The Outright Lies of "Insite"
Guest Blogger, Steve, reports on the false claims of the safe injection site:
"There's a bit more data in on OD Deaths in Vancouver.
It looks like my initial evaluation that there was a significant increase in deaths caused by the opening of the SIS may have been premature. I had stated that the deaths in Vancouver went up by 29% in 2004, while they went down by 22% elsewhere. These numbers have since been revised to +22% and -8% respectively. http://www.pssg.gov.bc.ca/coroners/publications/docs/annualreport2005.pdf
Previous to 2003, the numbers for Vancouver tracked fairly closely with the numbers for the rest of BC. So I attributed this sudden divergence to the opening of the SIS.
If that were true, the trend would have continued. It didn't. OD deaths in Vancouver went down in 2005 (by 13%), while they went up in the rest of the province (by 22%). More data is required to make a proper evaluation.
I don't have complete numbers for 2006 or 2007 yet, but the Globe and Mail reported a comparison between the first six months of each of those years, and reported that, while OD deaths went up in Vancouver during that time (from 26 to 36), they went down in the rest of BC.**
However, if I extrapolate those numbers, it looks like OD deaths in Vancouver decreased in 2005 (as above) by about 13%, and again in 2006 by about 16%, only to shoot up again in 2007 (by about 38%). I don't know precisely what the rest of BC did during 2006 and 2007. I don't yet have those numbers.***
Early evaluation indicates that after the SIS opened, OD deaths went up slightly, but not significantly more than the rest of BC.
In any case, the differences are small enough to be of limited statistical significance. So the SIS doesn't seem to be having a large effect in either direction.
This sounds like a non-result, until you remember that the SIS proponents have been publishing glowing positive results, and overtly and categorically stating that the SIS is an amazing success, "according to the science". THIS AGAIN PROVES THEY ARE LYING, and have been lying all along.
As scientists, they should know that their own science never proved anything of the kind. As Colin Mangham pointed out in his report, far better than I ever could.
So far, the only thing we can say for sure is that the SIS is definitely not saving lives. The lowest number of OD deaths in Vancouver was in 2002, the last full year before the SIS opened. No matter what math you do, you can't make a case for any improvement in OD deaths in Vancouver. The situation is slightly worse. But that amount is probably not statistically significant.
8 comments:
What? We got that from the same article? When I first read it I thought it was a result of the garbage strike, you know; because of all the bottles. But if the data is for half of 2007, then instead of pointing to the failure of a small experimental initiative such as Insite, I would point to the failures of all three levels of government. The failure of the federals to meet its commitment to all 4 pillars, including treatment. The failure of Provincial welfare reform and the tripling of homelessness since Campbell took office, and the failure of Sullivan to prevent eviction from SRO hotels in the rush to gentrify the DTES before the 2010 Olympics.
But yeah, you're probably right. Its Insite's fault.
I'm really surprised by your comments, Sean.
First, I did NOT say anything was "Insite's fault."
Second, I have been the most publically vocal person in the country urging exactly what you have pleaded for - real funding for the other so-called pillars, in particular treatment.
Sullivan and Campbell and all of the mayors and premiers and prime ministers before them for the last 40 years are completely responsible for never putting a penny into treatment.
We are on on the same side of the argument and aught not to be fighting.
David and others, please take into account that OD deaths as listed by government agencies and the coroner's office include all overdose deaths, not solely through injection drug use. A facility that targets specifically injection drug users will, obviously, have little to no effect on overdose deaths from other methods of doing drugs. Personally, I don't know the numbers, but can guess that with the high numbers of people using crystal meth, some of the deaths are due to stimulant (non-injected) OD.
Also, the science on Insite includes all of the targeted outcomes, which a lot of people do not remember to take into account. These include reducing rates of bloodborne disease transmission, helping people link up with services such as health care, housing, detox, welfare, mental health, etc etc, and to help reduce all of the harms associated with drug use, not just overdose deaths. If one looks at the research done on those areas as well, the numbers and the label of "impact" make sense.
Thanks to stir discussion around the topic, I'll look forward to reading your blog in future.
With respect, Lori, you're been misinformed. But you're not alone. There's been a lot of disinformation on this subject. To answer your comments:
The vast majority of OD deaths are from injection drug use, and so fall under Insite's purview. Crystal meth accounts for very few (1-3) OD deaths per year. And stimulants are injected, including Meth. In fact, the high rate of Hep C and HIV transmission is mainly associated with cocaine injection.
As for the rest of the supposed benefits of Insite, well, they don't exist either. But that wasn't the focus of this article. The "targetted outcomes" stated by Insite's original mandate were fewer overdose deaths and lower prevalence of disease. Neither of these happened.
As for the other outcomes, the science to support them is very very weak. If one reads the research done on them (and not just the summaries) you can fairly easily see that. I read all the reasearch, and was appalled that they often published conclusions that were either not supported or contra-indicated. Look up Colin Mangham's report on the subject.
It's a pet peeve of mine that nobody reads the actual research and just buys into the party line that all is well in Mudville.
First, I did NOT say anything was "Insite's fault."
No of course you didn't say that, but you i
nferred it.
"Second, I have been the most publically vocal person in the country urging exactly what you have pleaded for - real funding for the other so-called pillars, in particular treatment."
Awesome. Good work.
"Sullivan and Campbell and all of the mayors and premiers and prime ministers before them for the last 40 years are completely responsible for never putting a penny into treatment".
Totally.
"We are on on the same side of the argument and aught not to be fighting"
I wasn't trying to start a fight. Just thought that there might be other reasons for OD deaths, and not that Insite was in fact lying.
Thanks for your response, Sean.
I am sorry to tell you that I can guarantee you that Insite is lying.
They talk, for example about referring people to treatment. Huh? What treatment? And how do yopu say to a kid to whom you've just given a cookie at 2am that he'll get no more cookies?
Sean;
Thought I'd weigh in on this.
There's nothing to prove Insite is causing more deaths. But the main point is there's definitely nothing to prove that Insite is causing fewer deaths.
The proponents of Insite have been very vocal in saying that the science shows the SIS has been reducing the number of deaths, in fact "saving hundreds of lives". But the science, the coroner's reports, everything, even their own research shows that is not true. Ergo, they are lying.
Is there something else causing the deaths? Yes. Drug abuse.
If you sink all the money wasted on the SIS and needle exchange (about $4 million a year) into long-term treatment centers and an anti-drug media campaign, I guarantee you'll see a dramatic drop in OD deaths.
But right now? A slight rise, both in total numbers, and also when compared with areas in the province with no SIS.
Creating change in community takes a great deal of time.
We need a needle exchange, not just for people who are addicted, but for people who have diabetes, are undergoing hormone therapy or require drugs for injection. The needle exchange and SIS have virtually eliminated the black market for needles.
When insite reports state that they are saving thousands of lives, they don't just mean from OD. They also mean from infections (sepsis/multi-organ failure, etc), HIV/AIDS, Hep C.
Insite is a first-point contact. It's a safe place. People with addictions can access services and get INTO treatment without fear of being arrested, judged or facing other barriers. Not everyone with an addiction is ready to let go of that addiction. We are talking about the very margnialized populations in our cities, the most vulnerable. We're not talking about West Side Shaughnessy residents.
$4 mil a year is a TEENY amount compared to what they spend on enforcement, which was %75 of the 2003 budget, which was $368 million . Hell, $4 is %0.01 of the budget!
Those numbers were pulled from a poster we made during our community health rotation (creating drug awareness posters!) and the actual references are on a different computer, but they were off credible sources!
Anti-drug media campaign will only work to a point. Prevention and education is one of the pillars and a very much underfunded and underutilized aspect of the 4 pillar approach, so I agree with you on that! But the people on the DTES are very very sick and in a great deal of pain (mentally, physically, etc). They use drugs to escape their pain. All of the sex workers in the DTES are survivors of horrendous childhood sexual abuse, and nearly all of the residents with addictions have a history of severe trauma (also wrote a paper on the mis-use of substances in dealing with uncontrolled pain!).
None of these issues were addressed in your article. Drug abuse and addiction are also two very different things, you can abuse a drug and not become addicted (having more than 5 drinks at a bar is abusing alcohol, but that doesn't mean you're addicted!).
The total number of people with addictions in Vancouver has risen, so strict numbers isn't statistically accurate. Ratios and percentages need to be incorporated (% of people with addictions having OD's, and then the % of those people who either recover or die).
Does anyone remember the pneumonia outbreak in the DTES last year that killed a ton of people? That is a harm from IVDU.
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