Author Topic: Safe Injection Sites in Ontario and the Idea of 'Evidence'  (Read 623 times)

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Offline Omni

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You seem to be completely missing the point. I will repeat what I have said above: the bias comes from the criteria chosen to define "effective". i.e. just because you decide that that reducing the number of drug overdoes deaths means the SIS is "effective" that does not compel me to to agree that your criteria are reasonable. As I also stated above: to be effective the SIS would have to increase the rate at which addicts get clean and there is little evidence of that.

So there no onus on me to prove anything. I simply do not agree with the criteria that you want to use. The onus is on you to provide an argument for why your criteria are more appropriate that mine. i.e. please explain why keeping addicts alive but addicted is defined as success when what these addicts really need is to get off drugs. How many resources are been taken away from detox centers and recovery homes because governments are obsessing about enabling drug addictions by reducing the incentive to clean up?

So the effect of saving lives is not a worthwhile effect in your mind. Sheesh!

Offline ?Impact

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just because you decide that that reducing the number of drug overdoes deaths means the SIS is "effective" that does not compel me to to agree that your criteria are reasonable. As I also stated above: to be effective the SIS would have to increase the rate at which addicts get clean and there is little evidence of that.

Come clean or die?

You are saying that addicts do not deserve to live. Yes, overcoming their addiction is the ultimate goal but sometime we have to settle for something less than best. Yes the statistics on them coming clean are good to know, but they are only one part of how effective the clinics are.

Offline TimG

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So the effect of saving lives is not a worthwhile effect in your mind. Sheesh!
Saving a few lives while prolonging the duration of addiction for many more is hardly a net benefit for society. We need to help addicts get clean. That has to be the primary objective of any intervention.
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Offline TimG

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Yes, overcoming their addiction is the ultimate goal but sometime we have to settle for something less than best.
But what if the clinics makes things worse by enabling addictions? The first thing any relative of an addict is taught that they must not enable the addiction because enabling the addiction prolongs the addiction. Why would SIS be any different? Everyone wants to jump on the "lives saved" statistic because it is easy to measure and makes great headlines, however, it is a smoke screen. To make progress we must save lives by getting people clean.


Offline Omni

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But what if the clinics makes things worse by enabling addictions? The first thing any relative of an addict is taught that they must not enable the addiction because enabling the addiction prolongs the addiction. Why would SIS be any different? Everyone wants to jump on the "lives saved" statistic because it is easy to measure and makes great headlines, however, it is a smoke screen. To make progress we must save lives by getting people clean.

Now your "logic" seems to suggest people go to a SIS to become addicted. Here's a hint: they go there because they are already addicted. And they don't just get supervision that helps keep them alive, they also have access to counseling to help them to beat their addiction. Your silly notion would simply cause more people to die.

Offline wilber

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It seems logical that they would prevent many OD deaths but their proponents should be able to provide some statistical evidence anyway.
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Offline Omni

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It seems logical that they would prevent many OD deaths but their proponents should be able to provide some statistical evidence anyway.

I posted a link a while ago that shows that type of evidence from a YVR SIS.

And it was not only OD deaths prevented but also various infections including HIV from dirty needles.
« Last Edit: August 14, 2018, 01:48:26 pm by Omni »

Offline TimG

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Here's a hint: they go there because they are already addicted. And they don't just get supervision that helps keep them alive, they also have access to counseling to help them to beat their addiction.
And how effective is this counselling? What percentage of addicts go into detox after a referral by the SIS? How does this compare to communities with outreach programs but no SIS? Is there evidence that addicts are less likely to enter detox if a SIS is available? These are all very reasonable questions but are ignored because people want to jump on the "lives saved" bandwagon and don't really care about the complicated, expensive and harder to measure question of recovery.

Offline ?Impact

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Is there evidence that addicts are less likely to enter detox if a SIS is available?

There is clear evidence that detox clinics are not available due to budget constraints. Socioeconomic forces are a huge enabler of addiction, many thousand times more than SIS.
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Offline Omni

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And how effective is this counselling? What percentage of addicts go into detox after a referral by the SIS? How does this compare to communities with outreach programs but no SIS? Is there evidence that addicts are less likely to enter detox if a SIS is available? These are all very reasonable questions but are ignored because people want to jump on the "lives saved" bandwagon and don't really care about the complicated, expensive and harder to measure question of recovery.
And why do you keep demeaning the saving of lives as some sort of "bandwagon"? You're talking about lives FFS!

People who go to a SIS are offered counseling and ways to enter detox.
« Last Edit: August 14, 2018, 02:13:49 pm by Omni »

Offline SirJohn

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I posted a link a while ago that shows that type of evidence from a YVR SIS.

To determine if it was unbiased you'd need to know something about the two doctors doing it and what evidence they used and where they got it from.
I don't readily find out anything about one of them, but the other is listed as Medical Director of the Portland Hotel Society, which is an advocacy group for 'marginalized' people in the lower east side which opened its own illegal injection site. As such it can't qualify as unbiased.
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Offline SirJohn

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And why do you keep demeaning the saving of lives as some sort of "bandwagon"? You're talking about lives FFS!

There's math at play here which we can't do because we don't know the numbers to plug in.
It's something like how many lives saved from an OD minus those who stayed on drugs longer because they felt enabled and died through some other drug related cause.

And, from a broader societal standpoint, the good these sites do for the community vs whatever ill affects the might have.
"When liberals insist that only fascists will defend borders then voters will hire fascists to do the job liberals won't do." David Frum

Offline Omni

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There's math at play here which we can't do because we don't know the numbers to plug in.
It's something like how many lives saved from an OD minus those who stayed on drugs longer because they felt enabled and died through some other drug related cause.

And, from a broader societal standpoint, the good these sites do for the community vs whatever ill affects the might have.

And it's like how many don't die because, even if they fail to beat their addiction, they can use safely.

Offline TimG

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There is clear evidence that detox clinics are not available due to budget constraints.
Which is my point. Politicians pushing SIS are using it as an excuse to avoid spending money on the real problem which is messy and complicated. The studies that provide "evidence" about how SIS "works" simply serve a smoke screen to distract a public that does not understand the real issues.
« Last Edit: August 14, 2018, 06:13:43 pm by TimG »

Offline Gorgeous Graham

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When it comes to injection sites I believe almost all of the studies are being done by people who wish to see the government spend money on harm reduction research which means they set up their studies in a way to make injections sites look as good as possible by emphasizing the positive while minimizing the negative. So it comes as no surprise that the "evidence" says they work.

Interesting and much discussed theory, but do you have any evidence to support it?

Obviously confirmation bias exists, but to what extent?
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