Insite - Reception

Reception

Insite enjoys strong local support. While Insite is well liked throughout British Columbia, its popularity is highest inside Vancouver, where some 76% of residents expressed support for the facility. Furthermore, according to a 2007 national survey by Mustel Group, some 63% of Canadians believe the federal government should renew the Insite's mandate while 27% oppose. Support is lowest among Conservatives, only half of whom believe the site should continue operating. Among clients, 95% or greater rated the facility's services as excellent or good, and its staff as reliable, respectful, and trustworthy.

Partners of Insite include the City of Vancouver, the Vancouver Police Department, and the PHS Community Services Society. The site has the support of Vancouver's mayor Gregor Robertson, former mayor Sam Sullivan, Premier of British Columbia Gordon Campbell, and former Vancouver mayors Larry Campbell, Mike Harcourt, and Philip Owen. The International AIDS Society, B.C. Centre for Excellence in HIV-AIDS, and the Canadian Union of Public Employees have also expressed support for Insite. Though initially opposed to the safe injection site, the Chinatown and Gastown merchants associations now support it. International supporters include the UK-based think tank Senlis Council, the Australian Parliamentary Group for Drug Law Reform, and the American Drug Policy Alliance.

The site drew criticism from the Bush administration; the director of the White House Office of National Drug Control Policy called Insite "state-sponsored suicide" on its opening. In 2006, the Canadian Police Association voted unanimously to encourage the federal government to stop funding Insite and instead invest in a national drug strategy. Moreover, Federal Health Minister Tony Clement branded Insite an "abomination," telling the Vancouver Sun that "allowing and/or encouraging people to inject heroin into their veins is not harm reduction... it is a form of harm addition."

The Royal Canadian Mounted Police (RCMP) has also criticized Insite. This is despite a report commissioned by the RCMP and conducted by two criminologists that concluded in favour of the injection site. The RCMP in British Columbia had agreed to announce their support for Insite in 2009 at a joint news conference with the BC Centre for Excellence in HIV/AIDS; they planned to note "an extensive body of Canadian and international peer-reviewed research reporting the benefits of supervised injection sites and no objective peer-reviewed studies demonstrating harms", and they were to admit that reports commissioned by the RCMP criticizing Insite "did not meet conventional academic standards." However, the RCMP in British Columbia were ordered by headquarters in Ottawa to cancel the news conference days before the event.

The most significant published criticism has been an article by Colin Mangham, the director of research for the Drug Prevention Network of Canada, in the online-only Journal of Global Drug Policy and Practice (JGDPP), which is said to be "posing as open-access, peer-reviewed scientific journal" In the article Mangham claims that “the published evaluations and especially reports in the popular media overstate findings, downplay or ignore negative findings, report meaningless findings and overall, give an impression the facility is successful, when in fact the research clearly shows a lack of program impact and success.” He also claimed that interviews with area treatment centres revealed no referrals from Insite, and that police presence was deliberately bolstered in the area. Based on this article, Tony Clement told an August 2007 meeting of the Canadian Medical Association that his belief that Insite should close had been reaffirmed. Clement stated that "there has been more research done, and some of it has been questioning of the research that has already taken place and questioning of the methodology of those associated with Insite." The Journal of Global Drug Policy and Practice that Clement was referring to is run by the Drug Free America Foundation, and received much of its initial funding in a $1.5 million grant from a U.S. Department of Justice agency now under investigation for corruption.

Mangham's article has been questioned because it dismisses more than 20 peer-reviewed studies published in reputable medical journals such as The Lancet, the New England Journal of Medicine, and the British Medical Journal, all of which indicate that Insite has a positive effect. The Journal of Global Drug Policy and Practice (JGDPP) article, which was commissioned and financed by the RCMP, drew further criticism in the journal Open Medicine, where a commentary described it as being "fraught with a host of outright factual inaccuracies and unsubstantiated claims." More than 130 scientists signed a petition endorsing the commentary, which also criticized the government's evaluation of Insite as distortive and politicized. Another commentary in the International Journal of Drug Policy characterized the government's evaluation as "what may be a serious breach of international scientific standards".

In answer to an op-ed in National Post, the President for Drug Prevention Network of Canada, Gwendolyn Landolt, maintained her organization's view that the research on Insite is flawed. She said that much of the research on Insite was done by scientists who had lobbied for the clinic's establishment and that they consequently lacked objectivity. She further suggested that the these researchers conspire with the editors of academic journals so that their papers are reviewed by referees that supports harm reduction. Gwendolyn Landolt also maintained that data shows that deaths from drug overdoses have actually increased in the vicinity of Insite most years since its inception, contrary to the point made by the allegedly biased Thomas Kerr in his preceding commentary on the misinformation her organization is peddling around. The next day the Provincial Health Officer of BC, Perry Kendall said that he had never heard of the data Ms. Landolt refers to and confirmed Thomas Kerr's assertion that death from drug overdoses have indeed declined in the preceding years - especially so in the vicinity of Insite.