Open Letter to Minister Clement on Harm Reduction

Hon. Tony Clement
Minister of Health
House of Commons
Ottawa, Ontario K1A 0A6

Dear Minister Clement,

I am writing to express my grave concern regarding your misleading and irresponsible attacks on harm reduction and Vancouver’s InSite supervised injection site at the recent World Health Organization XVII International AIDS Conference in Mexico City and again at the 2008 Canadian Medical Association conference in Montreal.

At both of these conferences, you persisted in representing harm reduction and drug rehabilitation/treatment as two mutually exclusive, alternative approaches to problems associated with drug addiction. As has been explained to you on numerous occasions by health researchers, medical professionals, drug treatment experts and others, this is an entirely false dichotomy. Harm reduction is one component of a comprehensive “Four Pillar” approach, which also includes prevention, treatment and law enforcement. Low-threshold programs, such as supervised injection sites, are essential in the Four Pillars approach for reducing overdose deaths and the spread of diseases such as HIV/AIDS and Hepatitis C, and also for drawing hard-to-reach users into treatment and rehabilitation. Harm reduction is part of a continuum of care that includes treatment and prevention, and the only voices in Canada portraying it as a ‘substitute’ are you and your government.

Unfortunately, your recent comments in Mexico City and Montreal are only the latest episodes in a well-established pattern of putting ideology and partisan politics ahead of rational public policy on this issue.

•The Conservative government’’s National Anti-Drug Strategy has essentially abandoned the Four Pillars approach for a “One Pillar,” US-style “war on drugs” that puts almost all resources into law enforcement. As of 2007, law enforcement accounted for an overwhelming 73% of spending in the National Anti-Drug Strategy, while treatment only received 14%, research just 7% and prevention and harm reduction a pitiful 2.6% each.
•The Conservative government delayed a decision on the status of InSite for more than two years, claiming more research needed to be done. Now the research has been done, and it is absolutely clear. More than 20 peer-reviewed studies by internationally recognized researchers have demonstrated the health, safety and cost benefits of InSite. Even the criminologist hired by the government to evaluate the existing research said that InSite contributes to public order and saves lives. The response from the government in the face of this overwhelmingly favourable body of research was that the decision on InSite would not be based on scientific evidence alone.
At the XVII International AIDS Conference in Mexico City, you called supervised injection sites “harm addition,” contradicting the official policy developed by the World Health Organization in conjunction with the world’s leading addiction and health researchers. •At the 2008 Canadian Medical Association conference, you attacked the CMA’’s support for InSite and harm reduction generally, even going so far as to question the ethics of the 80% of Canadian doctors who support supervised injection sites.

Given the weight of evidence and the time that you and your government have had to digest it, I can only conclude that this continuing opposition to the Four Pillars approach is not because of an honest lack of comprehension, but is instead driven by the partisan political concerns of the Conservative Party. At a time when a comprehensive approach to the problem of drug addiction is so desperately needed, it is frustrating that you and your party have chosen cheap partisan political games over rational, evidence-based public policy.

My concern about your statements is compounded by your party’’s recent use of public money to mail leaflets containing dehumanizing language into East Vancouver and other communities across Canada. People with addictions are amongst the most desperate and vulnerable in our society, and referring to them as “junkies” is simply bullying and has no legitimate place in public discourse. While your party was clearly attempting to fear-monger and appeal to people’s safety and security concerns, the Conservative Party has instead simply displayed the mean-spiritedness and lack of compassion that underlies so many of its policies. Will future Conservative Party leaflets begin referring to Canadians with mental illnesses as “nutcases”? Or maybe call people with physical disabilities “cripples”? Canadians have moved beyond this sort of stigmatization and dehumanization of vulnerable and ill people. I have received numerous letters and phone calls from constituents and people across Canada outraged by this mailing.

Based on the above concerns, I strongly urge you and your government to take the following actions:

1.Abandon the time- and money-wasting appeal of the BC Supreme Court’’s decision on InSite, and start work on implementing a well-funded, comprehensive, evidence-based and effective Four Pillars strategy for dealing with drug addiction. This government must recognize that harm reduction programs like InSite are a necessary component of a broader strategy that includes prevention, treatment and enforcement.
2.Commit to basing drug policy decisions on scientific evidence and the informed opinion of the mainstream medical and research communities. History is full of tragic examples of governments and other institutions ignoring evidence because of ideological bias and short-term political concerns. In the case of drug policy in Canada, the price of Conservative ideological purity and political partisanship will be paid in lives ruined and lost. That’s too high a price to pay for political games.
3. Respect, support and strengthen effective, locally-developed initiatives dealing with addiction related issues. InSite grew out of the experience of groups and individuals working on the frontline of Vancouver’’s health and poverty crisis. There is broad community consensus in support of the project, including local residents, community groups, social service providers, businesses, law enforcement officers, municipal and provincial politicians, and people coping with addiction themselves. Your government’’s efforts to disregard the will of the community on this issue shows arrogance and poor judgment.
4. Stop wasting public money distributing dehumanizing, fear-mongering material on this issue to Canadians. Instead, Canadians need access to realistic information on addiction-related issues, both to inform public policy and for use in prevention and harm reduction campaigns. This issue is far too important to be manipulated for cheap, partisan political purposes.

I look forward to your reply on this serious matter.


Libby Davies, MP (Vancouver East)
NDP Spokesperson for Drug Policy Reform

Jack Layton MP, NDP Leader
Judy Wasylycia-Leis MP, NDP Health Critic
Joe Comartin MP, NDP Justice Critic