out on the street.

It’s discouragingly common for people, particularly those who have lost loved ones to heroin abuse, to ascribe special demonic attributes to the drug, distinguishing it from other substances of abuse by anthropomorphizing it in a frankly untenable, ridiculous way. Lilley is not to be confused with these people. He has little or no inherent problem with the idea of government letting people inject heroin under supervision, in the name of utilitarian health-care considerations.

What bothers him, it seems, is that the clients bring the “street drugs that they have purchased on the street” with them into the facility. He’s worried about the “poisonous” nature of what they’re shooting. But he’s also admitted it’s not the heroin itself he really has an issue with. So what can he mean? The whole point of Insite is largely to let junkies inject without the fear of AIDS or hepatitis, and with the assurance of immediate medical assistance if they get a too-pure or adulterated batch. Surely it is indisputable that Insite accomplishes that much—that it protects the drug user, while he is within its confines, from the “poisons” that actually threaten his life—whatever other problems may be hazily attributed to it?

It is impossible for me to see what kind of coherent understanding, what non-contradictory set of principles, could lead one to Lilley’s position. If we are going to have the “moral” conversation about Insite, the soundness of the moral reasoning ought to count for something. Lilley doesn’t score high marks here. The “immorality” of Insite, which doesn’t give anybody drugs and has kept plenty of people alive long enough to kick them, has to be located and specified by its opponents rather than just presumed. Personally, I’m damned if I can find it.


Insite: does it incite insight?

  1. Basically Lilley is saying that even if something (like a policy or program) is pragmatic, practical and shows tangible results it is subject to being trumped by ideology. Ideology is something that needn’t be fact based and isn’t reached by the application of reason or logic. It’s more in the nature of a worldview that combines things like faith, emotional reactions, prejudices, so called ‘common sense’, and subjective intuition. The odd helpful fact might be thrown in, but they don’t get you where you need to go all by themselves.

    This is the best argument he can make, and he thinks it should win. He appears to be in good company. 

    • Agreed.  It reminds me of the same reasoning used by Christian Temperance League types back in the 1920s for imposing and maintaining prohibition on alcohol.  It wasn’t a practicalities-based argument at all; it was all about sin & wickedness etc. 

      • “It wasn’t a practicalities-based argument at all …. ”

        Christian Temp League types were on the side of angels as far as I am concerned.

        Temperance League people, mostly women who didn’t have the vote, were responding to having their husbands beat them after returning from saloon or their kids were starving because dad was an alcoholic. Seems entirely practical to me that women didn’t want to be beaten by drunk husbands any longer than necessary.

        And a little talk about sin and wickedness was appropriate because many men were wicked.

        • The thing to do, then, is to charge the husbands with assault, not to make alcohol illegal.  Lots and lots of people, myself included, are perfectly capable of consuming alcohol without subsequently committing assault or harming anyone in any way.

          •  This is now, that was then.

          • Yes, and I’m sure you’re prefectly capable of the occasional hit of heroin as well.  The two concepts are the same. 

            To me, It’s all about sin and wickedness. 

            But guys like you know that heroin is perfectly fine, there’s nothing wrong with it, you can pop a vein once in a while and you’ll not be committing assault or harm to anyone. Heroin’s perfectly fine!  What’s the big deal?

          • So you’re saying we should return to alcohol prohibition. Interesting strategy.

          • Look scf, I’m not going to go into a huge essay here about the pros and cons of recreational drug prohibition.  There are tons of studies, articles, books and documentaries on the subject.  I think the case has well been made elsewhere that making recreational drugs illegal has been a colossal policy failure.

            I agree that heroin is one of the toughest cases (e.g., a tougher one than marijuana) because of its considerable addictiveness.  However, I think when you run a rational, objective cost-benefit analysis on Insite, as has been done, to me it’s clear that the benefits (e.g., greater opportunities to get addicts referred to health and counselling services, reduced hep and HIV risk) outweigh any negative consequences.

            This “but we’re letting them shoot up” argument to me is utterly unpersuasive.  They are going to shoot up one way or another.

    • You gotta love Lilley:  Consistently and stubbornly wrong about everything he writes on. 

  2. No one wants to address what seems to be the underlying belief that justifies closing down a safe-injection site. Starkly put, that belief is that those who use drugs deserve to die, and therefore nothing should interfere with their demise.

    That may be ideological, but I don’t think it’s Christian.

    • There are actual real treatments to drug addictions that actually work.  Drug addiction is not a death sentence, and it wasn’t a death sentence before insite was invented either.

      • There are actual real treatments to drug addictions that actually work

        Yes, and Insite not only keeps people alive long enough to perhaps seek out such treatments, it actively encourages them to do so, and refers hundreds of people into them, getting many, many people off of drugs.  Having Insite gets more people off drugs than not having Insite, and it gives people who can’t kick the habit a greater chance of not dying from it.

        Drug addiction may arguably not have been a death sentence before Insite came along, but a lot of people who would have died as a result of their drug addiction did NOT die because of the existence of Insite.

  3. It’s crass and callous to say it, but the main reason people care about drug abuse at all in Vancouver is the crime & disorder that the drug addicts bring with them.  InSite doesn’t really do anything about this problem – the drugs still have to be purchased by the user, and they usually finance themselves through theft and prostitution.  InSite also doesn’t do anything to address the homelessness, disorder, and antisocial behaviours of the addicts.  So, great – InSite makes drug abuse safer for the addicts.  It also has some potential to reduce costs to society by reducing disease transmission and associated health care costs.  It doesn’t do anything about keeping those addicts from breaking into your car, vandalizing your property for scrap metal, wandering stoned around the streets and yelling incoherently, and generally making you feel less safe and comfortable in a city where you work, pay taxes, and try to comport yourself as a good citizen.  Call it selfish, call it insensitive, but there it is. 

    • Frankly, whether Insite exists or not, drug related crime will exist in that area.  If Insite was not there, the addicts wouldn’t all magically stop committing crime in the area.  What Insite does do, however, is help addicts recover by providing treatment counselling, and a detox/short-term housing facility called Onsite, for users of the facility, which certainly may lead to a reduction in drug related crime.

    • “InSite also doesn’t do anything to address the homelessness, disorder, and antisocial behaviours of the addicts.”
      Have to disagree with you there, A-W.  What InSite likely does is PROLONG the homelessness, disorder, and antisocial behaviours of the addicts both directly, by delaying the point they hit rock bottom which is when the majority of recovered addicts begin the process of recovery, and indirectly, by signaling to them that the state isn’t really THAT upset with their behaviour.

      • “…by delaying the point they hit rock bottom which is when the majority of recovered addicts begin the process of recovery…”

        Seems to me that “rock bottom” for these hardcore addicts would be death. Can you back up your assertion that it’s the point at which the majority of addicts begin to recover?

        • Either you hit “rock bottom” and decide to recover and live for a while in sobriety or you hit “rock bottom” and die.  Either way it is a right turn from addiction.  No evidence is needed to back up the assertion.
          Go ahead and dispute that making drug injection safer and thus prolonging the ability to continue the destructive behaviours move the finish line of “rock bottom” further along.
          While I have personal difficulty with providing funds for safe injection sites with street drugs, I must support any addict’s chance to hit the other “rock bottom” the one other than death 

        • Rock bottom probably is death for some of them, which is the same rock bottom for some alcoholics, some glue sniffers, some crystal meth users, etc.  It is near death for others.  I wish it were not so, but it is.  If by “back up  (my) assertion” you mean quote peer-reviewed scientific literature about addiction recovery, try this:

 thing about Insite is that it will prolong the onset of recovery – indeed, it can do nothing but prolong the onset of recovery – because it has no interest in deterring or disincentivizing the self-destructive behaviour.  It’s only interest is making particular incidences of the behaviour less self-destructive.  The unassailable consequence of making a behaviour less risky is that the behaviour will continue longer.I have no doubt whatsoever that Insite brings about a reduction in the fatality rate, measured over a particular time frame, among a certain segment of addicts in a certain region of Vancouver.  What seems to be lacking in the public discussion about the merits of Insite is the overall positive impact, if any, on the region as a whole, i.e. have the fatality rates/crime rates/etc etc of the region also been impacted by the “success” of Insite?  I do subscribe to Donne’s view that no man is an island, but I also doubt we’re getting much overall harm reduction per Insite dollar spent compared to a lot of alternative programs.

        • If you talk to recovery addicts / alcoholics, you’ll find it’s a common assertion.  

          But, then, those are the people who need to spend their lives focusing on their sobriety.  So there is a possibility that those who are able to curb addiction before they hit that point may be less likely to be involved in continuing addiction programs, thus less likely to vocalize their opinions on the matter.

        • Actually, “rock bottom” is the particular experience that causes the epiphany that sends you to rehab before you die (because you don’t want to die). This is a pretty well known fact in addiction treatment.  Some people never hit rock bottom.  They continue to abuse substances.  People who die before getting clean have never hit rock bottom.

      • So insite users are less likely to kick their habit than non-insite users?  
        Do you have a cite for that?

        • It’s obvious.  Every hit of an addictive substance strengthens the addiction.  That’s how additions work.  If you make it easier for junkies to get their hits, you’re not helping them.

          The only way to cure oneself from drug addiction is to stop doing the drugs!  Rehab!

          This is common sense. I don’t need to give you a citation to state that addictions are addictive.

          It’s widely established what is needed to cure addictions. There are a gazillion studies on the issue. It’s not easy, but it’s doable. Rehab.

          •  Sorry, but the research coming out of the Insite experiment clearly shows their rates for obtaining treatment are quite high, AND their success rate in rehab programs is higher than the norm- running at about a 45% program completion rate in Onsite, their related rehab program
            The purpose of Insite isn’t just to provide them with a place to use drugs, it’s outreach.
            Fatal overdoses in the immediate Insite are have decreased 35%-this saves money in healthcare and calls to police and ambulances and yes – disruption to local commerce and public disturbance

            Five – 5! – past mayors of the city say it works-the city wants it, they obviously see the difference it’s making in THEIR community

            The government can’t come up with one piece of evidence to present to the court that shows it doesn’t do what it set out to do -why? because it works. There is not a single piece of evidence that shows it doesn’t and THAT’S what galls

          • Your entire assertion is based on a fallacy – that Insite makes it easier for addicts to get fixes.
            And yes, you need empirical evidence to support the claim that Insite users are less likely to stop using than non-Insite users.

          • you need empirical evidence to support the claim that Insite users are less likely to stop using than non-Insite users

            Especially given the PILES of empirical evidence that shows that Insite users are more likely to stop using than non-Insite users.

            The Government’s own lawyers admit that it’s working.  Their argument isn’t that we should shut it down because it’s not working, their argument is that we should shut it down despite the fact that it’s working.  The government’s not actually interested in a reduction in the numbers of drug addicts and corpses as long as someone somewhere can spin this program as being “soft on crime”.

          • Why on earth would anyone go there if it does not make things easier?  What’s the point?  

          • Because it makes it safer. That’s the point, the one some people who would like to shut down this Den of Iniquity find so damned inconvenient.

          •  “What’s the point?”

            You don’t know that it’s a safe injection site?
            What did you think it was?

          • So you concede my point then.  Thank you. 

            It makes safe injections easier.

            Most addicts would never get an “unsafe” fix. Therefore, as I said, the site makes it easier for addicts to get their fixes. 

            In fact, it makes all injections easier. They give you all the tools, all you need to bring is the heroin.

    • That is my opinion of Insite as well, Atomic Walrus. Insite is certainly better than nothing but is it really the best program that could be created? If you list all the problem associated with urban drug abuse – crime, prostitution, disease transmission, aggressive panhandling, business disruption, overdose, worried family members etc. – Insite solves very few of these problems.
       I don’t have a problem with giving addicts drugs or helping them shoot-up safely but it should be done in an in-patient facility that protects them from exploitation and increases public safety. Helping them be ‘safer’ addicts and then sending them back out on the streets seems cruel and not just to addicts but the entire community.

      • Absolutely… if anything, it’s cruelty.  It’s cruelty to the addicts, it’s cruelty to the community, and it’s tax dollars from everyone’s pocket that is funding the cruelty.  It’s a wicked program.

        • Is this the “they’d be better of dead” argument?

          Also, I don’t think the community sees it as cruelty.  The community now pretty much overwhelmingly supports keeping the program running.  It’s not even very shocking that they do.  The question for the community is basically, “Would you like to keep Insite, or would you rather there be more drug addicts and corpses on your streets?”.

      • Where are these brilliant in-patient facilities that mass-produce ex-addicts and increase public safety? You are describing the model Vancouver has been trying for the 100 years before Insite, and it lacks any of the research benchmarks to which Insite has been subjected. In-patient care is effectively the control group here. To condemn Insite because it only solves a few of the problems created by prohibition (one of them being the problem of junkies dropping dead) doesn’t look much like sincere concern to me.

  4. I have no problem with Insite personally.  The thing is, I can’t think of another program where the state acts in a way to facilitate criminal activity, or to ensure that individuals, when committing what has been deemed criminal, are able to so without being harmed as much as they otherwise would be harmed.  It’s a disconcerting prospect that can be seen as corrosive of the notion of legality, so I understand people’s visceral objections.

    I tend to think, however, that it would be better to solve the cognitive dissonance Insite provokes by reevaluating what is and is not illegal in society, as opposed to taking that fact for granted and attacking state actors for being complicit in the law’s breaking.  In other words, we maybe should not challenge the ‘state helping people’ part of the equation, but rather the ‘commit a crime’ part.  Mill’s harm principle may be helpful in this regard.

    • “It’s a disconcerting prospect that can be seen as corrosive of the notion of legality….” 

      I would like different Ministries to be on same page but that’s too much to ask for. Insite is absurd – take heroin at one spot in East Van and you are given tea and cookies, anywhere else in Vancouver and you are in jail. 

      How are people supposed to know in what ways does Government want them to behave?

      I also don’t believe State should be complicit in people killing themselves. Government should be uplifting people, not helping them to their demise. People can kill themselves on their own, don’t need Government assistance.

      •  How are people supposed to know in what ways does Government want them to behave?

        My point, if I have one, is that people should even have to ask this question if they’re not causing any tangible harm to other non-consenting adults.

        • Re your original post Olaf, it seemed to me that where you were going is that the logically coherent way of dealing with this whole schmozzle would be to legalize most, if not all, recreational drugs.  If that’s your point, I agree.  I find that when you look at the history of drug laws and policies, the original decisions made to designate certain drugs “criminal” (e.g., marijuana, heroin) and others “ok/respecable” (percodan, valium, oxycontin, etc.) tend to be ridiculously arbitrary and often based on voodoo quasi-science and misinformed hysteria.  That’s why I find this “well, it’s ILLEGAL” argument to be so bloody bogus.  Get that out of the way, and we have a chance to have a debate that’s not so gummed up with irrelevancies and red herrings.

  5. Cosh, you missed Lilley’s point completely.  He’s saying it would be OK if the supervised injection were part of an actual treatment, something that might conceivably make the person eventually end his/her adddiction.

    But it’s not, Insite is not a treatment.  It’s not a treatment at all.  It’s enouraging people to shoot up as much as they like.  The benefit of avoiding AIDs or hepatitis is not a treament.  Not choosing to jump off a tall building is also not a treatment.  A cop pulling someone over for driving 200 km/h is also not a treatment.  They’re all called harm reduction.  Most people would not consider a speeding ticket to be a health policy.  Most people would not consider the fence at Niagara Falls a health policy.  But at least the fence at Niagara Falls is there for the people that unintentionally or mistakenly would have falled into the river.  Insite is intended for people who actually choose to harm themselves, people that at one point in their life decided it would be a joy to stick a heroin needle in their arm and have been hooked ever since.

    While you may be amazed at Lilley, I’m amazed at you.  I’m completely baffled that so many people miss this blinding, glaringly obvious point. 

    To think that so many people think this is a health policy I find ridiculous.  Claiming that you should allow someone to poison themselves, and that you eliminate some possible additional stupidity in their actions, and you label this a health policy, and then you question people who think otherwise?

    It’s like having a clinic for alcoholics, but you don’t take their drink away,  What you do is you stand next to the drunk so that when he falls to the ground you’re there to put a cushion underneath.  The drunk is laying unconscious on the floor, but you’ve got peer-reviewed evidence to prove that you’ve successfully ensured the drunk did not experience a head injury while falling unconscious to the floor. Success! Worth every penny! After doing that a few hundred times, the drunk might have nothing left of his liver or his family, but at least he’d have fewer bruises on his head. Success!

    Giving people free needles is not a treatment.

    • It’s not a treatment, no. It’s a way to keep them from dying and saving Canada money. I can live with that tradeoff. 

      • You do realize there are real treatments that actually work?  Drug addiction is not a death sentence.  And it wasn’t a death sentence before insite was invented either.  It’s better to treat addicts rather than help them to destroy themselves.

        • You can’t effectively treat an addict that doesn’t want to be treated. And from the coldly pragmatic view, a user that dies of the drug itself and doesn’t participate in spreading HIV or hepatitis, is still less of an overall drag on the public purse than the alternative.

          • You’re making the argument that we should change our morality due to the existence of universal health care.
            The best way to eliminate the drag on health dollars is to reduce the number of users and to keep the drug illegal.

        • It’s better to treat addicts rather than help them to destroy themselves.

          If only Insite was directing hundreds of addicts into treatment programs!

    •  Hey Dr. SCF: What constitutes a “treatment”?  Is giving someone pills for high blood pressure a “treatment”?  It doesn’t stop them from eating cheeseburgers or otherwise harming themselves, it just makes it less likely that they’ll die from it anytime soon.  What about every other kind of pill that treats the symptoms and not the disease?  Are those also non-treatments?

      • Hepatitis is not a symptom of drug injection. You seem to be confused with the concept of “symptom”. It doesn’t take Dr. SCF to understand something so simple.

        You know, it’s pretty easy to inject oneself with heroin and avoid hepatitis and AIDs. They’re not symptoms of heroin. And it’s pretty easy for any sane and responsible individual to spend a few pennies on clean needles, especially when these same people are spending gargantuan sums on liquid poison.

        There is a fundamental contradiction in the liberal mind when it comes to Insite. On the one hand, they want us to think that heroin can be treated as a lifestyle issue, that you can hop in and out of their fancy clinic and lead a decent existence with a little bit of supervision. Heroin is perfectly normal! If we just hand out those needles, heroin’s all good. Heroin for everyone.

        On the other hand, they want rubes like me to believe that users are so child-like that they can’t even make the simple effort to get clean needles, rather than intentionally inject themselves with potentially fatal blood-borne diseases.

        Hmmm, should I spend a few pennies on a needle, or should I spend every single cent of a gargantuan amounts of money in order to get as many hits as possible and potentially inject myself with a fatal disease? Choices, choices…. it’s tough being a liberal. Hmmmm…. OK, I know the answer, I’ll pick up that needle out of that trashcan in the middle of the park over there, that will do the trick. That’s the answer! Aids, schmaids. It’s not so hard being a liberal after all.

        So which is it? Is heroin a lifestyle? Or is it something that causes people to become child-like wards of the state? To be in favour of Insite, you have to believe that it’s both. Heroin’s a lifestyle activity, like walking dogs or reading books. You pop into that clinic once in a while and you’re good to go. But heroin is also a mind-bending disease, once you’ve tried it you’ll inject yourself with fatal blood-borne diseases just to satisfy the wicked addictive cravings.

        This is the fundamental contradiction to the position of liberals on this issue.

        We’re supposed to believe it’s perfectly fine and normal to be handing over needles for people to inject themselves with poison. It’s no big deal! It’s a health policy like any other! Nothing to be shocked about.

        We’re also supposed to believe that these clinics save thousands of lives! They prevent scourges of disease! It’s impossible to avoid the rampant spread of hepatitis or aids without Insite. It’s scientific! It’s shown to save countless lives from a disaster that cannot be avoided otherwise!

        • And it’s pretty easy for any sane and responsible individual to spend a few pennies on clean needles

          That’s the point, though. They’re not responsible. They’re not weighing all the risks, and in the heat of the moment looking for a fix, buying new works is the last thing on their minds. Providing free needles for injecting drugs is objectively not a good thing, but it’s still the least bad semi-effective solution to the much, much worse problems of communicable diseases.

          • Are you a big proponent of the nanny state? Because it sounds like you are.  You are saying government is there to become the responsible adult for the irresponsible, and the reason for this is that government has instituted universal health care.

            So the more nanny statism we have, the more it becomes the reason for even more of it.

            Now we need more government to prevent us from injecting ourselves with fatal diseases.

        • “It’s pretty easy … to spend a few pennies on cheap needles” 

          Is that your problem with In Site? That the government of BC is intruding on private needle sales?

          • His problem is that somewhere, someone is doing something he disagrees with, yet is not being sufficiently punished for it.

          • Wrong.

          • Perhaps. But if presented with reasonable evidence that I am wrong, I generally consider whether or not I should change my mind.

            I’d make a poor CPC member.

          • What on earth are you talking about?

    • Actually, there’s a managed alcohol program in my city (Ottawa) that provides alcohol by dose to long-term, hardcore alcoholics in exchange for accommodation in a former fleabag motel.You could read this Ottawa Citizen column about it: Geoff Turnbull, the president of the CMA and the mastermind behind this program, claims it’s saving the system $3.5M per year. 

      • Bob,  that looks dangerously like a successful government program. Watch out, political pressure to end its existence will likely be swift in coming… 

        • I’ve envisioned a wonderfully successful program where government money is deposited in my bank account.  Countless individuals would benefit, myself primarily, but also many colleagues and acquaintances would benefit from the program, in numerous ways.  It would be a smashing success.  Quality of life would go up, in terms of good health and good eating, for numerous deserving Canadians.  A fantastic government program. I guarantee that every cent would go towards eliminating problems.

          So Craig, if any program that involves spending tax dollars on peoples’ problems is a success, why don’t you just send me your money directly and eliminate the middle man? I guarantee you it would solve the problems of numerous deserving Canadians.

          Do you understand what “opportunity cost” is? Apparently not.

    •  “Giving people free needles is not a treatment.”

      No it isn’t. But in addition to the lives it saves, Insite helps thousands of people get treatment:

      “In 2010 alone, Insite counsellors made more than 5,000 referrals to
      other social and health service agencies, the vast majority of which
      were for detox and addiction treatment. The calendar year 2010 also saw
      458 admissions from Insite into Onsite, the adjoining detox treatment facility which recorded a program completion rate of 43 per cent in 2010.”

      But that would be evidence, which Lilley feels is unimportant.

      • Nice one, TJ.   

      • And then, of course, controlling the distribution and use of the needles reduces the number that get littered about – meaning reduced risk of infection for unsuspecting members of the general public, as well… 

      • So how many of the 5000 referrals actually showed up for their appointments.  And if they did not, did Insite cut them off the next time they showed up to shoot up?

        And how many admissions would there have been to Onsite had Insite not been next door (I suspect roughly the same).

        A publicly funded entity putting forward selective stats to try to maintain it’s funding – there is nothing new under the sun.

    • s_c_f if you want a treatment centre, why don’t you raise funds, canvas community support, convince conservatives to drop their ideological objections, convince liberals to agree on an approach, and find a community willing to host it? In the meantime, what possible objection could you have to a facility that reduces infectious diseases and death rates?

      Your objection is that it’s not a treatment? Neither is lawn bowling, Sunday school and hot dog stands and I look forward to your posts condemning their inadequacies.

      • Lawn bowling, Sunday school and hot dog stands are not government programs.

        Do you have a point?

        I find it bizarre (and scary) that you believe the government should be funding lawn bowling, hot dog stands and Sunday school. You are an extreme believer in the nanny state – so much so that I wonder if you have any interest in taking on any responsibility of your own for anything. I don’t want to live in your totalitarian world where the government runs our leisure, our meals, our religion and everything else.

        • I believe his point was that Insite isn’t intended to be a treatment program. It has two main goals: harm prevention for addicts and as a gateway to treatment programs. And the data shows it to be accomplishing those goals.

          • “Harm prevention for addicts” – no disputing an addict being handed a clean needle by a nurse prevents “harm” in the sense said addict isn’t using a dirty needle in an alley.  However, there’s a very good chance “harm” will occur as a consequence of his need to get money to buy his drugs in the first place.  Because of Insite, more of this type of “harm” will inevitably occur. 

            “a gateway to treatment programs”  – Insite would be a gateway if clean needles and medical supervision were conditional on the addict accepting addiction treatment.  There is no such condition, therefore whatever success Insite can claim as a gateway to treatment programs has nothing to do with providing clean needles and medical supervision.

          • “There is no such condition, therefore whatever success Insite can claim
            as a gateway to treatment programs has nothing to do with providing
            clean needles and medical supervision.”

            Nonsense.  The users wouldn’t be there without those things.

        • Pro Trolling Tip: save your nanny state claptrap for someone who isn’t already a leftish big government sympathizer who APPROVES of government-funded treatment centres. Or any treatment centre – I’m past caring who pays for it.

          I find it bizarre (and scary) that you believe a facility that reduces AIDS and prolongs life expectancies should be dismantled and all the occupants set on fire.

          Your turn for make-believe.

  6.  Colby, I believe Lilley’s point is that heroin should be legalized and regulated.  He seems to have no problem allowing persons to inject heroin at a government-supervised facility, only that the drugs have been (1) purchased on the street and (2) may be adulterated.  Obviously, this is a call for the legalization and careful regulation of heroin.

    If LIlley does *not* support heroin legalization, then you’re right, this makes no coherent sense.

  7. Everybody is in favour of pragmatic evidence-based policymaking, until it goes against their cherished beliefs. The left is as guilty of this as the right (for instance the minimum wage raises unemployment, by pricing some workers – namely the poorest ones – out of the market, but we have it anyway because it is “unfair” to pay people low wages). 

    Personally, I want to hate Insite, but the evidence just isn’t there. Maybe we need a pact – the right will accept global warming and the failure of the drug war, while the left accepts the tenets of free market economics, and the dubiousness of homeopathic medicine. Anti-vaccine folks will be shot into space.

    •  Maybe we need a pact – the right will accept global warming and the failure of the drug war, while the left accepts the tenets of free market economics, and the dubiousness of homeopathic medicine. Anti-vaccine folks will be shot into space.

      That sounds suspiciously like moderated centrism to me.  Let’s get him fellas.

  8. Life’s tough for some and even tougher for others. For various reasons people end up addicted to things. Some of these addictions are clearly worse than others, and this has been the case for all of recorded history.

    So how is criminalizing some of these addictions supposed to help, and has it ever?

    I understand its convenient politically, but from my perspective all the government has done is abdicated its responsibilities to society at large.

    In fact, it seems a mere step away from criminalizing homelessness, given the rate of drug abuse amongst that portion of the populace.

    Study after study tells us that it’s easier for teenagers to score pot, hash and other harder drugs, than it is for them to get cigarettes or booze.

    Doesn’t this tell anyone anything?

  9. If I want cigarettes or booze, I have to walk into a publically controlled setting where proof of my identity can be immediately required for access. Age limitations are enforced and supply can be regulated.

    Meanwhile, I can go downtown in almost any major city in this country and score most types of illegal drugs quickly and easily, no matter who I am.

    Now I understand the desire to send a strong message about the dangers of drugs and why people would be leery about even the appearance of sanctioning such behaviour. However, the subsequent loss of control, most notably our ability to limit access by children, seems a steep price to me for delivering that message through the legal system.
    Legality cannot change the fact that where there is demand, there is supply. Any fiscal conservative worth his salt knows that.

    So what then? We’re knowingly increasing access and decreasing control? And for what precisely? So we can look down our noses at people? Really? Risking our children for that? Really?

    That doesn’t even get into the mindless persecution aspects of criminalization. Marginalizing people so they’re less likely to seek help and are more at the mercy of organized crime. That one just blows my mind entirely.

    So when do we get over the tribal moralism and start governing with our heads people? Any time soon you think?

    I bloody hope so. This is getting ridiculous.

    • Great post, Phil.  Very well put. 

  10. Fewer people die with Insite in place than would without Insite, and more people get off of drugs with Insite in place than would without Insite.

    One can argue that one doesn’t care about those benefits, or that those benefits aren’t worth the cost, but lets not forget that getting rid of Insite means having more drug addicts and corpses than we have with Insite around.

  11.  I’ve heard second hand (so I can’t vouch for the veracity of the report) that in Norway, homeless drug addicts are almost unheard of, as the government doesn’t allow people to get to that point of depravity to begin with.  The person who told me this stated that any homeless people and/or drug addicts found on the street are “rounded-up” by the police and forced into institutionalized care, where they stay until they are better (which for some people, may be never).  Heavy-handed perhaps, but the person I spoke to says it seems to work.

    If this is true, is this something the Government of British Columbia could do?  I’m not sure about the civil liberties side of the equation, but I would think mental health funding would have to be massively increased before this sort of system could be a viable option.

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