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

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Offline wilber

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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.

True. If someone decides they want to get off drugs, you can't tell them to wait a couple of months. Addiction doesn't work that way. The time is the time, not a month from now.
"Never trust a man without a single redeeming vice" WSC

Offline TimG

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Obviously confirmation bias exists, but to what extent?
How could it be any other way? Researchers are forced to specialize. Once they commit to a specialty they need to make sure it stays relevant lest they be out of work or have to start over in a new field. They simply cannot afford to say anything that undermines their specialty or their career prospects.

Let's put it another way: if scientists work for a oil company or a drug company most people will assume, without proof, that any science produced by these scientists is biased. I am saying that the same thing is true for every scientist but it can be more difficult to figure out how the incentives in their field create their bias.

If you are going to insist on accepting all science at face value unless someone provides "proof" of bias then I can dig out any number of studies by tobacco companies which you have to accept at face value unless you can *prove* bias. Is that the standard you really want to set? Or are you going to be a hypocrite and argue proof of bias is only required when you decide it is necessary?


« Last Edit: August 14, 2018, 07:36:31 pm by TimG »

Offline Gorgeous Graham

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How could it be any other way? Researchers are forced to specialize. Once they commit to a specialty they need to make sure it stays relevant lest they be out of work or have to start over in a new field. They simply cannot afford to say anything that undermines their specialty or their career prospects.

Let's put it another way: if scientists work for a oil company or a drug company most people will assume, without proof, that any science produced by these scientists is biased. I am saying that the same thing is true for every scientist but it can be more difficult to figure out how the incentives in their field create their bias.

If you are going to insist on accepting all science at face value unless someone provides "proof" of bias then I can dig out any number of studies by tobacco companies which you have to accept at face value unless you can *prove* bias. Is that the standard you really want to set? Or are you going to be a hypocrite and argue proof of bias is only required when you decide it is necessary?

It's a good theory, very plausible, confirmation bias happens, but theories need evidence, especially if we're talking about academic research which relies on evidence.  You can't brush off entire fields of social science as hogwash without evidence, we don't even know the extent of this problem if there is one.  Maybe there's even studies out there done on this subject.
« Last Edit: August 14, 2018, 08:31:54 pm by Coonlight Graham »
I can tell how good of a person you are by how you treat the people you disagree with.

Offline cybercoma

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Tim, You know “researchers” are often tenured professors, right? The entire reason for tenure is the freedom to research what you want without having to worry about your next pay cheque. That’s the whole reason professors “can’t” be fired.

Offline TimG

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You can't brush off entire fields of social science as hogwash without evidence, we don't even know the extent of this problem if there is one.
Except I am not saying it is "hogwash". In this thread I acknowledged the evidence that SIS reduce overdose deaths. What I question is the definition of success as defined as advocates. Saving lives is good but for every life saved how many languish longer in addiction because the SIS enable their addiction or because resources are being spent on SIS instead of expanding detox beds? None of the evidence I have seen addresses these concerns. The reason is most likely because of the bias I noted above. The researchers are keen to report areas of success while they play down the negative consequences.

Offline TimG

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Tim, You know “researchers” are often tenured professors, right? The entire reason for tenure is the freedom to research what you want without having to worry about your next pay cheque. That’s the whole reason professors “can’t” be fired.
So what? Their professional stature and status among their peers depends on the relative respect conferred on their specialty. More importantly, tenure does not fund labs or graduate students. The ability to get their next grant has to always be a top priority for any tenured professor. When professor Peterson started vocally expressing his views the funding bodies quickly found excuses to cut off his grants because they did not like what he was saying. It did not affect him personally but he lost his students and that has to matter to any tenured professor.

IOW, your idea 'tenured professors' are free of bias because they don't fear the loss of their paycheck is nonsense. Bias can come from many sources and tenured professors are not immune.

Offline Omni

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Except I am not saying it is "hogwash". In this thread I acknowledged the evidence that SIS reduce overdose deaths. What I question is the definition of success as defined as advocates. Saving lives is good but for every life saved how many languish longer in addiction because the SIS enable their addiction or because resources are being spent on SIS instead of expanding detox beds? None of the evidence I have seen addresses these concerns. The reason is most likely because of the bias I noted above. The researchers are keen to report areas of success while they play down the negative consequences.

Please try and explain to us how a SIS "enables" addiction. People who show up at a site are already addicted. They go to the site for some safety to do what they are going to do anyway. And they can get help to battle their addiction as well, so your theory falls apart.

Offline ?Impact

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Please try and explain to us how a SIS "enables" addiction.

It prevents them from overdosing or getting AIDS so they live longer to continue their addiction.

Offline Omni

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It prevents them from overdosing or getting AIDS so they live longer to continue their addiction.

Ah I get it. Let them die and then they disappear. That oughta work.

Offline TimG

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It prevents them from overdosing or getting AIDS so they live longer to continue their addiction.
I can't believe how ignorant you guys are about what addiction is. If someone has an addict in the family he first thing any professional will tell the person is about the importance of not enabling the addict because enabling the addict can discourage the addict from seeking help:

https://alcoholrehab.com/addiction-articles/enabling-addiction/

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Enabling is one of the key aspects of addiction and substance abuse. Many people who struggle with addiction find that they have a close relationship with a person who enables them to deny that they have a problem with drugs or alcohol. This dysfunctional relationship also allows them to ignore and be disconnected from the consequences of their behavior An enabler will provide emotional and financial support, help them to hide their addiction, fund their addiction and even make excuses for their problems. The addict knows that there is always someone there to help them, even if they permit the most hurtful, painful and even criminal acts.

Enabling addiction can have disastrous consequences. Health problems, financial ruin, relationship breakdown, injuries and incarceration are all very real outcomes of a persons drug or alcohol addiction. Allowing a person to continue to abuse alcohol and drugs without any repercussions can mean that they will not face up to their problems and addiction until it is too late.
So enabling an addict *is* a serious concern and SIS are a type of enabling and will result in more addicts delay facing their problems. The question is how to balance the lives saves by preventing overdose vs. the lives destroyed by keeping the addict comfortable with their addiction. It is delusional to pretend this trade off does not exist.

More from the op:
Quote
Enabling is borne out of good intentions, love and care for another person however it has disastrous consequences. An enabler means well by their actions, but their actions simply prolong the consequences of an addicts behavior.
IOW, the road to hell is paved with good intentions.
« Last Edit: August 14, 2018, 09:54:07 pm by TimG »
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Offline ?Impact

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If someone has an addict in the family he first thing any professional will tell the person is about the importance of not enabling the addict because enabling the addict can discourage the addict from seeking help:

That is based on AA program, but not backed up by a single piece of evidence. Please provide the research that supports your theory.

What we do know about supervised injection is they reduce overdose mortality, cut transmission of HIV and hepatitis C, decrease public injecting and the presence of dirty needles in streets and parks, and even reduce local crime and violence rates — all while improving health.
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Offline Gorgeous Graham

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So enabling an addict *is* a serious concern and SIS are a type of enabling and will result in more addicts delay facing their problems. The question is how to balance the lives saves by preventing overdose vs. the lives destroyed by keeping the addict comfortable with their addiction. It is delusional to pretend this trade off does not exist.

Don't the sites have counseling support ready if they want to quit?  What's the quit rate vs the general population?  And the death rate? etc.

We don't have the time to delve into the stats and all the literature here, but as MH eluded in the OP, the people in government should and decisions should all be based on evidence based on what outcomes are desired and not knee-jerk emotion.

The thing with Doug Ford is he's not anything near an academic, he doesn't know anything about the scientific process or research & evidence so things will get canned based on emotion and ideology.
I can tell how good of a person you are by how you treat the people you disagree with.

Offline Omni

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That is based on AA program, but not backed up by a single piece of evidence. Please provide the research that supports your theory.

What we do know about supervised injection is they reduce overdose mortality, cut transmission of HIV and hepatitis C, decrease public injecting and the presence of dirty needles in streets and parks, and even reduce local crime and violence rates — all while improving health.

I guess if we follow Tim's logic the way to get rid of alcoholism is to simply shut down all the bars.
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Offline TimG

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Don't the sites have counseling support ready if they want to quit?  What's the quit rate vs the general population?  And the death rate? etc.
What is the quit rate compared to an outreach program where the same counselling is made available without a SIS? We want an apples to apples comparison.

The thing with Doug Ford is he's not anything near an academic, he doesn't know anything about the scientific process or research & evidence so things will get canned based on emotion and ideology.
I am not convinced Doug Ford's motivations are any different from the majority of SIS supporters who refuse to acknowledge the trade offs.

 

Offline ?Impact

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I guess if we follow Tim's logic the way to get rid of alcoholism is to simply shut down all the bars.

Bars are improving with bartenders now being held to account for not looking out for their patrons. If we added the notion that nobody was allowed to drink alone at a bar (friends looking out for each other) then they might become closer safe/supervised drinking sites.
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