A major flaw in Tony Clement’s claim of "harm addition"

The federal government’s opposition to Insite, Vancouver’s supervised-injection facility, has long baffled Canadian scientists, health professionals and social workers. Now, Canada’s Health Minister has managed to perplex an international audience as well. (Source: Globe & Mail editorial: An illogical Statement)

At the XVII International AIDS Conference in Mexico City, Health Minister Tony Clement said: “Allowing and/or encouraging people to inject heroin into their veins is not harm reduction, it is the opposite … We believe it is a form of harm addition” (Source: ‘Clement’s Insite attack leaves WHO red-faced, Globe & Mail).

Putting aside all of the scientific evidence that supports the “reduction in harms” from InSite1 for a just moment, I would like to point out the major flaw in Tony Clement’s statement.  The word “addition” suggests that something (in this case, “harm”) that wasn’t there already is being “added.”  So saying that having a supervised injection site such as Vancouver’s Insite is “harm addition,” suggests that in the absence of Insite, those harms weren’t there.  Is Clement suggesting that people who use injection drugs weren’t subject to harms (such as HIV or hepatitis infections, drug addiction, negative effects of drugs on the body, or risk of overdose death) before Insite existed, and thus Insite is a “adding” these harms to the situation? Or is he suggesting that people who weren’t using injection drugs before are now starting to use drugs because Insite exists, thus adding those harms to their lives?  Of course not.  He’s making a stupid play on words to hype a misguided opposition to supervised injection sites.  Why?  Because, despite the Conservatives’ claims to the contrary, he can’t back his views with science.

For a summary of the research findings on InSite, click here.  Or just check the peer-reviewed scienctific literature – it’s all in there!

And for one of the best articles I’ve read on Vancouver’s supervised injection site, check out Dr. Stephen Hwang’s paper “Science and Ideology” in Open Medicine.

1Of which there is, unequivocally, plenty.

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  • Most adults in North America understand that prohibiting alcohol consumption was not at all the same as stopping alcohol consumption. Yet most adults in North America misunderstand the relationship between prohibiting other vices and stopping other vices. In the U.S., conventional wisdom holds that increasingly draconian prohibitions actually do somehow “fight” drug use. In many circles it is a social taboo simply to bring hard data into a related discussion. In our political mainstream, no candidates speak clearly or strongly in favor of a new paradigm. Some gain support by demanding an even harder line.

    Obviously, Canadians have the good sense not to break so much new ground in the realm of imprisonment. Still, I suspect much of the public discourse is as warped up there as it is down here. There is a folksy common sense quality to the assumption that prohibition prevents or dramatically reduces the rate of a particular behavior. Appeals to history (“the” Prohibition) and appeals to science (quantifying harms) both land on the side of truth. Yet popularizing those arguments is an uphill battle against decades of widespread propaganda.

    As an aside, in personal exchanges a simple method of disarming prohibition’s supporters is to ask if the change at issue would also change their behavior. Does that Minister contend that he is much more tempted to shoot up now that there is a safe place to do it? If he is not so tempted, who is? Just who are these potential addicts, holding back only for lack of clean needles? This sort of thing is easy to resolve once a rational clash of ideas is underway, but difficult to engage as a rational clash of ideas in the first place.


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