6 ms·

See Vancouver's Insite program for proof it works. It's been a huge economic and social success, allowing timely intervention to help drug users get clean, red

See Vancouver's Insite program for proof it works. It's been a huge economic and social success, allowing timely intervention to help drug users get clean, reducing the rate of HIV and HepC amongst intravenous drug users and helping numerous people get a fresh start at life.

forrestthewoods 10y ago
Serious question: what is the proof that Vancouver's program works? How is the program "falsifiable"? Meaning what condition(s) would need to be met for it to be considered a failure? And how much money was spent to reach the current levels of success?
edblarney 10y ago
"See Vancouver's Insite program for proof it works. It's been a huge economic and social success" No - this is not true. OD's are at an all time high in the region [1] It's a highly politicized issues and the entities behind it are strongly incented to make it seem as though it's working. The only evidence of Insite 'working' is provided by them - and the data points they provide are selective, unscientific and definitely not objective. There is no objective evidence to indicate that 'it's working'. If it were a success - we should see number of users down, crime down, cleaner neighbourhood etc. - but no. None of that. There has been no effect on the overall drug using population. There are no external metrics for success at all. By 'success' Insite points to the 'number of ODs prevented' the number of 'addicts into programs' - but this assumes that those ODs would have resulted in death or would not have been dealt with otherwise, and that there are not other ways to get people into recovery programs. Given the amount of $$$ being spent on the clinic, I'm very doubtful that we can claim any degree of success. It boils down to a cleaner place to shoot up - that's about it. I think it's worth keeping open as a 'point of experiment' so that we can try different methods of approach - but it's ripe to call it a 'success'. When numbers of users is measurably down, crime is down, that area is safe to walk in during the day (it's not as of now) - then we can start claiming success. [1] http://www.cbc.ca/news/canada/british-columbia/drug-overdose-bc-november-1.3903256 http://www.cbc.ca/news/canada/british-columbia/drug-overdose...
- nikcub 10y ago
  That data has to be normalized for the surge in fentanyl use. Sydney has had safe injecting for 15 years, initially the rate of overdose went down ~75% to around 1 per month but now in the past few years it has spiked back up again to record levels. There are also other factors to safe injecting rooms - such as opening pathways to recovery, removing litter from the streets, preventing hepatitis and other diseases and removing the taboo from drug addiction. I don't think anybody claims that safe injecting alone can prevent all opioid deaths, its part of (and usually the first step of) a multi-pronged approach.
  - edblarney 10y ago
    "That data has to be normalized for the surge in fentanyl use" I agree. "I don't think anybody claims that safe injecting alone can prevent all opioid deaths," 'Safe injecting' is not saving any lives and is not doing any 'harm reduction' is my point. The only evidence provided that 'it's working' is the sites data where they say 'we prevented x number of ODs' - but this is not quite valid - just because they think they prevented an OD, does not mean they did. Someone who takes too much on the street can still get an ambulance and emergency services. Someone on the street who does 'way too much' is gong to die one way or another. There's no evidence that the sites actually 'get more people into programs' than otherwise. I believe that more directly interventionist programs might work: if you are caught, high on heroin in public - then you don't go to jail, but you go to a facility of sorts. This facility is basically a 'dry out hotel'. The only thing about this facility is you have zero access to heroin - you have to go through withdrawal and be clean for 30 day. Withdrawal is the unavoidable 'first step' to getting off heroin. There is absolutely no other way, and it must be done. Then programs to help people stay off of it.
xorxornop 10y ago
New Zealand, where I live, also has a harm reduction program. Needles are cheap and easily available. It's been a huge success. MASSIVE drops in HIV/AIDS, Hep C, etc, as well as related things like infection and so on, in combination with reduced family harms like. Also instituted were our opioid substitution programs, allowing people to choose from methadone or buprenorphine (aka Suboxone, Subutex) at the dose they want. This, too, resulted in massive drops in overdoses and crime. There is literally no valid reason to oppose these programs supported by evidence. Not only are they the ethical thing to do... they also just work.
- xorxornop 10y ago
  * reducing family harms like breaking them up through imprisonment over paraphernalia, or harms to health (including death, obv.)

forrestthewoods 10y ago

Serious question: what is the proof that Vancouver's program works? How is the program "falsifiable"? Meaning what condition(s) would need to be met for it to be considered a failure? And how much money was spent to reach the current levels of success?

edblarney 10y ago

"See Vancouver's Insite program for proof it works. It's been a huge economic and social success" No - this is not true. OD's are at an all time high in the region [1] It's a highly politicized issues and the entities behind it are strongly incented to make it seem as though it's working. The only evidence of Insite 'working' is provided by them - and the data points they provide are selective, unscientific and definitely not objective. There is no objective evidence to indicate that 'it's working'. If it were a success - we should see number of users down, crime down, cleaner neighbourhood etc. - but no. None of that. There has been no effect on the overall drug using population. There are no external metrics for success at all. By 'success' Insite points to the 'number of ODs prevented' the number of 'addicts into programs' - but this assumes that those ODs would have resulted in death or would not have been dealt with otherwise, and that there are not other ways to get people into recovery programs. Given the amount of $$$ being spent on the clinic, I'm very doubtful that we can claim any degree of success. It boils down to a cleaner place to shoot up - that's about it. I think it's worth keeping open as a 'point of experiment' so that we can try different methods of approach - but it's ripe to call it a 'success'. When numbers of users is measurably down, crime is down, that area is safe to walk in during the day (it's not as of now) - then we can start claiming success. [1] http://www.cbc.ca/news/canada/british-columbia/drug-overdose-bc-november-1.3903256 http://www.cbc.ca/news/canada/british-columbia/drug-overdose...

nikcub 10y ago
That data has to be normalized for the surge in fentanyl use. Sydney has had safe injecting for 15 years, initially the rate of overdose went down ~75% to around 1 per month but now in the past few years it has spiked back up again to record levels. There are also other factors to safe injecting rooms - such as opening pathways to recovery, removing litter from the streets, preventing hepatitis and other diseases and removing the taboo from drug addiction. I don't think anybody claims that safe injecting alone can prevent all opioid deaths, its part of (and usually the first step of) a multi-pronged approach.
- edblarney 10y ago
  "That data has to be normalized for the surge in fentanyl use" I agree. "I don't think anybody claims that safe injecting alone can prevent all opioid deaths," 'Safe injecting' is not saving any lives and is not doing any 'harm reduction' is my point. The only evidence provided that 'it's working' is the sites data where they say 'we prevented x number of ODs' - but this is not quite valid - just because they think they prevented an OD, does not mean they did. Someone who takes too much on the street can still get an ambulance and emergency services. Someone on the street who does 'way too much' is gong to die one way or another. There's no evidence that the sites actually 'get more people into programs' than otherwise. I believe that more directly interventionist programs might work: if you are caught, high on heroin in public - then you don't go to jail, but you go to a facility of sorts. This facility is basically a 'dry out hotel'. The only thing about this facility is you have zero access to heroin - you have to go through withdrawal and be clean for 30 day. Withdrawal is the unavoidable 'first step' to getting off heroin. There is absolutely no other way, and it must be done. Then programs to help people stay off of it.

xorxornop 10y ago

New Zealand, where I live, also has a harm reduction program. Needles are cheap and easily available. It's been a huge success. MASSIVE drops in HIV/AIDS, Hep C, etc, as well as related things like infection and so on, in combination with reduced family harms like. Also instituted were our opioid substitution programs, allowing people to choose from methadone or buprenorphine (aka Suboxone, Subutex) at the dose they want. This, too, resulted in massive drops in overdoses and crime. There is literally no valid reason to oppose these programs supported by evidence. Not only are they the ethical thing to do... they also just work.

xorxornop 10y ago
* reducing family harms like breaking them up through imprisonment over paraphernalia, or harms to health (including death, obv.)