Many harm reduction advocates believe the real harms are done by drug laws, not drugs - addicts, meanwhile, don't get the rehab they so desperately need
Billy Weselowski has seen it all, and he hates what he sees on Vancouver's Downtown Eastside. "You can't go a block without a bicycle pulling up and giving you all the syringes you want," he growls.
Mr. Weselowski knows this world all too well. He grew up here. His childhood was a nightmare of violence and abuse. At 13, he blacked out from booze for the first time, and quickly wound up on the streets. He injected, snorted, stole, pimped women, stabbed men and became an accomplished felon. He was the hardest of the hard core.
Today, he runs rehab programs for drug addicts that borrow from the tough-love model of AA. He has successfully treated thousands of people, using an approach that emphasizes structure, personal responsibility and abstinence.
But this approach to addiction is deeply out of fashion. The experts who make drug policy, allocate public money, dispense research funds, advise politicians and push for reform aren't interested in hearing from people like him. Instead, they're interested in "harm reduction" - which, among other things, means giving people all the syringes they want.
In Mr. Weselowski's view, harm reduction is a farce. "They're killing people by the truckload," he says.
Canada's official drug policy is known as the Four Pillars approach: prevention, treatment, harm reduction and enforcement. In practice, prevention and treatment have been neglected, while harm-reduction measures have steadily gained ground. Free needle and methadone programs are now widespread. (The term "needle exchange" is obsolete; needles are now handed out by the boxful.) Hundreds of addicts a day visit Vancouver's supervised injection site, which has become ground zero in an angry war of words.
Yet, harm reduction remains the orthodoxy of the day. "The supervised injection site is beyond questioning," says one Vancouver resident. "You are branded unprogressive, unfeeling and everything else 'un' if you criticize it."
David Marsh, the Vancouver region's medical director for addictions, says harm-reduction policies are often misunderstood. "Essentially, harm reductions are interventions that help reduce the harms associated with drug use, without necessarily requiring that drug use be decreased or stopped." They are a compassionate way to help the most addicted and marginalized of them all, to tide them over until they're able and willing to seek help. "It's part of Canadian tradition not to turn our backs to people at their lowest."
Harm-reduction advocates now rule the drug policy establishment. They dominate Health Canada, addiction research centres, drug policy groups, and the public health services of local governments. Nowhere is this more true than B.C., where social attitudes toward drugs are the most liberal in Canada. Public officials have fought tenaciously for the supervised injection site. For some, it represents a crucial step toward a far more sweeping form of harm reduction - legalization.
Many harm-reduction advocates believe the real harms are done by drug laws, not drugs. Prohibition is impossible, prevention is futile, and abstinence is unattainable for many. Therefore, if we stop criminalizing drugs, we'll get rid of most of the drug problems - the international gangs, the billions wasted on interdiction and enforcement, the crimes committed by addicts who need drug money, the imprisonment for petty drug crimes, and so on.
It's an attractive theory, at least on paper. Drug-law reformers have ideological allies around the world, in think tanks and at major universities. Among them is financier George Soros. Because of his deep pockets, he's been called the Daddy Warbucks of drug legalization.
All of this is spicy stuff. Harm reduction is a hot research field that attracts major money and offers major career opportunities. At Vancouver's international drug conference last year, no one was interested in reactionary things like 12-step programs, rehab or recovery.
The noisy marijuana lobby provides a lot of fuel for this crusade, despite the fact that pot is not the issue. Marijuana use is not what creates the lion's share of crime, public disorder, massive costs to the health system, and ruined lives. The real problem is hard drugs, especially cocaine.
Vancouver's last three mayors have been outspoken advocates for legalizing marijuana (and the source of a certain civic pride for Vancouverites). The current one, Sam Sullivan, has called for medical versions of hard drugs to be available to addicts. The city's official drug policy calls for the federal government to legalize marijuana, and also to review its prohibition policies for other illegal drugs.
Three years ago, B.C.'s public health officers - the same ones who've cracked down on smoking - released a detailed report calling for "government controlled supply" for formerly illegal drugs. "Harm-reduction strategies have not been as effective as possible due to their implementation within the prohibition model." It laid out an ambitious model for "post-prohibition harm reduction," where the government, guided by its wise public health officers, would supervise the production and distribution of legal heroin and crack.
Cuckoo? Not so much. Top health officials in B.C. already endorse the use of medical heroin, and a trial program has just wound up. Some of them belong to groups lobbying for legalization, and least one influential official is a vocal advocate for the benefits of psychedelic drug use.
Not surprisingly, the group that runs Insite, Vancouver's safe-injection site, stridently opposes current drug laws, as does the publicly funded drug users' lobby, VANDU. These two groups are notorious for the noisy lengths they go to in order to silence their critics. They're also good at high-profile PR stunts, such as the recent demonstration on Parliament Hill where they planted 868 wooden crosses to symbolize the 868 people who overdosed at Insite.
"Insite was about people dying - friends and neighbours!" spokesman Mark Townsend told me in an interview. In fact, the research found that Insite averts around one overdose death a year, not 868. When asked about this discrepancy, Mr. Townsend brushed it off as irrelevant.
Given the current government in Ottawa, it's unlikely that the push for legalization will make headway any time soon. There's also another obstacle: the public. Health officials have faced citizen revolts in cities where people don't want free needles passed out in their neighbourhoods.
Sadly, all this theatre has deprived Canadians of a genuine debate over drug policy. The question isn't whether Insite is good or bad. The question is what steps we can take that really will reduce the harm drugs do.
Despite the shouting, it's not too hard to guess where the moderate majority stands on drugs. They don't want people prosecuted for smoking a little weed. (After all, plenty of them do it, too.) But hard drugs are different. We don't want to decriminalize them. But we also don't want to punish addicts by throwing them in jail. We want a humane drug policy that will help them get better - and if that means giving them a choice between rehab or jail, then maybe that's okay.
So maybe what we need is not more Insites but more Billy Weselowskis - people who can give drug addicts a shot at dignity and a life. Mr. Weselowski knows that even hard-core junkies can recover. After all, he did. "We help get them connected to a spark of hope inside their soul."
source: The Globe and Mail, http://www.theglobeandmail.com