People who trust evidence versus people who trust their guts on supervised injection

Conversations about supervised injection sites, such as the one that might come to Sandy Hill, can get polarized fast.

On one side, you have the people who say, “How can you ignore all the evidence that supervised injection sites save lives and might even make the neighbourhood safer?” On the other, you have the people who say, “How can you honestly be arguing that the state should be paying to help people shoot up?”

The issue divides people along fundamental philosophical lines: those who trust the evidence, and those who trust their guts.

Politicians tend to fall onto one side or the other, too, but some of the more wily politicians hedge their bets. Ottawa Mayor Jim Watson, for example, has long argued that supervised injections sites simply aren’t the best use of scarce resources, which should fund rehab programs instead.

This is, from a political perspective, nice and safe. Nobody is going to argue against funding rehab programs.

From a policy perspective, though, it’s incredibly damaging. It perpetuates the false notion that treatment and harm reduction are two distinct paths. In fact, they’re often part of the same journey.

“We think of addiction treatment as anything that can move someone toward stabilization,” says Rob Boyd, director of the Sandy Hill Community Health Centre’s harm reduction program. That means something different for every person, depending on where they’re starting.

For the people who trust the evidence, there’s the record of Vancouver’s Insite program, which is impressive.

The people who trust their guts might want to think of that person in their own family or group of friends who has struggled with mental illness, physical rehab or a chronic condition. On the bad days, support might just mean helping someone survive. On the better days, support might mean being there for someone trying something new and taking steps toward improvement.

Offering the first kind of support doesn’t mean you can’t offer the second; in fact, it often makes that second step possible. What would be enabling in some circumstances would be like holding someone’s hand to help them take a small step forward in another.

The key to making good policy about addiction treatment is to get past the false dichotomy between treatment and harm reduction. We can get past it, not by taking mushy positions that look politically moderate, but by having thoughtful and respectful conversations. Yes, let’s talk about expanding rehab programs to create more spaces for people looking for that help. Let’s also talk about how to stop roughly 40 people from dying of overdoses in Ottawa every year, so they can make it to rehab programs.

It comes down to this: If there is any drug user in Ottawa who wants to take any step toward reducing harms to themselves and others, we should stand ready to support that, in our own interest as well as theirs.

The Sandy Hill Community Health Centre is holding public consultations every Monday night in April. Boyd recommends pre-registering and arriving before 6:30 p.m., as space is limited and they start right away.

Boyd says last week’s consultation was a real conversation, not the “heated back and forth” it might have been. “We felt it was really important to set an environment and a tone where people felt comfortable in asking questions and putting forward opinions.” And he seems genuinely interested in making sure the centre’s proposed service model is informed by what the community wants and needs.

So far, there seems to be a will among people of all perspectives to talk about this Sandy Hill proposal in good faith and with open minds.

I hope the same is true of the politicians and other local authority figures who will be asked to weigh in, before the federal government decides whether to grant the necessary exemption for a supervised injection site in Ottawa.

By Kate Heartfield
Source: Ottawa Citizen