Category: Treatment

  • New Provincial Guidance for Supervised Injection Services in BC

    New Provincial Guidance for Supervised Injection Services in BC

    Supervised injection sites help save lives and protect communities. This was the conclusion of over 30 research studies on Vancouver’s own supervised injection site known as Insite. And Canada’s Supreme Court agreed in September 2011, ordering the federal Minister of Health to grant a section 56 exemption to the Controlled Drugs and Substance Act to allow Insite to continue to operate.

    To scale up harm reduction and support the development of similar services throughout the province, the BC Ministry of Health has now revised its Guidance Document for Supervised Injection Services. Written for health care professionals, it provides advice to health authorities and other organizations considering supervised injection services in their local areas.

    Kenneth Tupper - B.C. Ministry of Health
    Kenneth Tupper – B.C. Ministry of Health

    At a recent public forum in Victoria, BC, Kenneth Tupper of the B.C. Ministry of Health affirmed the value of supervised injection as part of a “comprehensive program of harm reduction services.”

    “The courts have ruled that supervised injection is a valuable approach to health care,” Tupper said, “and the new Guidance Document affirms the province’s support of these services.”

    The “guidance document” could seem daunting for the uninitiated. It spells out a range of issues that should be covered by any organization considering a supervised injection site. This includes extensive knowledge of the local services, rates of HIV and Hepatitis C and any available estimates of drug use patterns. Interested organizations will also need to provide a detailed description of the proposed service and demonstrate how it will be consistent with the principles of harm reduction as spelled out by the B.C. Ministry of Health documents.

    According to provincial policy, anyone who wants to offer this service will need to consider how they will sustain the support of local groups like medical health officers, police departments and other potentially interested groups. They will also need to plan services to be offered in conjunction with supervised injection even if the proposed supervised injection site is small or mobile and carefully consider how client data will be collected and how issues like the risks of substance use and expectations for conduct at the service are to be communicated and documented.

    ‘Harm reduction’ refers to policies, programs and practices that aim to reduce the negative health, social and economic consequences of using legal and illegal psychoactive drugs, without necessarily reducing drug use. Scaling up harm reduction for individuals, families and communities is core to the work of the CDPC.

    We hope you will join us and help spread the word about the importance of services like supervised injection and help us scale up harm reduction in our communities.

     

  • Dr. Mark Tyndall – Supervised Injection sites are the lightning rod of harm reduction

    Dr. Mark Tyndall – Supervised Injection sites are the lightning rod of harm reduction

    I sat down with Dr. Mark Tyndall at the 21st Annual Canadian Conference on HIV/AIDS Research(CAHR) in Montreal this April. The theme of the conference was turning points and meeting new challenges. Tyndall is no stranger to confronting challenges and he is known as a national leader in HIV prevention and care. He worked for over a decade in Vancouver at UBC and the BC Centre for Excellence in HIV/AIDS, also as the head of Infectious Diseases at St. Paul’s Hospital. He now calls Ottawa home and serves as the head of Infectious Diseases at the University of Ottawa.

    “supervised injection sites have become a lightning rod of harm reduction, but we all know and recognize that they are a very important way to try and engage people in some kind of continuum of care…and the need is still quite large.”

    Having been at the forefront of Vancouver’s supervised injection site (INSITE), Tyndall knows that supervised sites and harm reduction services need to be scaled up.

    Tyndall says that there is a public health crisis in Ottawa, similar in some cases to what he saw in Vancouver a decade ago. The big question he asks is, do we need to repeat the same research process and make many of the same mistakes, or can we learn from places like Vancouver, Frankfurt, and Sydney and implement harm reduction and supervised injection sites efficiently. Tyndall was a speaker at a press conference we held in Montreal during CAHR looking at injection sites Nationally, and he also contributed to the Toronto Drug Strategy report that we wrote about this spring. Please get connected and leave your comments to let us know what you think needs to happen in your community.

  • Groundbreaking EU study supports use of heroin-assisted treatment

    Groundbreaking EU study supports use of heroin-assisted treatment

    On Friday, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA ) released a groundbreaking report examining heroin-assisted treatment for chronic heroin users, once thought to be untreatable.

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    Photo Credit: Jay Black

    The report, New heroin-assisted treatment, provides the first state-of-the-art overview of research, examining the latest evidence and clinical experience on the topic in Europe and internationally. The findings show that for the small minority of entrenched opioid users who repeatedly fail to respond to prescriptions of other substitute drugs such as methadone, supervised use of medicinal heroin can be an effective second-line treatment.

    The study’s findings show that Supervised Injectable Heroin (SIH) treatment can lead to: the ‘substantially improved’ health and well-being of this group; ‘major reductions’ in their continued use of illicit ‘street’ heroin; ‘major disengagement from criminal activities’, such as acquisitive crime to fund their drug use and ‘marked improvements in social functioning’ (e.g. stable housing, higher employment rate).

    From the report:

    ‘New heroin-assisted treatment is an issue that has attracted much attention, controversy and often confusion’, says EMCDDA Director Wolfgang Götz. ‘With Europe at the forefront of investigating and implementing this novel approach, the EMCDDA is proud to present the findings of the major contemporary research studies on the topic and the clinical and policy experiences of countries providing it. Our purpose in doing this is not to advocate, but to inform. We hope that this report will help policymakers and practitioners draw their own conclusions about this type of treatment within their own national context’.

    What do you think about expanding heroin-assisted treatment to communities in Canada?  Do you think it’s time to scale up harm reduction and provide evidence-based treatment options for our most entrenched drug users?  We want to hear from you.

     

  • Toronto Drug Strategy Consumption Room Feasibility study released

    Toronto Drug Strategy Consumption Room Feasibility study released

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    Dr. Carol Strike and Dr. Ahmed Bayoumi (photo by Yuri Markarov)

    In 2005 when the Toronto Drug Strategy was approved by Toronto City Council one of the main recommendations was to complete a needs assessment and feasibility study on the implications of establishing supervised consumption sites in Toronto.

    The independent research project – expanded to include Ottawa – was carried out over four years by Dr. Ahmed Bayoumi, a physician and research scientist at the Center for Research on Inner City Health at St. Michael’s Hospital, and Dr. Carol Strike, an associate professor in the Dalla Lana School of Public Health at the University of Toronto.

    The study recommends establishing injection sites, three in Toronto, two in Ottawa, that are fixed sites and should be integrated within existing service settings.

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    Download Report

    The study does not call for the establishment of consumption sites for people who smoke drugs but does call for more research on how best to provide supervised consumption through inhalation. Evaluation and the importance of a comprehensive approach to substance use is also noted.

    On September 30, 2011, the Supreme Court of Canada upheld the right of Insite, currently Canada’s only supervised injection site located in Vancouver, to remain open.

    Read the full research report here and let us know what you think.

  • Insite withstands test of international drug control conventions

    Insite withstands test of international drug control conventions

    At the 55th meeting of the Commission on Narcotic Drugs held in Vienna March 12 – 16th Damon Barrett, Human Rights expert at Harm Reduction International spoke candidly in the plenary session regarding the erroneous statements made by the International Narcotics Control Board (INCB) in their recent annual report (2011) concerning Vancouver’s supervised injection site, Insite.

    In paragraph 437 of the report the INCB clearly states: “drug injection and consumption outlets that allow illicit drug possession and use are not in line with the international drug control conventions”.  This is an outright falsehood and the United Nations Drug Control Program’s own legal advice commissioned in 2002 admits as much. It can be read here.

    Insite Press Conference
    Insite Press Conference

    The fact that the INCB still carries on trumpeting this false information ten years after the UN’s legal opinion was sought makes a mockery of the INCB’s integrity and credibility.

    Here is the offending paragraph from the INCB report:

    437. In September 2011, the Supreme Court of Canada handed down its judgement with respect to the applicability of the Controlled Drugs and Substances Act to a supervised drug injection facility in Vancouver. The facility had been allowed to operate due to an exemption to the application of the law for “medical or scientific purposes” that had been granted by a previous Government. The Court ruled against the Government’s decision to refuse to extend the injection facility’s legal exemption, thereby allowing the facility to continue to operate. The Board reiterates that under international law, provisions of national law cannot be invoked to justify non-compliance with the international drug control treaties to which a State has become a party. The Board further reiterates its position that drug injection and consumption outlets that allow illicit drug possession and use are not in line with the international drug control conventions, to which Canada is a party.

    Damon Barrett set the record straight for the INCB with this statement:

    The recent Canadian Supreme Court decision on Vancouver’s safe injection facility is criticized as running contrary to article 27 of the Vienna Convention on the Law of Treaties. This states that national law cannot be used to justify non-compliance with international legal obligations. This is true. But the Canadian Supreme Court Case was decided on the basis of Canada’s Charter of Rights and Freedoms, a constitutional document. As the Board is aware, article 3(2) of the 1988 Convention relating to the requirement to criminalize possession for personal use is subject to States parties’ constitutional principles. Similar wording is used in relation to the penal provisions of the 1961 Single Convention. In addition, in 2002, the UNDCP legal affairs team stated in an opinion on the matter that such interventions do not breach the conventions.

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    Vienna International Centre
    Vienna International Centre

    As such, there is no conflict between the Canadian Supreme Court ruling and the drug conventions. These provisions of the treaties, however, and the UNDCP opinion are not referred to in the Board’s analysis of the case. We would welcome clarification of the Board’s view of the Canadian Supreme Court decision in the light of these terms of the drug conventions and its view of the 2002 UNDCP opinion.

    To Canada’s credit the Canadian delegation also spoke up and let the plenary know that Canada was indeed in full compliance with all of the international treaties pertaining to drug control. Now that this mater is settled in the international arena, we look forward to our Justice Minister Nicholson reaffirming these facts for the Canadian public.

     

  • Thinking outside the box in Mexico City

    Thinking outside the box in Mexico City

    “There’s a crack in everything, that’s how the light gets in”

    Leonard Cohen

    That is how I started my presentation at the most amazing drug policy reform conference in Mexico City, organized by Mexico Unido Contra la Delincuencia (Mexico United Against Crime) February 12 – 14th, 2012. I played a song from Canada’s most famous poet, Leonard Cohen, which included the words, “There’s a crack in everything, that’s how the light gets in.” Mexico is certainly in need of some light. The long dark tunnel that is their present war on drug cartels continues to see death and despair permeate their news on a daily basis.

    Gillian Maxwell, CDPC’s Executive Committee member and I attended this important drug policy dialogue together in Mexico. The conference brought some of the leading thinkers in drug policy reform globally, NGOs from Mexico, academics from Mexican universities and members of the business community from Monterrey and Mexico City.

    The organizers were determined to “think outside the box,” and search for alternatives to the war on drugs that their government is waging on the cartels that is literally killing thousands of people in their country.

    Over 53,000 have died since 2006, others put the figure closer to 60,000.

    Held in the magnificent Museo Nacional de Antropología the conference had an historic air to it. Surrounded by thousands of years of Mexican history the intractable problem currently facing the country was put into perspective by centuries of history, energy and artifacts in the Museo.  One can feel the frustration with the continuing violence of the drug war. But Mexico is at a tipping point. The country may be getting close to breaking away from its historic path and taking a major leadership role in charting a new way forward with its Latin American allies.

    Those who attended the conference heard many reasons to take a new direction and consider alternative approaches to drug policy in Mexico. Ethan Nadelmann, Executive Director at the Drug Policy Alliance in the US, urged Mexican participants to do what is best for Mexico and not to wait for the United States to change its direction. He spoke of the historic leadership position that Mexico has in the region and the opportunity to lead other Latin American countries as they question the prevailing ideology of the war on drugs. This was echoed by other speakers from the US including Jack Cole from Law Enforcement Against Prohibition and former Judge, James Gray from California.

    As a citizen of a US border state I had to admit that Canadians often have the same discussion  – how can we change any of our drug policies independently of the Americans? But in fact, it was our good sense that lit the way for the US to abandon alcohol prohibition in the 1930s. And I believe we can do it again by designing an exit strategy for the war on drugs.

    Mexico is in the strongest of moral positions to call for an end to the drug war.

    There is movement afoot.  Two weeks before the conference in Mexico, Guatemalan President, Otto Perez Molina called for all Central American leaders to consider decriminalising drugs in an upcoming regional meeting. Cesar Gaviria, Colombia’s former President then presented at the conference and clearly called for legalization of drugs as a new way forward in the region.

    Steve Rolles, from the Transform Drug Policy Foundation laid out Transforms’ prize winning strategy paper, A Blueprint for Regulation that is one of the most well thought-out arguments for moving to a legally regulated regime for all psychoactive drugs.

    Nuno Capaz, a Sociologist at Instituto da Droga e da Toxicodepencia in Portugal outlined how Portugal decided to decriminalize all drugs for personal possession some 10 years ago and how that has been a success in terms of overdose prevention, HIV prevention and access to treatment. In addition, drug use itself has not increased and across many demographics has actually decreased.

    The second morning of the conference, Javier Sicilia came into the room and was graciously received by the conference organizers. Sicilia, a poet and journalist who lost his son to drug war violence has been leading a movement for peace and dignity in Mexico convening marches in the street and calling for the Mexican population to join him to protest the violence that is the daily reality in Mexico today.

    Sicilia attended the conference to learn how drug policy might have some answers to his questions. We met and hugged each other and conversed with rudimentary bits and pieces of language and many gestures and agreed to meet again to work on a plan for peace. Very cool!

    There were many other speakers from the Netherlands, Australia, the US, and the indefatigable Senator Larry Campbell from Canada. The United Nations Office on Drugs and Crime also gave an incredibly uninspiring, formulaic presentation that could only be called “maintain the status quo propaganda” and actually defended the drug war effort with its collateral damage of 50,000+ deaths.

    At the end of the three days in the Anthropology Museum, the directors of the MUCD pronounced the conclusions of the conference from their perspective. They were indeed a radical departure from the status quo.

    Among the eight key points, they called for Mexico to take a public health approach to drugs, and they asserted that countries must be allowed to take a sovereign approach to addressing drug problems that are in the best interests of their people. They also called for Mexico to move gradually towards a model of regulation and control of currently illegal drugs. Sound familiar? This is the same discussion that many Canadians and Americans are having.

    The movement for change is growing. If countries like Mexico can begin to move towards their own made-in-Mexico plan then surely Canadians can figure out a way out of the war on drugs. As with alcohol prohibition, perhaps the US needs Canadian ingenuity and leadership once again to lead the way.  Let’s be those leaders.

     

     

  • Bill C10: Weighing emotions & evidence in sexual offenses

    Bill C10: Weighing emotions & evidence in sexual offenses

    Over sixteen witnesses appeared before the Senate Committee during another marathon session of testimony on Bill C-10. Today’s session dealt primarily with the fight against child abuse and the spread of child pornography. Witnesses represented advocacy groups, victims of sexual abuse, and experts on sexual offenders.

    Many witnesses put forth a position that mandatory minimum sentences provide adequate deterrence for sexual predators and give more leverage to police during questioning. Senators Runciman and Lang voiced their opinion that Canadian judges give sentences to convicted predators that are too low and that judges across the country gave “inconsistent sentences” . The witnesses who were victims of sexual abuse were unanimous in their feelings that they had not received justice and that their perpetrators deserved harsher sentences.

    Yet incarceration was not the only topic that the committee discussed. Senator Jaffer and Paul Gillespie, a former policeman now with Kids Internet Safety Alliance, noted that incarceration should be one step in a comprehensive strategy to fight abuse.

    All witnesses agreed that funding for prevention strategies and treatment services needed to be increased.

    Senator Fraser read a submission by a Rupert Ross, a former crown prosecutor, who found conditional sentences a very useful tool in encouraging offenders to cooperate and possibly report other abusers. He implored the committee not to legislate mandatory minimums, as he feared it would cause less cooperation and more acquittals. This directly contradicted earlier testimony from Mr. Gillespie, who stated that Crown Prosecutors are demanding mandatory minimums to help them push for tougher sentences.

    Dr. Ellerby from the Association for Treatment of Sexual Abusers added further dimensions to the debate. Ellerby voiced opposition to the notion that abusers cannot be cured and stated that treatments have proven to work in rehabilitating offenders. He went on to argue that a range of approaches can be successfully used in fighting sexual abuse including community monitoring and engagement.

    With many offenders victims of abuse themselves, having an incarceration only approach for sexual abusers is fraught with contradictions.

    A number of witnesses referenced the need for a comprehensive strategy incorporating prevention, incarceration, mental health treatment and rehabilitation. Yet government-side questioning and discussion of the Bill continued on the assumption that tougher sentences were the only strategy to deal with sexual abusers, with little research to prove this.

    Dr. Ellerby flatly stated that if the goal is the reduction of crime and recidivism mandatory minimums will not succeed.This statement seemed to fall on deaf ears.

    Despite evidence that seemed to downplay the requests of many victims of sexual abuse for tough sentences, the unanimity of their request cannot be ignored. There is real debate to be had here, one that will involve weighing emotions and evidence to create a comprehensive sexual abuse strategy for both victims and offenders. All witnesses seemed very willing to have this discussion. But with the growing combative attitude between the federal government and voices that oppose it, it’s unlikely that Ottawa will be sanctioning such a discussion anytime soon.

  • Talk – Ending Drug Prohibition and Emancipating the Addict: The Last Frontier in a Struggle for Enlightenment

    Talk – Ending Drug Prohibition and Emancipating the Addict: The Last Frontier in a Struggle for Enlightenment

    Time to wake up – Time to get busy – Time to step up – Make ‘em go tizzy

    Peter Ferentzy holds a Ph.D. in Social and Political Thought from York University. He’s an author and activist working hard to liberate people with addiction problems and turn over destructive drug policy paradigms. He says he knows this topic “from the gutter right up to the halls of academe”. As a historian of addiction he brings a long-term perspective. Ferentzy wrote his bookDealing with Addiction — Why the 20th Century was Wrong after he lost two friends to overdose. In both cases he says “the governing approach to addiction was the cause”.

    In his huffington post article titled “Ending Drug Prohibition and Emancipating the Addict”  Ferentzy argues that…

    emancipation of those with substance addictions is consistent with what our civilisation has been accomplishing over the last two hundred years. The overcoming of harsh attitudes toward drug addicts will be viewed in much the same light as, today, we view the abolition of harsh punishments for children, the introduction of woman’s suffrage or even the abolition of slavery.

    Catch Peter Ferentzy’s talk:

    Ending Drug Prohibition and Emancipating the Addict – the Last Frontier in a Struggle for Enlightenment

    With a special introduction by Dr. Gabor Mate. Brought to you by the PHS Community Services Public Lecture Series

  • Calling for community health and safety in BC.

    Calling for community health and safety in BC.

    This fall the Canadian Drug Policy Coalition joined the recently formed Stop the Violence Coalition BC (STVBC), a coalition of law enforcement officials, legal experts, public health officials and academic experts from the University of British Columbia, Simon Fraser University, University of Victoria, and the University of Northern BC.

    http://stoptheviolencebc.org/

    The STVBC coalition is working to engage British Columbians in discussion about how the current policy of cannabis prohibition is working to achieve the goals of reducing availability and use of cannabis in British Columbia and minimizing the involvement of organized crime in the illegal cannabis market. The STVBC Coalition is calling for a new model of regulating cannabis to be considered – regulating and taxing cannabis within a legal framework.

    The CDPC applauds the leadership taken by STVBC in bringing this discussion to light in British Columbia. CDPC is committed to evidence informed public discussion with a goal of developing more effective drug policies for Canada. For too long there has been a taboo on discussion and dialogue about viable alternatives to drug prohibition, a policy framework that has thwarted experimentation and innovation in policy development. Given the normalization of cannabis use in Canadian society as a common recreational substance, the enormous scale of the cannabis market within Canada and concerns over health and safety within the cannabis market this report is a significant contribution to the public discussion on how best to minimize harm within the cannabis market.

    Here is a copy of the second report issued by the Stop the Violence BC coalition. It focuses on the impact of drug law enforcement on cannabis availability and the expansion of organized crime in BC. The report recognizes that cannabis prohibition laws are ineffective when it comes to decreasing rates of availability and price, and suggests ways to better protect community health and safety. More details at www.stobptheviolencebc.org >>

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