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Junkie science

Adam Radwanski, July 14, 2008 at 11:47 PM EDT

Far be it from me to contradict Mark Steinkampf, the Vancouver cop cited approvingly in Margaret Wente's Saturday column. Having worked the Downtown East Side for 18 years, he knows much better than I do what kind of shape it's in, and how it compares to years past. If he says it's getting worse, I'm prepared to accept that it's getting worse.

What I'm not prepared to accept is that this is in any way the fault of Insite, nor other harm-reduction measures deployed in the country's most drug-infested neighbourhood. Steinkampf - and, to be fair, our columnist - seem to have confused cause with effect. And they've overlooked one of the supervised injection site's most positive effects, recognized even in the most skeptical of the credible reports on its impact.

Nobody seems to be seriously suggesting that harm reduction programs cause people to get addicted to drugs, which would be an insane proposition. ("I've always wanted to inject heroin into my veins, but I've just never been able to find a clean needle. Thanks, Insite!") But there's an odd implication that the proliferation of services has caused the Downtown East Side to be infested with addicts, as opposed to the Downtown East Side's infestation of addicts having caused the proliferation of services.

While it's possible that the surplus of programs within a few blocks of each other has centralized the problem somewhat, the only way they've added to the number of addicts in Vancouver is if you believe - as Margaret seems to - that places like Insite actively discourage users from kicking their habits. And that's simply not borne out by the available research.

In her follow-up column in Tuesday's paper - the second in a five-part series - she notes that most of that research comes from a small cadre of enthusiastic Insite supporters. That's not untrue, although I'd point out that when it's appearing in places like the New England Journal of Medicine you probably don't need to put "peer-reviewed" in quotes. But if "'rehabiltation' and 'recovery' are terms you don't hear from advocates of harm reduction," as she wrote on Saturday, then it's unclear why the doctors and academics touting Insite are so eager to point out in their studies that the facility has resulted in a 30 per cent increase in the use of detoxification programs.

Nor is it just those advocates refuting the claim that the people offering harm-reduction services are disinterested in getting addicts to kick their habits entirely. From Tony Clement's advisory committee, which certainly wasn't part of the "enabling industry" that Steinkampf complains about, comes the following:

"INSITE encourages users to seek counseling, detoxification and treatment. Such activities have contributed to an increased use of detoxification services and increased engagement in treatment. VCH has now increased access to detoxification by opening a number of beds for detoxification in rooms above INSITE."

None of this is to say that Steinkampf, Wente or anyone else is wrong that inadequate resources are being directed toward rehab facilities. But that's not Insite's fault, and there's no reason - certainly not costs, which are relatively minimal in the grand scheme of things - for multiple forms of treatment to be mutually exclusive.

If one of the four pillars of Vancouver's drug strategy isn't as strong as another, it seems to me you reinforce it. You don't chop down the stronger pillar so that the whole thing collapses.

  1. Harper-approved lies are scripted talking points from Canada writes: Why does G&M even bother to print Wente's idiocy? Every time I read her gibberish, I feel like I need to take a bath, and I tell myself never to read her column again. She should be writing for FAUX News or some other rag, not an actual newspaper.
  2. D LF from Vancouver, Canada writes: Psst... It's the DTES - Downtown East Side. I think that you'll find that the Lower East Side is in Manhattan.

    I've lived here in Vancovuer for almost 5 years. Just over 4 years ago I had to walk through 2 blocks of the worst of the DTES to get to work. I used to see junkies shooting up on people's lawns and sitting on the curbs across the street from the VPD Main St. station.

    I quit that job, and now the only time I make it down to the DTSE is to volunteer at WISH - the drop-in centre for women and women-identified who work in the survival sex-trade. I have to walk past those same two blocks of the worst to get there.

    I don't see junkies on the lawns or sitting on the curbs anymore. That, in itself, is an improvement. Insite has helped many of the women at WISH. It's a part of my community that helps me feel that both the people on the DTES and the Vancouver community are a bit safer.
  3. jhane ball from Canada writes: Anyone who thinks there are four pillars operating as part of Vancouver's drug strategy is deluding themselves. The Treatment "pillar" is virtually non existent anywhere in British Columbia. I've often wondered if this fact has anything to do with cost and NIMBYism - hmmmm! Ask anyone who is existing in the war zone and looking to get themselves clean - its virtually impossible to find treatment facilities anywhere, anytime.

    How can we, and I include our politicians and citizens, pat ourselves on the back and claim any measure of success when treatment facilities are so desperately needed to complete the effectiveness of the much vaunted Four Pillars strategy.
  4. Randy McClure from Canada writes: Nice piece, Adam. You nicely show how people like Wente fall into the usual traps of illogic. Jumping to conclusions, suggesting that correlation implies causation ... "The number of drug addicts has increased since Insite has been around, so gosh darnit, I guess Insite is to blame." ... You might as well conclude that since Hitler and Stalin both had mustaches, all men with mustaches are psycopathic megalomaniacal murdering despots. The question to ask is how many MORE addicts would be shuffling around East Hastings if Insite were NOT around. Wente will never ask that question, because like all conservatives, she assumes that people are basically bad, and you can't trust them to behave well without COPS around to keep them in line ... not those pansy pinko liberal social workers. The reasearch suggests pretty stronly, that if insite is closed, more people will die than if it remains open.
  5. Chris Edwards from Greater Sudbury, Canada writes: It is refreshing to see an editor take on one of the paper's own columnists. This creates healthy debate, demonstrates that the paper intends to be a platform for more than one opinion, and highlights the fact that a columnists biased views on an issue (which is what they are paid to present) do not necessarily represent the paper's editorial slant.
  6. Michael B from Canada writes: Well said Chris. While I'm surprised that Wente gets front-page (online anyway) coverage, I am certainly glad to see Adam's quick rebuttal. Ms. Wente's journalistic dishonesty gets me more than a little incensed, and I was glad that a prominent voice was already denouncing it.
  7. Francesco Sorbara from Canada writes: I found ms wente's article to be a case of bad journalism and her arguements agains INSITE not helping any form of public discourse on the subject. Disappointing to say the least to read the column on my way to work this morning...had to stop after the second paragraph...junkie journalism i guess is the best way to characterize the write-up...
  8. Ruth Walker from Edmonton, Canada writes:
    It is important to remember that science is a social process based on openness, transparency, and peer review. The intent of that social process is to prevent us from fooling ourselves, and the way we do that is by getting others in the scientific community to check our work.

    Many famous scientists have said in various ways that belief hinders search for truth and reality. It is part of the human condition that we all adhere to some pretty absurd beliefs, and until we set those absurdities aside, we are blinding ourselves.

    Treating belief as harmful puts science at odds with politics and religion, or any mixture of the two. It is completely normal in politics and religion, for belief to override both established facts and formal logic. Moreover, politics turns on the specious argument, e.g. ad hominem attacks, or the indispensable red herring.

    Wente represents the religious right well. She relies on disproven theses and false inference in much of her writing. She makes it clear that nothing could ever shake her core beliefs. Is that not the opposite of science?

    Politicians usually see science as one more useful idiot. They pick and choose, to find helpful arguments "based on science". And whenever they do that, they defeat both scientific process and its intent. So truth gets bludgeoned, so what?

    Good governance is evidence-based and outcome-oriented. Too many politicians spend their days defeating good governance, and we are all worse off for it.
  9. Jake The Snake from Canada writes: Wait, the G&M is supposed to be a left wing rag. How could it be that a columnist such as Wente is even employed there? ;)

    Hey G&M if your giving Wente a 5 part slanted rant on something like this you might want to balance that with a columnist who reports the facts instead of the conjecture of Wente and the people she chooses to interview. Then juxtapose it.

    That way people can see the difference between an columnist who uses facts and figure vs opinion and preconceived notions.

    Now that would be a learning experience.
  10. Michael Sharp from Victoria, Canada writes:

    Insite itself claims to save, on average, one life per year.

    In order to reduce the spread of Hep C and HIV, a junkie would have to use Insite, all the time.

    The instant the junkie uses a dirty needle outside of Insite, Insite's effectiveneess of harm reduction is negated.

    Insite's sole function is to make the public feel better.
  11. J Hare from Saskatoon, Canada writes: Michael Sharp, some what true. For your conclusion to be correct we would have to assume that every dirty needle carried either Hep C or HIV so 100% of people who used those needles would potentially become infected. As this isn't the case we then need to look at the prevelence of dirty needles that carry infectious diseases. Once we determine that % we would need to determine the infection rate of those who used them since not everyone who uses an infected needle will necessarly become infected with that disease. Now we have the big number; ie. the corrolation of % of dirty needles carring infectious agents and can compare that use to infection rates. As a side we could then calaulate the spead of disease though needle sharing in an addicted comunity. What Insite does is alter the equation by adding non-infected needles into the pile (so to speak) it does two things. One it diluted the number of needles that are infected into a larger number lowering the % by increasing the base of over all needles avaliable. Second, by offering disposal it eliminates a % of the dirty needles normally avaliable for reuse. This is outside of any corrolatative effect on human behaviour seeking to activly reduce negative consequences of drug use.

    James Hare
  12. Vern McPherson from writes:
    Michael how would the public feel without it ?

    Better or worse ?
  13. Michael Sharp from Victoria, Canada writes:

    "Vern McPherson from writes:
    Michael how would the public feel without it ?
    Better or worse ?"

    Judging by the tenor and fervour of those claiming Insite to be an unqualified success (which even Insite does not claim), the public would feel worse.

    Social progression is not about results, it is about optics.
  14. Voltaire's Distant Cousin from Toronto, Canada writes: I'd really like to see Ms. Wente spend a week in the down town east side. I would even pay her hotel bills, but only if she stayed in one of the broken down buildings on Hastings. And only if she agreed to spend her time at Pain and Wastings, talking to the addicts, getting to know them.

    Somehow I doubt Prof. Umbridge, oh sorry Ms. Wente would agree to descend from her neo-conservative ivory tower to actually understand the real impacts of her heartless and intellectually unsound ramblings.
  15. Ace Frehley from Vancouver, Canada writes: Michael Sharp from Victoria, Canada writes: "Social progression is not about results, it is about optics."

    And if the results ain't perfect, give up and throw them all in jail because they are full of AIDS and Hep C.

    Ladies and gentlemen, may I present the next Justice Minister in Canada's (not-so-)New Government, Michael Sharp.
  16. Dennis F from Burlington, ON, Canada writes: Wente's column today argues that there is no evidence to suggest that Insite works.

    Your response seems to be that it does work because detox centre use is up as a result.

    Is that why these centres exist? Is that an example of positive harm reduction, or is there another way of getting people into detox centres?
  17. F H from Canada writes: Well put Adam. Ms. Wente throws out the straw man argument that drug use hasn't decreased since InSite opened. That was never the main goal. The main goal is to keep them alive long enough for the thousands upon thousands of beds in treatment centres are created. Until then, InSite has been offering councilling, help to get into detox and help to get into available treatment centres.

    No, it's not a cure. But it is a way to keep the patient alive until the cure is available.
  18. J Hare from Saskatoon, Canada writes: Dennis F, I'm not sure I see the distinction your trying to make. If they use Insite and this helps them into detox isn't that harm reduction? If they use Insite and don't enter detox then the facilities provided at Insite reduce the risk of harm (harm reduction) and it still holds true. Could you please explain what you mean further?

    James Hare
  19. Dennis F from Burlington, ON, Canada writes: James Hare, I actually don't see the distinction that you're trying to make. If they use Insite and don't use detox, how does that reduce risk of harm? In fact, that's the main argument of the Wente article, that there's no evidence to suggest such, which is why Radwanski seems to use the detox statistics.

    In other words, is Insite successfully pursing its mandate comprehensively?

    Or are there other ways of getting people into detox — if that's their main accomplishment — that doesn't involve condoning illegal activity.

    In fact, some people believe that's the purpose of sites like this, to promote decriminalization.
  20. Chris Edwards from Greater Sudbury, Canada writes: Dennis F from Burlington, ON, Canada writes: If they use Insite and don't use detox, how does that reduce risk of harm? In fact, that's the main argument of the Wente article, that there's no evidence to suggest such, which is why Radwanski seems to use the detox statistics. In other words, is Insite successfully pursing its mandate comprehensively? Or are there other ways of getting people into detox — if that's their main accomplishment — that doesn't involve condoning illegal activity. In fact, some people believe that's the purpose of sites like this, to promote decriminalization." First of all, if they use Insite and don't use detox, thay are still using clean needles, not shooting up in alleys and doorways, and hopefully staying healthier until they work up the will to get clean AND by using Insite, they are exposed to these programs and encouraged to enter one. The main thrust of Wente's article is NOT that there is no evidence to suggest Insite works, and Radwansky never acknowledges that fact. She just doesn't believe the proof that is out there. Radwansky didn't use any straw man. Read his blog again. On the topic of promoting decriminilization - no, that isn't their purpose. Besides, decriminilization is a half measure promoted by political cowards and apologists. Legalization makes far more sense.
  21. Haiden MitHand El from Canada writes: Chris Edwards from Greater Sudbury, Canada writes: ...On the topic of promoting decriminilization - no, that isn't their purpose. Besides, decriminilization is a half measure promoted by political cowards and apologists. Legalization makes far more sense.

    Chris -- one word -- Amen!
  22. Michael B from Canada writes: Michael Sharp you are the most stupidly annoying broken record in the world. You find a slogan and you just keep repeating it. Shut the hell up, child.
  23. Haiden MitHand El from Canada writes: Michael B from Canada writes: Michael Sharp you are the most stupidly annoying broken record in the world. You find a slogan and you just keep repeating it. Shut the hell up, child.

    Michael -- another amen is in order.
  24. Ace Frehley from Vancouver, Canada writes: Michael Sharp from Victoria, Canada writes:

    The instant the junkie uses a dirty needle outside of Insite, Insite's effectiveneess of harm reduction is negated.

    ______________________________________________

    Has it ever occurred to you that it's a good idea to have infected addicts shooting up at Insite, if for no other reason than to make sure that the dirty needle is collected?

    I didn't think so.

    Think more, pontificate less.
  25. Michael Sharp from Victoria, Canada writes:

    No.

    I will not shut up.
    My points are valid.
    My points speak to society as a whole, as well.

    If the purpose of Insite is to collect dirty needles, sharps containers at every street corner would accomplish as much.

    If the purpose of Insite is to provide counselling, AIDS Vancouver does the same.

    The social progressive does not like to be confronted on his belief system.

    It is heresy.
  26. Ace Frehley from Vancouver, Canada writes: Michael Sharp from Victoria, Canada writes:

    If the purpose of Insite is to collect dirty needles, sharps containers at every street corner would accomplish as much.
    ____________________________________________

    Kinda like the way that providing public garbage cans on every street corner prevents littering, eh?

    It obviously has not occurred to you that in the aftermath of injecting a completely stupefying substance, priority number one is not likely to be the safe disposal of the needle.

    Surely you are being deliberately dense.
  27. Fake Name from Canada writes: " Michael Sharp from Victoria, Canada writes:
    If the purpose of Insite is to collect dirty needles, sharps containers at every street corner would accomplish as much."

    It would make it even easier for junkies to know where to go digging for a needle to use, too. No more of this hunting around on the street for two or three minutes to spot one; just reach into the bin.

    I'm not sure that's a great idea.
  28. Orest Zarowsky from Toronto, Canada writes: People like Ms Wente and some of the posters here would have more credibility and a leg to stand on if they were as vehement in their demands for more rehab and treatment facilities as they are in their opposition to InSite and harm reduction. But they aren't. Thge main reason being that these cost money and would require public f8nding. AKA tax dollars. Ms Wente's position on public facilities and funding is well known, and the "pundits" here who agree wiuth her tend to hold the same position.

    Tragically, there's no free lunch.
  29. Michael Sharp from Victoria, Canada writes: Ace Frehley from Vancouver, Michael Sharp from Victoria, Canada writes:
    If the purpose of Insite is to collect dirty needles, sharps containers at every street corner would accomplish as much.
    ____________________________________________

    Kinda like the way that providing public garbage cans on every street corner prevents littering, eh?

    ================================================

    Kinda like the way that providing Insite reduces drug addiction and communicable diseases, eh?
  30. Ace Frehley from Vancouver, Canada writes: Michael Sharp from Victoria, Canada writes:

    Kinda like the way that providing Insite reduces drug addiction and communicable diseases, eh?
    ______________________________________________

    It may or may not do that in the end. The jury's out.

    What is certain is that the war on drugs is a catastrophic, unmitigated failure. What is even more certain is that our current government and its Australopithecan supporters only have one solution: do more of the war on drugs thing, ignoring the evidence that it does NOTHING except cause a proliferation of organized crime due to the enhanced profitability of illegal drugs.

    Oh yeah, it also makes the drug addicted more likely to commit property crimes, more likely to commit violent crime such as robbery, and more likely to end up in a horribly expensive prison system that does NOT provide treatment while providing ready access to the same drugs that got them there in the first place.

    So what's a good CPC zealot to do? Try something new? Hell no. More of the same, only a LOT more of it.

    Stupid. Cruel. Inhumane. Wasteful. Proven ineffective. Conservative.
  31. Ace Frehley from Vancouver, Canada writes: And by the way, Mr. Sharp, you failed to address my criticism of your idea to put sharps containers on every street corner.

    It's a stupid idea by any objective measure, which is to say it fits your long-established pattern. But I was at least hoping to see you show your ineptitude once again by coming to its defence.

    Of course, you changed the subject instead. You would do well in Question Period.

    Christ, maybe you are Peter Van Loan's alter ego!
  32. Michael Sharp from Victoria, Canada writes:

    Ace Frehley from Vancouver?

    No Insite in Victoria.
    There is, however, a needle exchange.
    They exchange dirty needles for clean ones.

    OK?
    How to reduce the problem of dirty needles?
    Give 'em clean ones.

    I'll bet there are needle exchanges in every major Canadian city.

    My concern for Insite is that it appears to be society giving tacit approval for IV drug use.
    Not cool.
    Way not cool.

    And by the way?

    The Needle Exchange in Victoria is disgusting.
    The street and sidewalk just outside are covered in human feces and other waste.
    Junkies hang out, less concerned with dysentery than Hep C.
  33. Michael Sharp from Victoria, Canada writes:

    How many of you have seen a junkie ravaged by HIV and Hep C?
    Malnourished and emaciated?
    Hopeless?

    How in Gawd's name can people support the idea of legalizing these substances?

    The absolute naivete of most posters is astonishing.
  34. Ace Frehley from Vancouver, Canada writes: Still waiting...
  35. Ace Frehley from Vancouver, Canada writes: Michael Sharp from Victoria, Canada writes:

    How many of you have seen a junkie ravaged by HIV and Hep C?
    Malnourished and emaciated?
    Hopeless?

    How in Gawd's name can people support the idea of legalizing these substances?
    ___________________________________________

    "These substances" do not cause either HIV or Hep C. The dirty needles that people share with each other do. Take the shooting off the street and you take the dirty needles off the street. Will it be 100% effective? No, some people will not go to Insite, some dirty needles will still float about, and HIV and Hep C will still be transmitted this way. Is that a reason not to try to reduce the rate at which this happens? Is this a reason not to try to mitigate the misery?

    You say that legalization is tacit approval. It's not. Legalization is simply a recognition that the prohibition model is an utter failure, and that it creates more harm (i.e. organized crime, pimps, etc.) than it has ever prevented.

    You conclude that legalization is approval because you take such a simplified view of the world: there is right and wrong. Everything that is wrong must be punished with criminal sanctions, and everything that is not so punished must be "right" and therefore condoned by the society that fails to punish it. I pity you your simplicity.

    Your attitude toward needle exchange and supervised injection seems to come to this: if an addict fails to go there even once and uses a dirty needle just that once, then Insite is a failure. Hence shut Insite down.

    Well by that logic then why not shut the entire prison system down? We've been throwing people in jail since god was a corporal and yet, geez, people still commit crimes. Clearly prisons have no role to play at all, eh?

    Lord god almighty, Michael Sharp, you are a stunned one aren't you? Have you no capacity to reason or no desire? Which is it?
  36. Michael Sharp from Victoria, Canada writes:

    "Ace Frehley from Vancouver, Canada writes: Still waiting..."

    Are you kidding?
    The sharps conatainers on every street corner was facetious.

    Why are you so concrete?
  37. Jim Q from Halifax, Canada writes: Michael Sharp from Victoria, Canada writes:

    Insite itself claims to save, on average, one life per year.

    In order to reduce the spread of Hep C and HIV, a junkie would have to use Insite, all the time.

    The instant the junkie uses a dirty needle outside of Insite, Insite's effectiveneess of harm reduction is negated.

    Insite's sole function is to make the public feel better.

    -------------------------------------------------------------------

    Actually, that "one-a-year" is strictly from preventing death-by-overdose. It does not include increased rates of detox and rehabilitation or the dropping rates of infection.

    Nice try though. I do hear that the National Post is looking for people with your firm grasp of facts and research. Perhaps you and Wente could apply together.

    In the meantime, on the big board of medical and public health debate, it's New England Journal of Medicine 1, Micheal Sharp 0. There's a shocker.

    Man, if you conservatives keep up this streak of getting it wrong on science, you're going to hand the Liberals the election on a silver platter. Your credibility is shrinking precipitously. I suggest you stop talking before it disappears entirely.
  38. Dennis Prouse from Ottawa, Canada writes: Vancouver is my home town, and in its present state I weep for it. Mark Steinkampf is right -- the Downtown Eastside is getting worse. We knuckle dragging right wingers were all soothingly told that needle exchanges and a safe injection site would improve the situation significantly. To absolutely no one's surprise, it didn't.

    The notion that a proliferation of services causes addicts to migrate to an area is hardly odd at all. Vancouver also has a large number of street kids, many of whom are tomorrow's addicts. The reason is that Vancouver is well known to have a good "street culture", i.e. lots of drugs, good panhandling opportunities, and plenty of access to social services. There is a difference between trying to help street kids and drug addicts, and facilitating their lifestyle. Vancouver has crossed into the latter category, and nothing symbolizes that more than Insite.
  39. Michael Sharp from Victoria, Canada writes:

    Jim Q from Halifax?

    As someone who appreciates a sharp tongue, I enjoyed your post.

    I do suggest you look at the very paper Insite submitted to Tony Clement.

    They are honestly admitting that they have no "hard" data and I pounced on the "one life a year" thingy not so much to discredit Insite, because I do think it is a noble endeavour, but to introduce a contrary position.

    1.) Insite provides clean needles, therefore Insite should remain open.
    Needle exchanges provide clean needles, therefore Insite is redundant.

    2.) Insite disposes of dirty needles, therefore Insite should remain open.
    Needle exchanges dispose of dirty needles, therefore Insite is redundant.

    3.) Insite provides counselling. AIDS Vancouver provides counselling. Vancouver General provides counselling. Strahcone Mental health provides counselling. many, many place provide counselling. Insite is redundant.

    4.) Insite saves one life per year from overdose. Learn CPR, save one life per year from overdose. You might need some Narcan, an opioid antagonist, see we'll give the nod to Insite on their "one life per year" accomplishment.

    5.) Insite condones IV drug use. Insite encourages IV drug use. Is that true?
  40. Randy McClure from Canada writes: Dennis Prouse from Ottawa, Canada writes: Vancouver is my home town, and in its present state I weep for it. Mark Steinkampf is right -- the Downtown Eastside is getting worse. We knuckle dragging right wingers were all soothingly told that needle exchanges and a safe injection site would improve the situation significantly. To absolutely no one's surprise, it didn't. ................................. Your logic is wanting ... OTHER factors contributed to the deterioration of the downtown eastside -- cuts to welfare, cuts to public housing, 3 generations of fallout from the residential schools fiasco, etc. You just don't have problems like these in Sweden. Taxes are high, welfare programs are generous, the middle class have smaller houses and cars, but they get to live in a country that doesn't have 20% of kids living in poverty, junkies and homeless on the streetcorner of every major city, and 3rd world living conditions on reserves. The downtown eastside is the result of conservative economic and social values. (Get what's yours, don't share, blame the poor for a lack of moral rectitude. Happens all over the Anglosphere.)
  41. Ace Frehley from Vancouver, Canada writes: Applying Michael Sharp's logic to other scenarios...

    1) Hospitals have doctors, therefore they are useful. GP's offices have doctors, therefore hospitals are redundant.

    2) Grocery stores sell food, therefore people buy food there. McDonalds also sells food, therefore grocery stores are redundant because people can already go to McDonalds.

    3) Hospital emergency rooms treat drunk drivers who get injured when they wreck their cars. Therefore, hospital emergency rooms condone drunk driving. Hospitals facilitate drunk driving.

    For some time I have thought that Michael Sharp is just dim. He might be that, but it is increasingly clear that his primary characteristic is maliciousness.

    The CPR comment? Oh, wait, I'm sure that was facetious. I'm not supposed to be so concrete as to think he MEANT that now.

    Sharp, you are a coward.
  42. Michael Sharp from Victoria, Canada writes:

    Ace Frehley from Vancouver?

    Hospitals are for acute care.
    GPs can not deal with acute care in an office.

    MacDonald's doesn't sell vegetables.

    Alcohol is legal.

    How does bravery enter into the conversation?
    Ad hominem personal attack, I get.
    But bravery?

    Can you say straw man?
  43. Michael Sharp from Victoria, Canada writes:

    The point is...

    What does Insite provide that isn't already provided by other agencies?

    Other than a place to do illegal drugs without hassle?
  44. Ace Frehley from Vancouver, Canada writes: Michael Sharp from Victoria, Canada writes:

    Can you say straw man?
    _______________________________________

    Yup, I can.

    "Insite permits its clients to inject illegal drugs. Therefore, those who support Insite support, condone and encourage illegal drug use."

    It's a straw man, and he's all yours.
  45. Ace Frehley from Vancouver, Canada writes: excuse the misuse of quotation marks above at 3:15 PM EDT. Of course, I was paraphrasing a well-worn path of argument not quoting.
  46. Michael Sharp from Victoria, Canada writes:

    Ace Frehley from Vancouver, no you can't.

    First off, that is NOT my quote.
    Close, but no cigar.

    Secondly if all of the services that Insite offers can be accessed elsewhere, why have Insite?

    Because it appears that the only thing not offered elsewhere is a safe plave to do IV drugs.

    It has been established by both Insite itself; and offered as legitimate criticism by the scientific community, that Insite is not really doing anything.

    When I ask then if Insite's only purpose is to give IV drug users safe haven, is that not societal approval of IV drug use and is that what we really want?

    Not a straw man.
    It is directly related to the argument.

    When you call me a coward (huh?), which is completely off-topic, THAT is a straw man.
  47. Vincent Dube from Canada writes: Michael Michael Michael. Dude – first, you obviously don’t know what a straw man is. Ace calling you a coward is not a straw man argument. A straw man is when you construct an argument that your opponent never made, shove it in his mouth, and then attack the argument as if your opponent had made it. And the paraphrase (Ace said it was a paraphrase and not a quote, despite the quotation marks) is not a straw man because it accurately reflects what you have said repeatedly in this discussion and in dozens before about Insite. What’s different about Insite? It offers medical care to an incredibly vulnerable group: those who have just injected potentially lethal substances. It offers them the care right then and right there, when they need it the most and where they need it the most. No other services or agencies you list provide that service at that time in that place, where it is most needed. None. What do you offer instead? CPR. You really think you are hilarious don’t you? I’ll tell you what that suggestion is: vile and malicious, even if you were trying to make a (very tasteless) joke. Incidentally, if your CPR suggestion was a joke, then you are again dodging the most important argument in favour of Insite without addressing it at all. And that’s cowardly.
  48. Vincent Dube from Canada writes: To continue... You repeatedly have put forth versions of the straw man outlined by Ace in order discredit those who disagree with you. You repeatedly sidestep arguments you can’t counter, set up pathetically weak replacements that your opponents never espoused (the straw men) and away you go. I dunno about you, but that's seems to be how a coward would argue. At 2:37 PM EDT you deftly identified 3 straw men. Good for you. Take a closer look and you may notice that setting up straw men was precisely what Ace was doing, on purpose, to highlight your own reliance on straw men. So then let's look at your stuff. In responding to Jim Q you set up a VERY elaborate straw man. First you look at the clean needle argument in favour of Insite. You hold it up as if Insite supporters argued that this one point alone makes Insite worthwhile. You then argue that this one service already exists, hence no need for Insite. Then you repeat the process 3 more times with different arguments that you ascribe to Insite supporters. Meanwhile, you ignore the Insite supporter’s biggest point, which is that these services are COMBINED at Insite in a way that is not done at any of the other places. Take a point. Strip it of context. Present the point in isolation as if it is your opponent’s entire position. Attack and destroy the point. Classic straw man. Come to think of it, this is classic Faux News methodology. You claim not to be a fan, yet you emulate them so well. You, like Bill O’Reilly and the rest of them at Faux, are a coward and an intellectual fraud. Don’t hate me for exposing you as such.
  49. Vincent Dube from Canada writes: Michael Sharp:

    Secondly if all of the services that Insite offers can be accessed elsewhere, why have Insite?

    Because it appears that the only thing not offered elsewhere is a safe plave to do IV drugs.
    _______________________________________

    EXACTLY. You're catching up. We knew you could do it, Mikey.
  50. Michael Sharp from Victoria, Canada writes: Vincent Dube? Calling me a coward when the discussion is no where near about bravery strikes me as very straw like. Am I to defend my bravery when it was Insite we were talking about? No. Discussing aspects of Insite point by point is NOT straw like. Insite claims to reduce communicable disease. Take that point. That claim is given as evidence that Insite provides a valuable service. I bring up two counter-points to the communicable disease issue alone. 1.) Insite claims to prevent communicable disease by providing clean needles. Needle exchanges provide clean needles. What then is SO special about Insite's providing clean needles? 2.) In order for Insite to be prevent communicable disease, the addict would have to use Insite 100% of the time. Just the same as the addict would have to use clean needles provided by the needle exchange 100% of the time. No one would argue this is happening. It does, however have some harm reducing properties, no doubt. All of those topics are directly related to Insite. CPR seems to have upset people. Insite claims "one life, on average, per year to have been saved". This would be a heroin overdose treated with Narcan. If it is one life per year we are seeking to save, anyone of us could do that by learning CPR, in context of the general public. My point remains: What is Insite offering that isn't available elsewhere, except a place to do IV drugs hassle free? Very unstraw-like. Very straight-forward. Does the combination of those services and an admitted limited efficacy (Insite's own literature) counter a perception that Insite condones IV drug use?
  51. Michael Sharp from Victoria, Canada writes:

    So then.

    The argument in favour of Insite is that it is a legal crack house, staffed by nurses, and paid for by the taxpayer.

    Is this really a road we want to go down?
  52. Michael Sharp from Victoria, Canada writes:

    See Wente's new column.
    Europe is more enlightened than we are with their approach to IV drug use.

    They are TOUGHER!

    Sweden has a third less drug use than the rest of Europe.
    Because they have taken a hard-line approach.

    Their "have some free heroin" approach did what was expected.
    More people did heroin.

    Insite is part of the problem.
    It is not part of the solution.

    Insite IS societal approval of IV drug use.
  53. Alan Ogborne from London, Canada writes: Insite was established as a pilot project and many of us in the public health field hoped that research would show whether or not it was successful. To date however, much of the needed research has not been done. The impact of the service on morbidity (including HIV status) and mortality rates among users has not been established. The effect on rates of hospitalization for overdose or other conditions has not been investigated and there is no evidence to show that the service contributes to significant and sustained changes the health of those who use it. More research is also needed to establish INSITE´s cost effectiveness with respect to its main objectives when compared with other means for achieving these objectives such as outreach service, enhanced needle exchange service, drug courts, and opening more detoxification and treatment services. Further research is also needed to show that the economic benefits exceed the costs. A significant investment in research will be needed to address these issues. The value of Insite as a pilot project would also have been greater if those who set it up had, from the outset, established clearer objectives and measurable indicator of success. This is an important concern because in the absence of clear, a prior, statements, about what would constitute “success” almost all subsequent claims of success or failure are equally valid.
  54. Grant Bowen from Canada writes: jhane ball from Canada writes:
    How can we, and I include our politicians and citizens, pat ourselves on the back and claim any measure of success when treatment facilities are so desperately needed to complete the effectiveness of the much vaunted Four Pillars strategy.
    =========================================
    You are so right! That's why it is so disappointing that the Conservatives and other previous governments have offered so little money for treatment, instead over-spending on the only pillar they really believe in: enforcement. It has failed and it has wasted our precious tax dollars.
  55. Grant Bowen from Canada writes: Michael Sharp from Victoria, Canada writes:

    So then.

    The argument in favour of Insite is that it is a legal crack house, staffed by nurses, and paid for by the taxpayer.
    =============
    No, Mr Sharp, the argument is it saves lives and helps direct addicts to treatment. But nice bit of bs there

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