Wednesday, May 28, 2008

Insite ruling and a new way forward on drugs

The ruling on the future of Vancouver's safe injection site should change the way we talk about drugs and addiction.
It will certainly reveal that those who cling to the status quo - like federal Health Minister Tony Clement - place prejudice ahead of evidence and the law.
Justice Ian Pitfield was ruling on an injunction application aimed at preventing the federal government from closing Insite.
The injection site needs an exemption from drug possession laws to operate, so people can bring their drugs to he centre. Vancouver Coastal Health Authority would likely not continue funding if the site was operated illegally.
With barely one month to go before the current exemption expires, the government wouldn't say if it would renew it.
The critical aspect of the judgment rested on one main issue. Would shutting down Insite violate the users' charter rights to "life, liberty, and security of the person"? And if it did, was the violation of their rights justified by the greater good? Governments are allowed, under the charter, to strip individual rights with a good reason.
Answering those questions raised issues fundamental to the way we think about drugs and addiction.
First, Pitfield had to decide if Insite did protect individuals' charter right to safety and security. If not, then closing it would be fine.
Both sides presented evidence. The federal government's established that the scientific debate about whether harm reduction or abstinence-based approaches were most effective continues.
But the evidence and research showed that allowing people to inject in a clean, supervised site reduced death and illness, (as well as public disorder). It was health care to deal with the sickness of addiction; removing it would violate the clients' right to personal security, just as denying care to a lung cancer patient would.
The federal government also raised an important argument. People choosing to use drugs, its lawyers argued. The charter of rights doesn't provide any protection if people make bad choices.
Pitfield reviewed the medical evidence supplied by both sides.
And he found that Insite users weren't making a choice to inject drugs. Addiction is a disease.
"However unfortunate, damaging, inexplicable and personal the original choice may have been, the result is an illness called addiction," he found.
"While there is nothing to be said in favour of the injection of controlled substances that leads to addiction, there is much to be said against denying addicts health care services that will ameliorate the effects of their condition," Pitfield found. "Society does that for other substances such as alcohol and tobacco."
The decision was based on the evidence.
But anyone who looked at the life of a hardcore injection drug user wouldn't see it as a choice. How many people want poverty, homelessness, a one-in-six chance of contracting HIV, almost certain hepatitis, dangerous sex work, abscesses, fear and a constant need to get more drugs?
That left one issue for the court. The government can remove individual rights for the greater good - if it can show a pressing reason.
The federal government argued that the allowing Insite a continued exemption would increase drug trafficking and might violate international treaties.
But it had little evidence. And drug laws, Pitfield ruled, could still prohibit possession while allowing specific exemptions for programs like Insite.
That's an important point. The government can still do as much as it wants to arrest dealers or users. It can ramp up prevention programs and add treatment centres. Insite is no barrier.
Pitfield's ruling doesn't say society should condone drug use. It does find addiction is an illness - a potentially deadly one - and proper health care can help people survive, while reducing the damage to the community.
It is a good starting point for rethinking the way we treat those suffering from that illness, and help stop others from stumbling into that terrible sickness.
Footnote: Clement said the Harper government still doesn't approve, though he did not explain why people should die for its prejudices. The facts, as the court found, support Insite, which is also supported by Premier Gordon Campbell and Health Minister George Abbott and is funded by the province. Vancouver's mayor and police force also back its continued operation.

Insite judgment well worth reading

I'll get a post up on the Insite judgment in B.C. Supreme Court judgment tonight or tomorrow morning, but I'd urge you to read it. It's a remarkable piece of work by Justice Ian Pitfield, one that cuts straight to the basic medical, social and legal issues and sorts them out in a clear, logical way.
It's about 60 pages, but you can skip big sections where he quotes from previous court decisions and focus on his summary of the law and the evidence and his analysis and ruling.
You can find it here.

Tuesday, May 27, 2008

Barring poor voters, Tasers and barking MLAs

Making sure poor people don't get a vote, the Taser scam and zapping MLAs who behave badly. Sometimes, there are just too many good topics, so several items get rolled into one column.
Start with the changes to the rules for running elections. The attention has been on the Liberals' gag law, which restricts the right of individuals to run ads to raise issues in the five months before an election.
The bill has another creepy provision, which will make it harder for poor people to vote.
The law will be changed to prevent people from voting unless they have a home address and government-issued photo ID to prove it.
So if you don't have a driver's licence, or a home, then no vote for you. Estimates put the number of people deprived of the right to vote at 170,000.
Attorney General Wally Opal says the changes were recommended by Elections B.C. to guard against voter fraud.
That's just not true. (I'm not saying Opal is lying; he's not a detail guy, to put it kindly, and relies on what people tell him. But someone isn't telling the truth about this.)
In fact, Elections B.C. is trying to make it possible for more people - including the homeless - to vote. Its last annual report looked at voter fraud and found it's just not a problem in B.C. Not at all.
No one except the Liberals - literally - has said this change is needed.
Which leaves it looking like the party in power is trying shut out some voters in next May's election to increase its chances of success in close ridings.
The link between that topic and Tasers is the question of honesty.
The government has always maintained Taser use was governed by rules designed to protect police and the public.
Those rules, it said, were strengthened after a review done for the Police Complaints Commissioner in 2005. That report said Tasers should only be used when suspects are "actively resisting" police. People who were just unco-operative or difficult shouldn't be zapped.
The claims just weren't true. The solicitor general's ministry sent out a letter to police chiefs after the complaints commissioner's report, with a copy to the RCMP.
But it said nothing about changing policies to limit Taser use. (And in any case, the RCMP, which polices about 70 per cent of the province's population, doesn't accept any direction from or accountability to the provincial government.)
The head of the B.C. Association of Municipal Police Chiefs confirmed the lack of leadership at the current inquiry into Taser use.
"The lack of clarity, the lack of a provincial policy and different opinions is something that has made it more difficult and I look forward to the process of making it clear for our office," said Bob Rich, a deputy chief in Vancouver.
And, finally, a suggestion from Liberal MLA Dennis MacKay that harnesses the power to zap people in a way that might bring better government.
MLAs get to make members' statements just before question period each day. Usually, they say nice things some person or event in their riding. (Though sometimes there's substance - Liberal Bill Bennett and New Democrat Corky Evans have offered thoughtful commentaries on the polygamous community at Bountiful this session.)
MacKay chose to pass on a suggestion from a constituent.
He noted - quite accurately - that many MLAs behave wretchedly during question period, braying and shouting insults and abuse.
"The behaviour would not be tolerated in classrooms in our school system today," MacKay said. "At times it sounds like dogs who bark just for the sake of barking."
You can buy electronic collars that give dogs a shock when they bark, he noted. "I would suggest, Mr. Speaker, that you could look at a similar device to control members of this Legislature. All members who enter this chamber for the debates would be required to wear a similar device."
Shout or heckle, and be zapped.
Footnote: The political culture that embraces, and sometimes celebrates, stupid and rude behaviour in the legislature is baffling and destructive. Most MLAs don't participate, but enough do to disgrace them all. Insults and abuse substitute for sensible questions and answers. Behaviour that would see an eight-year-old sent to his room draws enthusiastic desk-pounding from performing seals on either side of the legislature. It's a sad waste of good people.

Monday, May 26, 2008

Big tobacco's best customers

If you're schizophrenic, you're most likely a smoker. In fact, if you're diagnosed with any mental illness, you're twice as likely to be using cigarettes. I haven't seen stats for people with other addictions and smoking, but based on my observation, they are big tobacco users too.
This Youtube video by a Victoria group looks at the issue.
It would be nice if a lot of people saw it.