Straight talk on Canada’s “safe injection” experiment

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The 18th century English poet Thomas Gray wrote that “Where ignorance is bliss, ‘tis folly to be wise.” Certainly Randy White can attest to the truth of this observation after a recent dust-up between him and Senator Larry Campbell in the online edition of the Globe and Mail.

The exchange took place when both were invited to participate in a forum on the subject of Vancouver’s so called “safe injection facility” Insite.

Opened in 2003, Insite is a pilot project (the first of its kind in North America) designed to provide addicts in downtown Vancouver with a place where they can inject themselves with drugs, under medical supervision, with a public health nurse and addiction counselors present.

Because what the users of this facility are doing is illegal, the federal government, under the control of the Liberals, had to issue a special dispensation exempting both the clinic, and those using it, from being prosecuted. This exemption runs out soon and must be renewed in order for the site to continue to operate legally.

The whole practice of exempting certain people from prosecution when they openly commit a crime, while others face arrest and imprisonment for the same crime, raises important constitutional questions that deserve a whole discussion unto themselves. I propose to address only the so-called science of the issue.

The debate between White and Campbell began with Jim Sheppard, Executive Editor of, asking both to make a preliminary statement outlining their thoughts about the injection site. (To view the forum click here to read the entire report) as the source for their identical statements that “Insite has reduced the number of people injecting in public and the amount of injection-related litter in the downtown eastside.”

Intuitively, this seems to make sense. But here’s what the CMAJ actually reported:

The opening of the safer injecting facility was independently associated with improvements in several measures of public order, including reduced public injection drug use and public syringe disposal (emphasis added)

The use of the word associated is important, because the data only supports the conclusion that there was a correlation between reduced public injections and the opening of Insite and not, as claimed, that one was the result of the other. Concluding that the perceived improvement was due to the opening of Insite is like arguing that my weight problem is caused by the great cuisine of my favourite restaurant. My weight and the quality of the food at that restaurant are certainly strongly correlated, but one does not cause the other – I’m overweight because I eat too much.

Blurring the line between causation with correlation is one of the most common and fundamental mistakes novice researchers make…usually while still in their first year of undergraduate school. It’s also one of the most common tricks used by pseudo-researchers who are out to prove a point rather than get at the truth, something that White alludes to in his reply to Sheppard.

Ironically, a second, more thorough study, also cited by both the PCH and the Centre for Excellence in HIV/AIDS in support of Insite, treats this issue in some detail. According to this second study, (click here to read the entire document) the presence of Insite “has not led to an increase in drug-related crime. Rates of arrest for drug trafficking, assaults and robbery were similar after the facility’s opening, and rates of vehicle break-ins/theft declined significantly.”

This quote has also been widely disseminated by Insite’s cheerleaders, but here’s the rest of what the study had to say (all italics are added):

The present study has several limitations. Most importantly, some crime statistics may be confounded by discretionary policing practices and levels of police deployment. Because of these issues, we did not investigate reports of drug possession, since the Vancouver Police Department has a discretionary approach towards drug possession. Specifically, in many instances police have directed or escorted IDU (injection drug users) to the SIF (safer injection facility), whereas during other periods an increased number of possession charges have been laid against IDU injecting in public reportedly as a police strategy to maximize use of the SIF and to reduce public disorder.

In other words, both the lack of increase in crime rates observed in this study, and the perceived improvements in measures of public order observed in the previous study, were due to the police forcing addicts to use the facility either by picking them up and dropping them off there, or arresting them and charging them with possession. Either way, the decisive factor in increasing public order was proactive policing, not the availability of a safe injection site.

What about drug trafficking? Has this activity actually declined in the area as many of Insite’s defenders claim?

After warning that “…the potential influx of drug dealers to sell drugs to the SIF’s clientele has not been thoroughly investigated” the study goes on to make what observations it could:

…the local police have a zero tolerance approach towards drug trafficking…there was a spike in the drug trafficking data in the pre-SIF year coinciding with a well described police crackdown, hence the small decline in drug trafficking charges in the post-SIF year is due to this effect.

In fact, the whole argument that Insite’s presence has reduced drug trafficking is specious since none of the drugs used at the facility are supplied there and still need to be obtained illegally. Any increase (or decrease for that matter) in clientele at the clinic must therefore be directly proportional to the number of illegal drug transactions necessary to supply those clients. It cannot be otherwise. What direct impact Insite has had on the over all rate of drug use and trafficking in the community is a matter of pure speculation.

What about assaults, robberies, vehicle thefts and break-ins? Insite supporters claim that the study proves the project reduced the rates for these crimes. Here’s what the study actually says:

The categories of assaults and robberies and vehicle break-ins and thefts were combined in the source data and it was not possible to separate these indicators.

In other words, the available statistics fail to indicate how many, if any, of the aforementioned crimes were ever attributable to drug use and how many to other motivations both before and after the opening of Insite. Hence, the study quite rightly concludes by warning that “…due to the above concerns, we caution against inferring that this reduction was due to the SIF.” Despite this clear admonition on the part of the study’s authors, supporters of Insite continue to do exactly that!

Finally, what about Senator Campbell’s declaration that the rate of HIV infection has gone down thanks to Insite? Neither the claim, nor the alleged evidence in its support, can be found on either the PCH and Centre for Excellence in HIV/AIDS websites, and I was unable to find such a study through my own research.

There is one claim that cannot be refuted though. It seems that of the 500 overdoses that occurred at Insite over a two-year period, none resulted in a fatality. As commendable as this is, however, it begs the question: how is it possible that there were so many overdoses in the first place? Insite is supposed to be a “safe” facility where injections are supervised by medical staff. Surely this statistic is as strong an indictment of the whole project as it is a fact to be celebrated.

Has Vancouver’s safe injection experiment helped or harmed the situation? Judging from the available evidence, the likely truth is that as a strategy for reducing drug use, it’s effect has been neutral.

It is, however, an example of how the left misappropriates the language of science – at the expense of scientific integrity – to support its radical ideological agenda. The result is a charade.

The coming decision whether or not to renew Insite’s special status by exempting them from prosecution for violating Canada’s drug laws is a litmus test for the current government. There is no scientific reason to keep the charade going – only ideological. On January 24 millions of Canadians said “enough” to that ideology. That message was delivered to the Liberal Party loud and clear. The question is: did the Conservatives hear the message as well?


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