SCC ruling: Insite to stay open

[TimG]

Again, if the aims of Insite does nothing to save lives, then perhaps we could cut costs in the hospitals by re-using dirty needles, not cleaning other medical supplies and throwing the used needles on the sidewalks out back.

But, but I thought you believed in 'evidence based decision making' and rejected decision making based on 'intiutive gut feelings'?

Look, I agree that it is possible that insight saves lives. All I am saying is when political activists flog "peer reviewed studies" these studies need to be taken with a big grain of salt.

[Sir Bandelot]

Right, now your telling us the Lancet has an agenda to make drugs freely available to addicts.

Ridiculous. I'll go with scientists and doctors, not the opinion of Barbara Kay in her blog.

Here's the Lancet study.-

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)62353-7/fulltext

By the way, "The Journal of Global Drug Policy and Practice" that posted your information is run by the Drug Free America Foundation, which received its initial funding in a $1.5 million grant from a U.S. Department of Justice agency, and is now under investigation for corruption.

[cybercoma]

Give Barbara Kay a break. She didn't get her degree in social policy, medicine or science. She's an English lit. major. She just reports the... What's that? It was in the comments section of the paper? Oh...

[Sir Bandelot]

They are teaching kindergartners that the wealthy elites are the enemy?

Whoa! Can't wait to see what they bring to the table when they are adults...

Generation change, culture change, that's what the new paradigm is all about.

When Jack Layton came to Kingston a few months before he died, he met with these groups to express his complete support. I believe they are now looking for funding from social groups, to help take the programs to a provincial level, and from there on to the rest of the country. this is big stuff we're talking about. The idea is that this generation will teach the next generation, and so on, until we completely eradicate those who would judge drug addicts as though they were somehow inferior to anyone else.

[TimG]

Ridiculous. I'll go with scientists and doctors, not the opinion of Barbara Kay in her blog.

I know she was quoting political activists on the other side so their claims need to be taken with a grain of salt too. However, did I quote specific criticisms that I think need to be explained. i.e. looking at the graph of the data I cannot see any connection with insight. It does appear that any reductions in overdose deaths is coincidental.

Do you have any counter argument or are you just going to bang the 'appeal to authority' hammer?

Edited October 7, 2011 by TimG

[DogOnPorch]

If you agree with enabling addicts, open up your house to junkies so they can shoot up in your can. There's no reason for tax payers to fund this. Heroin is illegal.

[waldo]

Bad news for people who say the science supporting insight is clear:

http://fullcomment.nationalpost.com/2011/10/05/barbara-kay-the-supreme-court-used-flawed-data-to-make-its-insite-decision/

I think it is time for an update to that old saying:

"There are lies, damned lies and peer reviewed studies".

If someone if pushing a political policy based on a scientific study the best position to take is to assume the data has been manipulated to support the politics until proven otherwise.

I know she was quoting political activists on the other side so their claims need to be taken with a grain of salt too. However, did I quote specific criticisms that I think need to be explained. i.e. looking at the graph of the data I cannot see any connection with insight. It does appear that any reductions in overdose deaths is coincidental.

Do you have any counter argument or are you just going for the 'appeal to authority' hammer?

ah yes, more... more... TimG analysis by 2D graphic rendering!

you are soooooo quick to pass judgement on the Lancet study... based on... a National Post article that can't even bother to provide a reference/link to any formal counter to the Lancet study? Does one even exist? Certainly, if there is substance to the suggested criticism, it will need to be in the form of a formal challenge to the Lancet study, ala peer review. As you are repeatedly advised, science does not play itself out in blogs... or newspaper articles, most particularly those with designed intent.

as a follow-up to SirB's posting of the Lancet study abstract... here is the full complete study:

Reduction in overdose mortality after the opening of North America’s first medically supervised safer injecting facility: a retrospective population-based study

[TimG]

Here is some words of a recovering addict on Insight:

http://thebernermonologues.blogspot.com/2011/10/guest-editorial-insite.html

I would have laughed all the way to my dealer's corner and back. No consequences for bad, harmful and antisocial behaviour? No consequence for spreading fatal and life threatening disease? Drug injecting paraphernalia that I don't have to pay for? No expectation to contribute to my community to balance out my constant freeloading? No consideration given to the fact that I stole 15 purses and robbed an old lady for her grocery money so I could score on the way to Insite? An addicts heaven. I would have happily cranked so much junk, my eyes would have bulged. Malnutrition? No biggie. I'll get free and expensive Boost supplements from my doctor. Organ failure after a dozen years of injecting poison into my body? No problem in our free medicare system. Heck, I bet I could get a nurse to come inject my heroin while I wait for an organ transplant. Work for a living and pay taxes? I have a disease, I can't work. In fact, I'll take some disability cash over and above my regular welfare payments. I'll also need some taxi chits so I can get to Insite. I have a disease, don't you know. And be quick about it, or else I will sic the harm reduction people on you.

My opposition to Insight is not based on an moral problems with drug use. It is because my personal experience dealing with addicts in recovery has led me to the conclusion that enabling addicts is the worst thing you can do to them. Gerry Verrier message is the same message I have gotten over and over again from recovering addicts.

Edited October 7, 2011 by TimG

[TimG]

Certainly, if there is substance to the suggested criticism, it will need to be in the form of a formal challenge to the Lancet study, ala peer review.

I have no interest in playing your 'if it is not peer reviewed i refuse to even acknowledge the argument' games. Legimate questions have been raised. If you or another insight supporter can't answer them then I will assume that they can't be answered and that the Lancet study is political junk. Edited October 7, 2011 by TimG

[Sir Bandelot]

Do you have any counter argument or are you just going to bang the 'appeal to authority' hammer?

Neither. I could go and quote the 30 or so other studies done by reputable medical/ research organizations that show it's a success, vs. your dirty links and anecdotes, but I know that would be utterly lost on you. Having already proved it, I don't need to waste my time convincing those who simply refuse to believe.

[cybercoma]

Even if we assume the article in The Lancet is entirely wrong, they're only focusing on one aspect of Insite: overdose deaths. How many drug-addicts are killed by HIV/AIDS, hepatitis, or other infections associated with using drugs with dirty needles, other supplies and in unsanitary locations? Aside from the health benefits, what about the social benefits of not having used needles and people using out in the open on the streets? I keep hearing that my point about having hospitals re-use dirty needles is a "moral" one or a "gut-feeling". Really? The safety benefits of having clean supplies for intravenous drugs is not a "moral" or "gut-feeling" dilemma. It's a basic requirement for hospitals. It's also a requirement for licensed tattoo shops and they don't even hit veins. It's as though sanitation is a myth here.

[TimG]

I could go and quote the 30 or so other studies done by reputable medical/ research organizations that show it's a success, vs. your dirty links and anecdotes

The accusation is a study in the Lancet presented a picture of the data that has no connection with reality when you look at the time series. How much credibility do those other studies really have until the reasons for the failure of the Lancet peer review process are investigated?

[Sir Bandelot]

If you agree with enabling addicts, open up your house to junkies so they can shoot up in your can. There's no reason for tax payers to fund this. Heroin is illegal.

The point of this is to get them off the streets, get rid of the discarded needles, give them a resource to quit or just manage their habit. It also saves taxpayers money. This has already been covered, but thanks for stopping by.

[Sir Bandelot]

The accusation is a study in the Lancet presented a picture of the data that has no connection with reality when you look at the time series. How much credibility do those other studies really have until the reasons for the failure of the Lancet peer review process are investigated?

Again, your sources are highly suspect, and shown to be funded by partisans. I'll stick with those who do not have an agenda. You follow your people

[waldo]

ah yes, more... more... TimG analysis by 2D graphic rendering!

you are soooooo quick to pass judgement on the Lancet study... based on... a National Post article that can't even bother to provide a reference/link to any formal counter to the Lancet study? Does one even exist? Certainly, if there is substance to the suggested criticism, it will need to be in the form of a formal challenge to the Lancet study, ala peer review. As you are repeatedly advised, science does not play itself out in blogs... or newspaper articles, most particularly those with designed intent.

as a follow-up to SirB's posting of the Lancet study abstract... here is the full complete study:

Reduction in overdose mortality after the opening of North America’s first medically supervised safer injecting facility: a retrospective population-based study

I have no interest in playing your 'if it is not peer reviewed i refuse to even acknowledge the argument' games. Legimate questions have been raised. If you or another insight supporter can't answer them then I will assume that they can't be answered and that the Lancet study is political junk.

of course you'll dismiss the Lancet study, outright, because you found a National Post article that pumps your ideological bent. You state, "legitimate questions have been raised"... really, is there a study you can offer reference/link to? As I said, "Certainly, if there is substance to the suggested criticism, it will need to be in the form of a formal challenge to the Lancet study, ala peer review". Again, as difficult as it is for you to stomach, blogs and... newspaper articles are not the medium for science understandings to be either formally reviewed, challenged, enhanced, complemented or usurped.

[TimG]

Even if we assume the article in The Lancet is entirely wrong, they're only focusing on one aspect of Insite: overdose deaths. How many drug-addicts are killed by HIV/AIDS, hepatitis, or other infections associated with using drugs with dirty needles, other supplies and in unsanitary locations?

A fair point. But a net benefit is not a given. If illegal drug use increases outside of the clinic then the net effect of the clinic could be negative. If there are such obvious problems with one study how can you claim that the others are any better? Edited October 7, 2011 by TimG

[TimG]

Again, your sources are highly suspect, and shown to be funded by partisans.

That is where you are wrong. All of these studies are done by political partisans too. The only reason you insist they are 'objective' is because you agree the conclusions they make.

In any case, your have made your position clear.

You have made up your mind and the facts are irrelevant to you.

FWIW: I was expecting someone to actually show why data Kay provided is wrong. I am surprised I have gotten nothing but 'I don't believe it so I am going to ignore it' as a response.

Edited October 7, 2011 by TimG

[Sir Bandelot]

A fair point. But a net benefit is not a given. If illegal drug use increases outside of the clinic then the net effect of the clinic could be negative. If there are such obvious problems with one study how can you claim that the others are any better?

TimG. The evidence shows that drug use dropped by 9% outside the clinic, but 35% within it. You should read articles before making your speculative claims.

[cybercoma]

Actually this study against Insite is laughable because it contains all overdose deaths, while the study they are criticizing makes it clear that this is not what they were considering. The article in question states, "all deaths deemed by the attending coroner to be caused by an accidental (ie, recreational or otherwise unintentionally fatal) illicit drug overdose were eligible for inclusion in this analysis," as opposed to all overdoses whether or not they were done accidentally or intentaionally, or by illicit or legal drug use. The "study" that criticizes the article in The Lancet included all drug overdoses in its analysis.

[TimG]

TimG. The evidence shows that drug use dropped by 9% outside the clinic, but 35% within it. You should read articles before making your speculative claims.

What are you talking about? From the study:

The fatal overdose rate in this area decreased by 35·0% after the opening of the SIF, from 253·8 to 165·1 deaths per 100 000 person-years (p=0·048). By contrast, during the same period, the fatal overdose rate in the rest of the city decreased by only 9·3%

[cybercoma]

A fair point. But a net benefit is not a given. If illegal drug use increases outside of the clinic then the net effect of the clinic could be negative.

If people don't use the resources available to them, that might be a failure on the part of the resource. At this point, though, that's quite a hypothetical.

[TimG]

The article in question states, "all deaths deemed by the attending coroner to be caused by an accidental (ie, recreational or otherwise unintentionally fatal) illicit drug overdose were eligible for inclusion in this analysis," as opposed to all overdoses whether or not they were done accidentally or intentionally, or by illicit or legal drug use.

In other words: the only difference is the Lancet study included suicides. I am not convinced the difference is material. Do you have evidence that the suicides by drug over dose are orders of magnitude larger than accidental overdoses? Because that is what is required to use that as an explanation for the difference between the coroner data and the Lancet study. Edited October 7, 2011 by TimG

[cybercoma]

The Lancet study used coroner data. So, yeah. There's a considerable difference when you add in a bunch of different types of deaths that the original study didn't consider, nor should they have.

[waldo]

I am not convinced the difference is material.

say what? Did your 2D graphic image eyeballing not pick out that distinction... the one you now claim as immaterial? Say now, what else is your graphic image failing to provide? Data? Data Analysis? Statistical Data Analysis? Methodology? Anyone... anyone... anyone... Oh, if only there were a peer-reviewed study for Barbara Kay & TimG to turn to!

[Sir Bandelot]

FWIW: I was expecting someone to actually show why data Kay provided is wrong. I am surprised I have gotten nothing but 'I don't believe it so I am going to ignore it' as a response.

It's you who has failed to show why 30 studies by reputable organizations are all wrong, while believing faithfully your one study, funded by the partisan Drug-Free America.

http://www.dfaf.org/content/about-dfaf-inc

Sounds like they've got their minds already made up.