Susan Martiniuk is being criticized for pointing out that Insite might being exaggerating (or imagining) reductions in overdose deaths but Insite is also imagining something else -- a reduction in drug addicts turning up positive on HIV tests.
A 2010 study by two SFU criminologists published in the International Journal of Drug Policy was a mathematical model that made this claim based on a single 1996 paper (des Jarlais), that lumped together data from three studies, only one of which contained both clean needle users and non-users. The three studies had significant differences which were ignored (age, race, frequency of injection etc.). What was pointedly ignored by the SFU criminologists was a well-designed study from 1997, based on IV drug users in Montreal. Published in the American Journal of Epidemiology, it showed that consistent clean needle users were 10.2 to 21.8 times MORE likely to become HIV-positive between 1988 and 1995 than IV drug users who never used the clean needle facility. Intermediate users of clean needles were intermediate in risk.
One factor that is rarely considered is the toxicity of street drugs, something that would be solved only by decriminalizing the drugs themselves, not merely the injection of them. A recent study showed, for example, that cocaine (specifically in Vancouver) is usually cut with a drug that causes severe immune suppression (levamisole).
- David Crowe
P.S. Four referenced papers available on request
Submitted to the Calgary Herald, but not published.
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