Harm Reduction Policy, Political Economy, and Insite
DOI:
https://doi.org/10.25071/1929-8404.34703Abstract
Abstract: This paper seeks to answer why Insite, Vancouver's safe injection facility, continues to be a controversial issue, given that empirical investigations of the facility have demonstrated that the site improves health and saves health care dollars. As Insite represented a shift to harm reduction policy, from historically dominant drug control policy, it has drawn opposition from local, national and international players. Using a political economy framework, this paper looks at the population around Insite, examining who the clients are and whether the facility is beneficial to them. The Downtown Eastside of Vancouver, where Insite is located, is known to be one of the poorest neighbourhoods in Canada, and as such the population is extremely marginalized (The Globe and Mail, 2008). This paper argues that the attempts by the federal Conservative Party to shut down Insite are based on ideology rather than the effectiveness of the facility. Using the Gramscian concept of hegemony, this paper argues that the federal Conservative Party attempted to use its hegemonic dominance to close down Insite. This paper will also briefly discuss the legal history of Insite, and the empirical literature, briefly summarizing the evidence researchers have found.
References
Amirkhanian, Y, A., Kelly, J, A., & McAuliffe, T, L. (2005). Identifying, recruiting, and assessing social networks at high risk for HIV/AIDS: Methodology, practice, and a case study in St Peterburg, Russia. AIDS Care, 17(1), 58-75.
Andresen, M, A., & Boyd, N. (2010). A cost-benefit and cost-effectiveness analysis of Vancouver's supervised injection facility. International Journal of Drug Policy, 21, 70- 76.
Ball, A, L. (2007). HIV, injecting drug use and harm reduction: A public health response. Addiction, 102, 684-690.
Bayoumi, A, M., & Zaric, G, S. (2008). The cost-effectiveness of Vancouver's supervised injection facility. Canadian Medical Association Journal 179(11), 1143-1151.
Brodie, J., & Rein S. (2009). Culture as a (contentious) cultural concept. In Critical Concepts: An Introduction to Politics (pp.197-211). Toronto: Pearson Prentice Hall.
Buxton, J. (2005). Vancouver site report for the Canadian Community Epidemiology Network on Drug Use (CCENDU). Accessed October 4/2011 at http://vancouver.ca/fourpillars/pdf/report_vancouver_2005.pdf
Canadian Broadcasting Corporation. (2009). Timeline: Insite. Accessed October 9/2011 at http://www.cbc.ca/fifth/2008-2009/staying_alive/timeline.html
Collier, R. (2009). Medical journal or marketing device? Canadian Medical Association Journal, 181(5), E83-E84.
Fast, D., Shoveller, J., Shannon, K., & Kerr, T. (2010). Safety and danger in downtown Vancouver: Understandings of place among young people entrenched in an urban drug scene. Health & Place, 16, 51-60.
Fontana, B. (2006). State and society: The concept of hegemony in Gramsci. In M. Haugaard & H. Lentner (Eds.) Hegemony and Power: Consensus and Coercion in Contemporary Politics (pp.23-44). Oxford: Lexington Books.
Kerr, T., & Wood, E. (2008). Misrepresentation of science undermines HIV prevention. Canadian Medical Association Journal, 178(7), 964.
Johnston, L. (2002). Towards consensus: Market society. In Ideologies: An Analytical & Contextual Approach (pp.149-172). Peterborough: Broadview Press
Joseph, J. (2002). Two types of hegemony: Structural hegemony and hegemonic projects. In Hegemony: A Realist Analysis (pp.125-145). New York: Routledge.
Mangham, C. (2007). A critique of Canada's Insite injection site and its parent philosophy: Implications and Recommendations for Policy Planning. The Journal of Global Drug Policy and Practice, 1(2).
Petrar, S., Kerr, T., Tyndall, M, W., Zhang, R., Montaner, J, S., & Wood, E. (2007). Injection drug users' perceptions regarding use of a medically supervised safer injecting facility. Addictive Behaviors, 32, 1088-1093.
Solomon, S. (2007). "Doctors, get tough on drugs": Tony Clement. National Review of Medicine, 4(1).5
Supreme Court of Canada. (2011). Citation. Accessed October 9/2011 at http://scc.lexum.org/en/2011/2011scc44/2011scc44.html
The Globe and Mail. (2008). Canada's poorest postal code in for an Olympic clean-up? Accessed October 13/2011 at http://www.theglobeandmail.com/news/national/canadas-poorest- postal-code-in-for-an- olympic-clean-up/article704374/page1/
Tyndall, M, W., Kerr, T., Zhang, R., King, E., Montaner, J, G., & Wood, E. (2006). Attendance, drug use patterns, and referrals made from North America's first supervised injection facility. Drug and Alcohol Dependence, 83, 193-198.
Weatherburn, D., Jones, C., Freeman, K., & Makkai, T. (2003). Supply control and harm reduction: Lessons from the Australian heroin 'drought.' Addiction, 98, 83-91.
Wodak, A., & McLeod, L. (2008). The role of harm reduction in controlling HIV among injecting drug users. AIDS, 22(suppl 2), S81-S92.
Wood, E., Kerr, T., Lloyd-Smith, E., Buchner, C., Marsh, D, C,. Montaner, J, S., & Tyndall, M, W. (2004). Methodology for evaluating Insite: Canada's first medically supervised safer injection facility for injection drug users. Harm Reduction Journal, 1(9).
Wood, E., Kerr, T., Montaner, J, S., Strathdee, S, A., Wodak, A., Hankins, C, A., Schechter, M, T., & Tyndall, M, W. (2004). Rationale for evaluating North America's first medically supervised safe-injecting facility. The Lancet Infectious Diseases, 4, 301-306.
Wood, E., Montaner, J, S., Li, K., Zhang, R., Barney, L., Strathdee, S, A., Tyndall, M, W., & Kerr, T. (2008). Burden of HIV infection among Aboriginal injection drug users in Vancouver, British Columbia. American Journal of Public Health, 98(3), 515-519.
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