October 30th, 2020

Real evidence doesn’t support SCS model


By Letter to the Editor on August 6, 2020.

Re: “Harm reduction still an effective strategy,” July 22 letter to the editor.

The empirical evidence to which the author refers is clouded in a report that adds in alcohol, drugs and other addictive substances to hide the reality. What the evidence actually shows is very few addicts rehab based on the four pillars and fewer yet remain sober after two years. So the “empirical evidence” is only supported in one aspect and that is if someone is around an addict that is taking the illegal substance and that substance is strafed with something that may kill her or him, then the evidence shows you have a better chance of saving them.

The empirical evidence also shows that as a result of “being saved,” addicts will experiment with stronger drugs and more of them because death has been removed as a deterrent. SCSs for 50 years have manipulated the “empirical evidence” and for simple reason. The four pillars is the largest consumer of taxpayer money with the least measureable of results. It employs numerous professionals in a guaranteed job for life and as long as you can use bullying, berating and fake “empirical evidence” you can continue with the cash cow that the four pillars generates at all levels. No one wants to actually show the public the real numbers of recovered addicts because it pales against the numbers of new addicts.

So any city stupid enough to get involved in the four pillars is guaranteed to be riddled with crime for the next 40 years. The only people that suffer through the four pillars are the residents of the city stupid enough to get involved. Addicts don’t suffer because they quit as soon as the rehab gets tough. Very few meet the milestone of two years clean; the entire process is a joke and has been a joke since “the professionals” thought it up. You will always find numbers of referrals to the next pillar, and “lives saved,” but the end-game numbers disappear faster than the taxpayer funding!

Dennis Bremner

Lethbridge

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Southern Albertan

And yet, again, whatever Portugal has done with regard to opiate/drug addiction has been judged as the best strategy in the world. They certainly, still, are not without their problems, but one significant effect has been a significant drop in drug-related crime. They did decriminalize the possession of small amounts of drugs and it seems their support system for assistance is significant.
What Portugal has done is worth researching.

Fescue

A good perspective, so.ab.- decriminalization and care.

As opposed to the save-a-buck-and-let-them-die crowd, that is.

creator42

The author seems to be confused about the “four pillars.” The four pillars of drug control are prevention, enforcement, treatment and harm reduction.

The evidence in support of supervised consumption sites was sufficient for the Supreme Court of Canada in 2011. In a nutshell, the court ruled SCS save lives, prevent the spread of infectious diseases, increase uptake into treatment (FWIW) , reduce public drug consumption and discarded syringes and save money without encouraging, increasing or perpetuating drug use or addiction.

The most expensive but least accountable and effective of the four pillars is law enforcement. We allocate about 80% of our drug control budget to law enforcement, about 15% to treatment, about 5% to harm reduction and whatever remains to prevention. Drug laws interfere with prevention, treatment and harm reduction.

The evidence in support of InSite is consistent with decades of evidence from around the world.

“In terms of the historical development of this intervention, the first supervised drug consumption room was opened in Berne, Switzerland in June 1986. Further facilities of this type were established in subsequent years in Germany, the Netherlands, Spain, Norway, Luxembourg, Denmark, Greece and France. A total of 78 official drug consumption facilities currently operate in seven EMCDDA reporting countries, following the opening of the first two drug consumption facilities in the framework of a 6-year trial in France in 2016. There are also 12 facilities in Switzerland (see ‘Facts and figures’).”

“Perspectives On Drugs: Drug consumption rooms: an overview of provision and evidence,” European Monitoring Centre for Drugs and Drug Addiction, June 2017, p. 2, last accessed Nov. 8, 2017.

Dennis Bremner

I am not confused at all “creator42”. The four pillar structure is reasonable if all 4 pillars are used strategically. Europes SCSs are plexiglass sanitized rooms with 2 employees. The Harm Reduction portion is part of Rehab. So wound healing and care is another facility under control of the medical system ie. Mobile truck that tends to the addict. What they did is decoupled injection from Harm Reduction. So “statistically you are correct creator42 but you are taking the statistics from a SYSTEM WE DO NOT HAVE.

What we do is create an SCS that couples care with injecting. We save the lives of those who experiment with larger doses and bad drugs to try to get a bigger high. That is why statistically there are more lives saved in the 130 unique users of the Lethbridge SCS than the 1518 that do not use the SCS (data from SCS website saying Lethbridge has 1648 unique users). Or had you not thought of that? It is also the reason why there are more deaths (up 400%) within 1000meters of the SCS then anywhere else in Lethbridge.
So you compare apples to oranges in the hope you can proliferate this CON further.
All data furnished from the SCS website/AHS Website, none has been fabricated unless they fabricated it.
For your information. The first of 6 known “Fix Rooms” now Consumption rooms that Copenhagen Police were told to ignore were in Copenhagen in 1968 (Corrected I had my timeline wrong). The fix room was on Canal Street about 30meters from the docks. The first Gov Approved was as you say in 2013 but Copenhagen, Amsterdam, Brussels, Liverpool, Edinburgh, Oslo, Stockholm the list goes on, all had “Under the table turn a blind eye, “fix rooms” since the late 1960s. Lisbon had more “Fix Rooms” then restaurants on the waterfront in the 60s I know, I was there and saw them. I am not a drug user but in the Navy, the fix rooms were on the waterfront…which coincidentally was where the Submarines and ships I was on, had to tie up 🙂 So do not assume this “Pillar thing is new” or Fix Rooms is an idea of the Gov in 2012-2013, its as old as the 60’s in Europe just repackaged in the millenial.
So if you would like to start the history of an Addict and treatment in 2013 that’s fine with me, but you have no idea what you are talking about. Lethbridge has recreated the “fix room of the 1960’s not the Consumption room of the 2020s, THATS THE PROBLEM! Why do you think no Doctors would work in OUR SCS, they in fact considered it unethical! Why would that happen if this “60s Fix Room was the wave of the future”? Your proclamation of X% to enforcement is hollow because I am addressing a LETHBRIDGE PROBLEM not a Government of Canada problem ! So unless you know “Colored Socks” intimately you are throwing out a red herring to deflect. I await your “informed response creator42”. I also note your name links you too being a Northern BC Resident which tells me you know dick about Lethbridges problem.

creator42

By confused, Dennis, I meant your letter rails against the four pillars when you seem to have a problem with just one of them, harm reduction. You use the term “four pillars” as if it is synonymous with harm reduction.

I’m in Victoria, but my location is irrelevant to the science and jurisprudence supporting SCS.

No doubt underground consumption sites predate legally regulated sites, but when we prohibit things, we relinquish our ability to study them. As the study excerpt I shared explained, the first legal site appeared in 1986. InSite won in the Supreme Court in 2011, but it opened in 2003.

As was the case with InSite, and as it should be, SCS are typically located where there is already an open drug scene, people buying and consuming, like the downtown eastside of Vancouver, so it’s no surprise there are more ODs around the Lethbridge site. Don’t confuse correlation with causation.

Provincial drug control budgets are similarly skewed with respect to the four pillars. The lion’s share of money goes to fighting the “war on drugs,” cops, lawyers, judges, prison cells, etc., the next in line is treatment, then harm reduction and finally prevention.

What evidence can you share to back up your assertion that people saved by SCS “experiment with larger doses and bad drugs to try to get a bigger high?”

“There is no evidence that consumption rooms encourage increased drug use or initiate new users. There is little evidence that by providing better conditions for drug consumption they perpetuate drug use in clients who would otherwise discontinue consuming drugs such as heroin or cocaine, nor that they undermine treatment goals.”

Hedrich, Dagmar, “European Report on Drug Consumption Rooms” (Lisbon, Portugal: European Monitoring Centre on Drugs and Drug Addiction, February 2004), p. 83.

The fact is, most chronic opioid consumers aren’t partying, they’re typically self-medicating childhood trauma, too often sexual abuse.

We need a safe, legal supply, (see the NAOMI project), but in the meantime, in addition to saving lives and increasing uptake into treatment, opioid replacement and other social support services, harm reduction saves several dollars in downstream costs for every dollar invested in it; public disorder, first responders, ER visits, police, coroners, support for bereaved dependants, skin infections, the treatment of Hep-C and HIV, etc. If we didn’t have harm reduction, we would have less resources for the other pillars and fewer drug users seeking treatment.

biff

amazing that generations of “enforcement” has demonstrated beyond any doubt that “enforcement” does not work, even in the least. moreover, ‘enforcement” sucks up a massive amount of money, as creator42 notes.
of greatest concern is the very idea that a society that calls itself free accepts drug laws – or any laws – that take away the right of an individual to be the final and sole arbiter of one’s body. and then, to make matters worse still, illegal ‘enforcement laws’ prove to be a crime against humanity – so much resource going toward a cause that creates far more social issues and victims than it solves.

Dennis Bremner

Creator42 said :By confused, Dennis, I meant your letter rails against the four pillars when you seem to have a problem with just one of them, harm reduction. You use the term “four pillars” as if it is synonymous with harm reduction.

Not at all, all 4 parts of the 4 pillars are a blackhole for taxpayer money. If anyone is confused it appears to be you where you focus on enforcement rather than the entire system. There is not a section of the 4 pillars that does not bleed Taxpayer money in bucket loads and the “other 3 pillars” go into the medical profession that thought this failing system up. The mere fact you state enforcement consumes a larger portion is irrelevant if 15% of billions ends up in the pockets of those that created this ridiculous system its still buckets of money. If the reason 85% is consummed by law enforcement then perhaps you could convince the addict to steal and mug less?

Evidence on larger doses and stronger drugs. Well creator42 its a tough thing to do but you should try it. I have talked with both SCS employees and addicts themselves. SCS employees state that addicts come in and even though councilled not to take the dosage they are attempting to inject do so anyway. I have talked to addicts who state that they do use SCSs to experiment because they know that employees will help if they get in trouble. So the evidence is there and the mere fact you do not want to believe it or have not discovered it on your own tells me that you only really want to discover things that continue with this failed system. In fact your linked website heralds this system as wonderful.
Now you site DTES yet don’t mention the thousands and I mean thousands of lost lives and thousands more of destroyed lives because they provide the same “Fix House” mentality of the 1960s.
You also do not mention that an audit a few years back also found insiders lining their pockets for the cash cow a Fix House creates?
I never said SCSs initiates or creates new users so please do not put words in my mouth. What SCSs do is attract NEW users to their communities. Big Difference! We have a group here called Moms Stop the Harm and I am told by Addicts that MSTH members (rogue or not) were the ones driving addicts from other towns and cities to Lethbridge because Lethbridge had an SCS. Its rumour at this stage that the Person being investigated for their $343,000 pay check has direct links to the head of the MSTH organization. So we will see if any info comes out from Leth Police on the criminal investigation that is ongoing. If our Amazing Mayor got off his ass and checked into this then maybe he would quit denying what the Dr Turner report stated which was we had Migration from all the outlier communities, something he still denies in hope we will keep him as Mayor…fat chance!

I am not surprised you state their is no evidence of experimentation because what you are asking is for a system that makes MILLIONS for those that support it, to study something that may kill their cash cow? Why would you EVER suspect that would occur? If you suggest that the system would flush this kind of information out then I have another question for you!

Show me one report specifically stating Drug Addicts only numbers into Rehab in one year and success rate after two years, just one report, please! You see the system even knows how badly they are failing in a system that appears you support! They will not publish a report that does not include Alcohol and “other addictive substances” because the objective is to cloud their own failure in various other numbers.

You said: The fact is, most chronic opioid consumers aren’t partying, they’re typically self-medicating childhood trauma, too often sexual abuse.

Once again you speak of things you know NOTHING about. Have you been to Lethbridge, Galt Gardens, or do you just naturally assume you know the situation here because other places don’t party? You also fall into the category of Bleeding heart because you automatically default to “its not their fault they are an addict” because it must be childhood trauma or its sexual abuse! Strangely, in my day, there were addicts because they just took drugs to get a bigger high. But the Millenial Drug Addict or X Gen Addict , well they all suffered persecution of some sort and its never their fault nor is it their responsibility to get off drugs, its mine, and the rest of the idiot taxpayers! Oh and surprise surprise the X GEN just declared Obesity to be a Chronic Disease, so you can fork back all theMc D Cheeseburgers you want now and I will have to pay because you have “a disease” and are not responsible for being a pork ball,, I and the rest of the taxpayers are !

Your insistence that enforcement is a waste of money assumes enforcement is all encompassing on catching individual users, perhaps where you are, that is the case, that’s not the case in Lethbridge. Lethbridge enforcement is investigating B&Es, property damage, and muggings, beatings and murders created by the addicts. My assumption is you feel enforcement is a waste of money so just let the murders, beatings, muggings property damage be part of the never ending gifts of freebees to the addict?

Well I can tell you one thing, I would neither pay or donate to you or your site for your abilities demonstrated thus far, You appear to be a person who uses other peoples research to pretend you have a clue, when you really don’t.
You are supporting a system in hopes to make money from it!