[Psudo]

fifeboy wrote:

Rehab works only if the druggie, alcoholic or whatever is willing.

Agreed. That's why I'm skeptical of programs like Insite that try to convince people to get clean by handing them the tools to stay high. The people who rehab wouldn't help are the same people Insite supports. It perpetuates a class of addicts the same way our broken immigration policy perpetuates a class of illegals.

If you're willing to change, you should have aid available. If you refuse, your consequences are properly on you.

[PublicAnimalNo9]

Every junkie quits eventually. Either by death or by getting sick of living in hell.
Places like Insite increase the odds of junkies making it to the latter group.
Even if only 1% of junkies that go through Insite and similar centres in a year wind up getting off the junk because of access to sites like these, and since they aren't government funded AFAIK, isn't it worth having them around? Would you maybe prefer junkies lay around in the streets while they shoot up, and after they get all fucked up?

[Psudo]

PublicAnimalNo9 wrote:

Every junkie quits eventually. Either by death or by getting sick of living in hell.
Places like Insite increase the odds of junkies making it to the latter group.

There are three groups, not two: dead, trying to quit, and enjoying the high. Insite patients are more likely to escape the first group and more likely to join the third. I don't see how they grow the second, and their own stats don't even show it.

In the long run, the increased size and acceptance of the culture of addiction could add more people to the addict pool generally, including the dead pool specifically. That likely consequence of Insite would undo the only benefit of Insite. The whole thing looks self-defeating to me.

I would prefer our efforts go to people who ask for help and people we have some personal attachment to. On a societal scale, people who want to perpetuate addiction -- whether personally and culturally -- can bite me.

[PublicAnimalNo9]

Psudo wrote:

PublicAnimalNo9 wrote:

Every junkie quits eventually. Either by death or by getting sick of living in hell.
Places like Insite increase the odds of junkies making it to the latter group.

There are three groups, not two: dead, trying to quit, and enjoying the high. Insite patients are more likely to escape the first group and more likely to join the third. I don't see how they grow the second, and their own stats don't even show it.

Umm the third group was already implied by the term "junkie". Reread the first two sentences.

Psudo wrote:

In the long run, the increased size and acceptance of the culture of addiction could add more people to the addict pool generally, including the dead pool specifically. That likely consequence of Insite would undo the only benefit of Insite. The whole thing looks self-defeating to me.

This is the same thinking that says legalizing drugs would see a huge increase in drug use. Several countries have indeed proven that to be a fallacy.

Psudo wrote:

I would prefer our efforts go to people who ask for help and people we have some personal attachment to.

Oh that's nice. Almost every junkie has someone that is personally attached to them. In the meantime, places like Insite are still better than the alternative. I mean it's not like they are providng the friggin' heroin. They provide clean needles to prevent the spread of disease, diseases that don't differentiate between needle users and those that don't use drugs.

[fifeboy]

Psudo wrote:

fifeboy wrote:

Rehab works only if the druggie, alcoholic or whatever is willing.

Agreed. That's why I'm skeptical of programs like Insite that try to convince people to get clean by handing them the tools to stay high. The people who rehab wouldn't help are the same people Insite supports. It perpetuates a class of addicts the same way our broken immigration policy perpetuates a class of illegals.

If you're willing to change, you should have aid available. If you refuse, your consequences are properly on you.

If you believe that than we have a fundamental difference of opinion.

[andyt]

The junkies already have the tools to get high. Insite just gives them clean tools. And encouragement to get off drugs. Many junkies want to kick, but it's hard. Getting some encouragement and resources helps. Better yet would be if Insite had a rehab bed ready to go for each junkie that says they want to quit, and that is the failing here - the 4 pillars aren't equally supported. There is absolutely no evidence that Insite keeps people on drugs who would otherwise quit, in fact the opposite.

If we were all islands, then the consequences of not changing would be only on us. Fortunately we're not islands, much as it may seem so.

[fifeboy]

Psudo wrote:

PublicAnimalNo9 wrote:

Every junkie quits eventually. Either by death or by getting sick of living in hell.
Places like Insite increase the odds of junkies making it to the latter group.

There are three groups, not two: dead, trying to quit, and enjoying the high. Insite patients are more likely to escape the first group and more likely to join the third. I don't see how they grow the second, and their own stats don't even show it.

In the long run, the increased size and acceptance of the culture of addiction could add more people to the addict pool generally, including the dead pool specifically. That likely consequence of Insite would undo the only benefit of Insite. The whole thing looks self-defeating to me.

I would prefer our efforts go to people who ask for help and people we have some personal attachment to. On a societal scale, people who want to perpetuate addiction -- whether personally and culturally -- can bite me.

I have some personal experience with this. My daughter, we adopted her from a drug addict mom, became an addict herself. She may have "enjoyed the high" at first but as she moved more and more into her addictions the high became a relief from the pain she felt for the rest of the day. She was addicted because she needed the drugs to release her from the pain she felt when she wasn't high. She is clean now, (fingers crossed) but if she had had a safe injection site when she was active it would have kept her from some life threatening situations. I salute the people who have set up and supported the safe injection site and hope it allows more people an opportunity to clean up without too much baggage.

[Psudo]

My response to fifeboy is the most important, I think, since his was the most important post I am responding to. I saved the best for last.

PublicAnimalNo9 wrote:

the third group was already implied by the term "junkie". Reread the first two sentences.

It's existence was implied, but it was ignored as an outcome. You only treated it as a temporary transitional period between getting addicted and getting out. More people addicted longer and healthier make it more of a permanent outcome and, as examples from Studio 54 to Charlie Sheen demonstrate, a lifestyle. To pretend there is no societal advocacy to be a perpetual addict is blatant denial. I believe some of Insite's activities inherently contribute to that advocacy. If I'm wrong, show me.

PublicAnimalNo9 wrote:

Psudo wrote:

increased size and acceptance of the culture of addiction could add more people to the addict pool generally

Several countries have indeed proven that to be a fallacy.

Show me something empirical, or this is just a difference of opinion.

PublicAnimalNo9 wrote:

Almost every junkie has someone that is personally attached to them.

Then I'm excluding almost no one. More importantly, I'm not excluding any specific person; I'm excluding an attitude. Charlie Sheen can bite me, because he apologetically delights in drug use. If and when he changes his mind and wants to change, he instantly earns my support. I'm not leaving anyone out on the street to die.

andyt wrote:

Many junkies want to kick, but it's hard. Getting some encouragement and resources helps.

Getting some encouragement and resources helps them do whatever that encouragement and those resources are for. Giving them clean needles and a safe place to get high gives them a reason to believe that addiction won't be so bad and maybe they don't need to quit after all. If they add rehab advocacy, they make it a mixed signal -- still not a clear aid.

andyt wrote:

Better yet would be if Insite had a rehab bed ready to go for each junkie that says they want to quit

I agree, that would be better.

andyt wrote:

If we were all islands, then the consequences of not changing would be only on us. Fortunately we're not islands, much as it may seem so.

If you believe this is a criticism of my view, you do not understand my view. I explicitly offer exception for our personal attachments -- for those who are not islands, so to speak. Read below for more details.

fifeboy wrote:

I have some personal experience with this. My daughter, we adopted her from a drug addict mom, became an addict herself. She may have "enjoyed the high" at first but as she moved more and more into her addictions the high became a relief from the pain she felt for the rest of the day. She was addicted because she needed the drugs to release her from the pain she felt when she wasn't high. She is clean now, (fingers crossed) but if she had had a safe injection site when she was active it would have kept her from some life threatening situations. I salute the people who have set up and supported the safe injection site and hope it allows more people an opportunity to clean up without too much baggage.

Thank you for describing your personal experience. I know you've risked a lot by opening your life -- and your daughter's! -- to public scrutiny. I am certain she is blessed to have you and you are blessed to have her, and I will do everything in my power to respect you two and your relationship.

Within that promise there remains room for polite discourse. I do not see how her example conflicts with my philosophy. I wish to limit the public expression of compassion to those who are trying to live clean or to those to whom we have personal attachments. Your daughter always has and always will be the latter, and from your description seems to have been the former for quite some time. My philosophy does not exclude her from compassionate aid.

A possible implementation of my philosophy is for Insite to operate the same except that they take patients on a sponsorship basis -- if you sponsor her, she's in. That ensures that everyone getting treatment at Insite has an anti-drug influence (the definition of "sponsor") in their life outside of Insite itself. It ensues that Insite's limited resources are disproportionately provided to people with hope and desire to get clean. On practical result of that would be that your daughter is included while Charlie Sheen types are excluded.

Because of your personal experience, I especially desire that you judge my philosophy and tell me specifically where I am wrong and why.

[andyt]

Psudo - Insite has stats of the people who kicked from being referred by Insite. Do you have any data that shows that users stayed on drugs longer than would be the case w/o Insite?

As for your vision of familial or at best clan based interdependence - do you really want to live in Pakistan. The reason our societies advanced so far is because all our social structures recognize the interdependence of the whole society, as well as the frictions that can result form it.

[fifeboy]

Psudo: My daughter didn't have Insite to go to as she was in Vancouver for only a small part of her time as an addict. I can't even remember if it was in opperation at the time. She went the usual rounds and rounds of rehab, without much luck. However she did say she was "sick of it" eventually and broke the chain and got herself off of morphine and cocaine. She is, for sure, still mentally ill and will be at risk for the rest of her life. For her, something like Insite would have only provided her with a safe site, clean materials and perhaps access to regular medical advice and advice about rehab. I don't see it as a way out, just as a place where druggies can be safe and receive advice.

[fifeboy]

andyt wrote:

Psudo - Insite has stats of the people who kicked from being referred by Insite. Do you have any data that shows that users stayed on drugs longer than would be the case w/o Insite?

As for your vision of familial or at best clan based interdependence - do you really want to live in Pakistan. The reason our societies advanced so far is because all our social structures recognize the interdependence of the whole society, as well as the frictions that can result form it.

[Psudo]

andyt wrote:

Insite has stats of the people who kicked from being referred by Insite.

Are those the same stats I discussed earlier? 'Cause they show no such thing. They show a pattern of saving lives medically, not of dissuading drug use. Even the Canadian Supreme Court said so (though they reasoned that saving lives was enough).

andyt wrote:

As for your vision of familial or at best clan based interdependence - do you really want to live in Pakistan.

1) Pakistan is not the only tribal society. Neither is the Muslim world generally. Anthropologically speaking, we're all members of tribes.
2) I'm not advocating that only family can vouch for you. Friends, social workers, anyone who wants you to quit can be a sponsor. Tribalism is irrelevant to my view.

andyt wrote:

The reason our societies advanced so far is because all our social structures recognize the interdependence of the whole society, as well as the frictions that can result form it.

That's horrible reasoning. The United States is the most powerful nation on earth, and has a tradition of atypically low recognition of formal, centralized interdependence. If power proves philosophical rightness as you suggest (it doesn't), it follows that the resulting power of the USA demonstrates that the rest of the world is too collectivist.

[Psudo]

fifeboy wrote:

Psudo: My daughter didn't have Insite to go to as she was in Vancouver for only a small part of her time as an addict. I can't even remember if it was in opperation at the time. She went the usual rounds and rounds of rehab, without much luck. However she did say she was "sick of it" eventually and broke the chain and got herself off of morphine and cocaine. She is, for sure, still mentally ill and will be at risk for the rest of her life. For her, something like Insite would have only provided her with a safe site, clean materials and perhaps access to regular medical advice and advice about rehab. I don't see it as a way out, just as a place where druggies can be safe and receive advice.

That's very reasonable, but doesn't disagree with my stated views.

[andyt]

Psudo wrote:

That's horrible reasoning. The United States is the most powerful nation on earth, and has a tradition of atypically low recognition of formal, centralized interdependence. If power proves philosophical rightness as you suggest (it doesn't), it follows that the resulting power of the USA demonstrates that the rest of the world is too collectivist.

You've got to be joking. The US is a few degrees less socialist than the rest of the Western nations. It has all the the structures of a welfare state except universal healthcare, and that hasn't worked out too well for it.

And I said advanced, you changed it to power - how come? Do you see them as equivalent?

And, from an archived copy of the Vancouver Sun:

Quote:

Despite all of this positive evidence,
detractors have continued accusing
Insite of “facilitating” drug use, and
have argued that it doesn’t help people to get off drugs. Now, with the latest study by researchers at the B.C.
Centre for Excellence in HIV/AIDS,
published in the current issue of the
top-ranked substance abuse journal
Addiction, it’s time to put those objections to rest.
The study built on a previous
paper in the New England Journal of
Medicine, which found that regular
use of Insite and contact with Insite’s
addiction counsellor were each independently associated with entry into
residential detoxification programs.

[Psudo]

andyt wrote:

The US is a few degrees less socialist than the rest of the Western nations. It has all the the structures of a welfare state except universal healthcare, and that hasn't worked out too well for it.

That only make sense if history stops 4 years ago. The decades and centuries before that tell a different story. And regardless of what history would prove if might made right, might does not make right.

andyt wrote:

I said advanced, you changed it to power - how come?

If there are multiple cultures and one advances faster than it's neighbors, the resulting balance of power favors the fastest advancement nation. If you meant technological advancement, the USA has had the most advanced technology in the world for the majority of the past century. What definition of "advanced" should I have used?

andyt claims the Vancouver Sun wrote:

the New England Journal of Medicine [...] found that regular use of Insite and contact with Insite’s addiction counsellor were each independently associated with entry into residential detoxification programs.

The actual Journal article wrote:

an average of at least weekly use of the supervised injecting facility and any contact with the facility's addictions counselor were both independently associated with more rapid entry into a detoxification program

Insite's own statistics say that the average visitor used Insite's injection facility an average of 17-18 times in 2009. The NEJM article found a correlation between weekly use and earlier detox treatment; that would mean about 26 visits a quarter, seemingly much more often than is typical. The way Insite is typically used and the use correlated with detox don't appear to match often. Also:

The same article wrote:

Because our study design was observational, it is possible that other factors may explain the observed associations; for example, greater concern for one's health or a tendency to “comply” might lead to greater use of the supervised injecting facility, as well as more ready acceptance of detoxification.

In other words, the kind of druggie that comes to Insite weekly might be, as druggies go, unusually health conscious or unusually susceptible to social pressure to quit. I think the sponsorship program I proposed would focus Insite's services on that particular group it is most likely to help.

This article addresses the effects of the use of Insite on the patents themselves. It doesn't address how the presence of Insite and the associated reduction of the danger of addiction would motivate behavior in greater society. In doing so, it misses the political point the Sun claims the NEJM article discredits. If Insite makes addiction less harmful (and we agree that it does), then there's less reason to avoid chemical experimentation. Perhaps more people will become druggies and and need help. Less (not zero) harm applied to more people is not a clear improvement.

The Addiction Journal article the Sun cites is here. It notes the article's conclusions generally, but withholds specifics. It appears to only address patient benefits, not societal effects.

If Insite's only effect is to help the few, it should continue to function as it does. If it hurts the many to help the few (as I think it does), it should not continue in it's present state. Your sources do not address that question.