The harm in 'harm reduction'
by Margret Kopala

Published in the Ottawa Citizen, May 17, 2008

Health Minister Tony Clement announced new funding for drug treatment facilities in Vancouver but, understandably, he didn’t comment on Insite because its future is now before the courts. Hearings over jurisdiction of Vancouver’s controversial safe injection facility concluded in a B.C. Supreme Court on May 7 and though a judgment is due in early June, appeals are probable, as is an injunction to keep the facility open past June 30th when its exemption under federal drug laws expires.

Certainly, the plaintiffs are well prepared. The Vancouver Area Network of Drug Users, an association of heroin and cocaine users, and The Portland Hotel Society, a downtown eastside residents group that helps run Insite, are largely funded through B.C.’s health ministry by the Vancouver Coastal Health Authority which in turn runs Insite. Experienced advocates and demonstrators all, the purposes of these convoluted funding arrangements aren’t clear but it wouldn’t be the first time the courts were used to advance an agenda with camouflaged taxpayer dollars footing the bill.

That aside, the plaintiffs’ arguments are clear enough: drug addiction treatment is a health issue and therefore provincial jurisdiction. Moreover, and like the Supreme Court of Canada’s decision on medicinal marijuana, Canada’s Controlled Drug and Substances Act contravenes the addict’s Charter rights and shouldn’t apply to cocaine and heroin addicts in treatment at Insite.

It’s an argument that smacks of having your drugs and harm reduction too but, as reported by the Canadian Press, counsel for the federal government appropriately took the argument at face value. “The primary activity at this site, which is drug injection for drug users, is not medical treatment, which the Charter could protect,” said John Hunter. “They are allowed to use drugs without any discussion of treatment.”

“At the end of the day, there is no constitutional right to use heroin or cocaine, even if you are addicted to them.”

Hunter might have added that not only is Insite not a treatment facility, a few hastily installed beds notwithstanding, but as an expert panel for Health Canada reports, of the few Vancouver addicts who use it even fewer seek treatment elsewhere.

It is all part and parcel of the twisted logic, moral gymnastics and legal quagmire that has engulfed Insite since its inception in 2003. North America’s first legal supervised injection site, like other vaunted harm reduction programs, aims to reduce the spread of infection and overdose deaths even as addicts use their own illegally obtained and financed drugs, often at great harm to others. So far, no one is discussing liability though this issue must inevitably arise once an addict dies or a business closes due to use of, or proximity to, such facilities.

But it is the Clockwork Orange world evoked by the harm reduction approach that is most disturbing. The prophetic Anthony Burgess novel describes a society where antisocial behavior is reduced to an ‘illness’ for which the required ‘treatment’ is a form of state induced stupor. Human agency, free will and moral capacity are surrendered, denied, or made null and void.

There is another way. Restoring vagrancy laws, rescinded in 1972 by then Prime Minister Pierre Trudeau, would help remove the most vulnerable - young prostitutes, squeegee kids and new drug users – from harm caused by dealers and pimps. Governments and civil society would in turn be compelled to deal with homelessness in a professional way. In Alberta, the Protection of Children Abusing Drug Act allows parents to commit their adolescents for compulsory treatment while outreach programs and drug courts offer compassion but demand accountability. As for addictive drugs with purported medicinal properties, they should undergo accepted legal and scientific protocols before being marketed or prescribed, protocols circumvented by medicinal marijuana that now need correction.

In the meantime, we must remove the harm in harm reduction - a fatalistic, patronizing, no-hope approach that sanitizes, normalizes and facilitates continued use of drugs. For while such concepts are seductive, in a culture that believes everything should be controlled except human appetites, they are also treacherous. The twin pillars of public order and human dignity are finally and only sustained by the desire to be and do our best in accordance with the highest standards of human conduct and when we slip, and with provision for illness, to be accountable.

The alternative is a Clockwork Orange world.

MARGRET KOPALA’s column on western perspectives appears every other week.

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