Tag Archives: Insite

Harm Reduction

Last week’s column in The StarPhoenix was an interesting one for me.  I wrote on the absurd decision of Alberta Health Services to stop giving out crack pipes to addicts while still giving out needles and in the process, came out strongly for harm reduction for a variety of theological reasons.

It was the harshest reaction to anything I have ever written anywhere.  People who I thought were friends were angry that I would write something like that and some questioned my orthodoxy.  An editor asked if it was like a kick to the shins and I said, “higher than that”.  Some mentioned how disappointed my mother and grandparents would be in the article (it wouldn’t be the first time something I wrote or did would fall into that category).   It was not a pleasant couple of days.  The argument that everyone used was that I was compromising and I was on a slippery slope.  Neither argument I found particularly compelling.

I have long been a fan of Meera Bai and the advocacy work she has done with Insite and her and I chatted on Twitter about being a Christian who believes in harm reduction.   On Monday it didn’t feel like there are many of us out there but as the week went on I got a lot of email telling me that they were at the same place as I was.  I realized that the divide wasn’t theological, it was between those who were on the front lines and those that who watched from behind their pulpit.  The more you interact and spend time with people on the street, the more places like Insite and harm reduction programs make sense.  As my good friend Scott Williams said to me, “If you think about it, harm reduction makes sense”.  I did and he was right.

I don’t normally hide behind the work of others but if you have a chance to read Meera Bai and John Stackhouse’s piece from last year in Christian Week, make sure you do.  A bunch of people sent me the link as encouragement.  I had read it when it came out but I appreciated not being alone.

Of course not everyone was angry.  I had a lot of discussion with officers and staff in the Salvation Army about harm reduction.  While I was in Chicago and Mississauga at their Social Services conference there a lot of respectful discussions as people wrestled with both the theology and practice of harm reduction.  It’s not an easy discussion, especially when like me, they come from a holiness tradition.  Some disagreed with harm reduction as a viable strategy.  Others had implementation questions (don’t we all).  Some wanted to talk the politics of harm reduction.

After being scolded in email, on the phone and in person, keeping an addict safe and alive still means an awful lot to me.  If it means that I make some compromises, I’m okay with that.  As for the slippery slope, I’ll wear cleats if it means them and I can hang in there a little longer.

Looking at harm reduction from a Christian perspective

So Calgary has stopped giving out free crack pipes as part of it’s harm reduction strategy.

Free crack pipeSince 2008, Alberta Health Services had been giving out crack-pipe kits as part of the Safeworks program, an effort to reduce transmittable diseases. The kits contained a glass pipe, mouthpiece and cleaning tool and were handed out in an AHS van.

More than 14,500 crack pipes were given out as of June 2011.

However, AHS has discontinued the Safeworks crack-pipe program as of Tuesday, citing the “potential for a legal challenge with respect to distribution.”

Tim Richter, Calgary Homeless Foundation CEO, said the program was an effective first step in engaging hardcore, street-involved crack addicts.

“We’re disappointed the program has been cancelled in the fashion it was,” Richter said. “Harm reduction and giving these crack pipes out was good, smart public health.

“It seems like a knee-jerk reaction on fairly simplistic moralistic ground.”

Some groups, including the Calgary Police Association, recently expressed concerns with the Safeworks program prior to its cancellation. CPA president John Dooks said it set a dangerous precedent.

“It’s implying you can use elicit drugs or unlawful drugs in a safe manner,” Dooks said. “The message should be there is no safe way to use drugs,”

I grew up and still am an evangelical Christian.  My grandmother was president of the Women’s Christian Temperance Union in Saskatchewan and I work for the Salvation Army which coined the phrase “demon rum”.  Being against harm reduction and all for abstinence is in my DNA.   I hate what the drugs do to people.  I see it every day but for that very reason, I am for harm reduction.  Here’s why.  By the virtue that people are coming for free crack pipes, they are doing two things.  Realizing that things are out of control and putting themselves in contact with the very people that can help them.  That’s why Insite works.  Insite isn’t for just any heroin addict.  It’s for the addicts that realize that they need help and can’t continue on the path that they are on.  Insite isn’t a destination, it’s the start of the journey.  The same is with grabbing a crack pipe from a street worker, they are admitting that something is wrong and taking a small step in the right direction.

In Saskatoon there is still some debate about needle distribution, a debate I can’t understand, even from a Christian perspective.  You have drug users using dirty needles, passing them around, getting high.  Statistics tell us that they are at a very high risk of contracting HIV or Hep C, both are costly diseases to fight and we know many users don’t fight it.  As a friend who runs another agency once told me, up to half of our mutual clients have untreated HIV/Aids on any given night.  The more I think about it, the more I agree with her.  As a Christian who wants the best for them, by taking the needles/crack pipes away, we are just complicating things.  I am increasing the risk of a disease that will hinder them rest of their lives or shorten it drastically.  A lack of harm reduction options increases healthcare costs in addition to lost potential due to a shortness of life or a diminished capacity for life.  

The main reason to do so doesn’t seem to be a legal reason or even a moralistic one, it seems to be driven out of societies dislike and discomfort with addicts and their lifestyles and a desire to punish them.  If I can nuance Tim Richter’s stance, this isn’t about a moral stand, it’s a puritan stand, one that says that people that do wrong must be punished.

In my years of working at the Salvation Army, I have known one guy that enjoyed being an addict.  The rest hate it and want out but can’t do it yet.  On my walks home I run into a client who for years was an ass to deal with.  Was always angry at me, always yelling, and threatening.  One night he walked in and was clean of the drugs and was quite a nice guy.  Entirely different.  Part of his path out his hell was harm reduction.  He’s been clean (and struggling) ever since then.  He rents a place not far from me and is scraping out a legit existence doing a variety of jobs.  He stops by to chat when he sees that Wendy and I are around and stops by Wendy’s work to say hello to her.  Every time I see him he is always telling me that he is amazed that his drugs didn’t destroy his relationship with the Salvation Army and myself and goes on to say over and over again, how they destroyed almost everything else in his life.  His story isn’t unique.  I could insert in a variety of names and contexts into that story and the pain is always the same. 

When we look at drugs users, the explanation is that it is either a personal choice or they have a low genetic tolerance towards it (in describing Aboriginal Drug Abuse).  Both of these answers have the same underlying principle, it’s not my fault or responsibility.  One thing we overlook is the societal aspect of drug and alcohol abuse.  Drug and alcohol abuse on reserves was not a problem until the Residential Schools opened (The damage was done to those taken and those left behind.  How would you handle it if the RCMP took your children a part of a government policy.  I know I would be seriously messed up if I lost Ollie and Mark).  Now I do meet some men and women that came from extremely stable households who for whatever reason decided to self destruct with drugs as a personal lifestyle choice but for the most part the drug use is a result of escaping horrible family situations, mental health issues and is a part of concurrent disorders.  In other words the kind of individuals that we as a society have an obligation to help the most.  For decades Canada has had a social safety net for those that need this kind of help.  It has generally come in the form of healthcare or Social Assistance but as the drugs have become more potent and addictive, the solutions are more complicated as well.  Harm reduction works.  It’s not about the pipe, it’s about the pathway out the personal hell they are living in.  Alberta Health was wrong to back down and all of Albertans will pay the costs.  It’s my Christian faith that calls out for harm reduction strategies, it’s fear and a lack of grace that fights against them.

Notes:

1. My grandmother would be totally opposed to EVERYTHING that I wrote in this post.

2. I believe the phrase demon rum should be used more often than it is.  I try to use it as much as I can at work but to be honest, no one drinks rum anymore and it seems awfully judgemental to say about anything else.

My vote

Mount Lougheed I became a Conservative in 1980.  I was six years old and I wandered in where my parents and friends were watching Pierre Trudeau defeat Joe Clark in the general election.  I asked what happened and I was told that a bad man had taken power and a good man had lost. Oh did I mention we were living in Alberta at the time.  Soon after that the National Energy Policy was enacted and according to my teachers, Peter Lougheed not only saved Canada from the rising tide of socialism sweeping across Canada but fought off the villains from Kryptonite as well.  I actually remember watching a documentary about Peter Lougheed climbing Mount Lougheed.  It was riveting.

When we moved to Saskatchewan, Grant Devine was in power and I got involved in Conservative campaigns when I was 12.  I even ran for the Bill Boyd lead Progressive Conservatives in 1995 (got my clock cleaned).  I left my partisan ways behind me, became a pastor and became officially non-partisan.  While we no longer featured a lawn sign in our front yard, I still voted Progressive Conservative and donated a little money when we could afford it.  I bought a membership to vote for Joe Clark during his comeback and even had a Carol Skelton lawn sign in 2004.

During that time, my own political worldview had changed.  During the 2003 campaign, Eric Cline knocked on my door and we had an engaging discussion about deficits, the complexity of the U.S. economy, and his residency in the riding.  As he left I promised I would vote for him, the first time I have ever voted for an NDP candidate.

As I approached this election, I realized I was truly undecided.  I want to like Stephen Harper.  He wears sweater vests, he plays the piano, knows hockey, and he’s funny when Rick Mercer drops by.

I trust him on the big things like the economy but the things that bothered me started to add up. 

  • resampled_big_20110326-Campaign-Gallery02-11Bev Oda should have just been fired.
  • Centralization of power in the PMO and the constant neutering of the cabinet ministers (so much for Team Harper, there is no team, it’s Steve).  Dimitri Soudas steps to the microphone more frequently than most ministers which asks the question, what the ministers other than Jason Kenney (courting minorities), Jim Flaherty (finance), John Baird (getting angry at people), and Tony Clement (tweeting it live as it happens) doing?
  • He’s a tactician but I want a visionary.  I don’t get any indication that Harper has a big picture or dream for Canada.  He’s a competent manager and an excellent political thinker but I don’t see a lot of vision there.
  • Harper was just found in contempt of Parliament because he would not tell Canadians how much things cost.  Is this not why a Parliament is so important, to hold the government responsible.  Rewarding that seems wrong to me.  I know bringing down the government on that was a bit of a political game but the Speaker’s ruling was not.  It bothers me and shows a pattern of distrust for democracy that goes back to Harper’s Reform Party days.
  • The idelogical war against Insite.  As this excellent editorial in The StarPhoenix points outConservative Leader Stephen Harper has promised that within 100 days of achieving a majority mandate he would present Parliament with an omnibus crime bill that would in effect revert Canada’s legal and health systems to 19th-century standards.
  • I hate the level of income tax I pay as much as the next person but we need taxes.  Taxes aren’t evil, they are a part of being a community.  We need to come together to share the costs.  The right’s approach to taxes is that they are a burden on society and I despise that language.  By coming together as a country, we can do a lot more than I can do as an individual and that costs money.  At the same time, if you are going to bash taxes, stop spending our money like an idiot.  Chretien knew this.  G8/G20 summits don’t need fake lakes, nor do they need the kind of costs that you spent.  As PostMedia News pointed out, So the G20 summit, in Toronto, ended up costing $679 million. About $574.6 million was spent on security. Canada shelled out a lot more, however, than other countries that have hosted similar summits. The 2009 G20 summit, for example, set the United Kingdom back $20 million, with another $28.6 million spent on security, according to research out of the University of Toronto. In a July 2010 report, the U of T researchers say that between $129 million and $200 million was spent on Canada’s 2002 G8 summit in Kananaskis, Alta.
  • Where were the Conservative MPs during the potash debate?  Prorogued?  Held captive?  Away from the newspapers, telephones, email, and all other forms of communication?  Thank goodness Brad Wall or Dwain Lingenfelter didn’t waste anytime lobbying them and instead went to people that make decisions because they contributed nothing to the debate.

It isn’t just Harper’s performance as leader that I struggle with, I have some problems with Kelly Block as a local MP.  See part of me is spoiled by some great local representation.  A couple of years ago Wendy emailed Darren Hill about an abandoned lot and within minutes Hill and the fire department were both looking at it.  Over the next couple of days, Wendy was sent and forwarded a deluge of emails while the problem was resolved.  I was impressed and we both became avid supporters of Darren Hill.  In some ways if he was running in Saskatoon Rosetown Bigger, it wouldn’t even be close who we would be voting for.

Cam Broten replaced Eric Cline and has been a great MLA and local representative.  I think he was the first Saskatchewan politician on Twitter and alongside Pat Atkinson should be the model of how to use social media as a politician.  Of Twitter doesn’t make Cam a great MLA, he’s approachable, helpful, and fun to talk to.  

In my previous dealings with Carol Skelton, despite being in cabinet, she personally answered my emails and invited further conversation and comment.  I really appreciated that about her.  She also would periodically stop in and comment or email about something on Wendy’s or mine blog which was nice.  While she had constituency staff, I never dealt with them and always with Skelton, even if it was on minor issues.

A little over two years ago, a friend had a major issue that needed an MP to help with.  She emailed Kelly Block and was emailed promptly back the Conservative talking points on the subject by a staffer.  The staffer didn’t even acknowledge the situation.  I understand MPs can be busy but it was when government was prorogued and even if wasn’t, what else is there for a backbench MP to do than reply to constituent concerns.  At the same time, some of the Saskatchewan Party and NDP MLA’s were contacted.  Every MLA but one responded personally immediately and promised to work on the issue, even though it was a federal one.  The one MLA who did not respond immediately was travelling and was in an area where there was no cell phone coverage.  Once he was back in touch, he got involved as well.

As I watched this and read the responses, you had some MLAs working their butts off on the subject and then you MPs who had nothings else to do other than work on constituency concerns, having their staff send out talking points.  I realized then that something was wrong.  It happened on a couple more occasions where an inquiry into Block’s office were met with talking points from an staffers.

Speaking of staffers, it’s hasn’t been a strength either.  In 2010 it was Kelly Block’s Ottawa aide, Russell Ullyatt who leaked some confidential memos to lobbying groups in a huge breach of confidentiality (and stupidity) and was running a direct mail company out of her Ottawa office.  He was no stranger to controversy but Block defended him with this,

“I certainly didn’t Google Russell Ullyatt,” Ms. Block said, adding she checked all his references before giving him a job.

Speaking of jobs, there was rumors that Ulyatt was running a printing company out of Block’s office.

Liberal MP Yasmin Ratansi told reporters later the board of internal economy — the secretive, all-party committee that oversees the operation of the House of Commons, including MPs’ offices — is also investigating suspicions that Ullyatt was actually running a private political printing and mailing business out of Block’s office.

Joe Preston, the Tory chair of the procedural committee, appeared to suggest the same, although Marcel Proulx, the Liberal member of the internal economy board, refused to confirm the investigation.

Opposition MPs say they’ve seen expensive printing, paper-folding and envelope-stuffing equipment delivered to Block’s office. They’ve also seen huge stocks of brochures sitting in the hall outside her office.

A charge he denied.

Ullyatt told reporters on his way out of the committee that he operates his printing company out of his garage.

“I can’t even park my car in my garage because it’s chock full of equipment so, no, I do not operate a company out of a member of Parliament’s office,” he said.

Sadly the Conservative members of the committee would not let questions about the business be asked.

The Conservatives forcefully objected when opposition MPs tried to steer questions to the subject of Mr. Ullyatt’s private printing company, which has boasted of sending more than five million pieces of mail in the past two years as “Canada’s only completely political mail provider.”

New Democrat Thomas Mulcair, who has said he’s seen a “very elaborate printing machine” and pallets of boxes outside Ms. Block’s office, tried to ask why the Saskatchewan MP would need these materials. But Joe Preston, the Conservative chairman of the committee, said the questions were irrelevant to the leak of the budget report.

Parliamentary rules do not allow MPs’ offices to be used for activities that are clearly of a private interest, and a secretive all-party Commons body called the Board of Internal Economy is investigating whether Mr. Ullyatt was running a business out of Ms. Block’s office.

Ms. Block cut short her testimony to MPs on Thursday, saying she had “other commitments.”

She left after one hour, refusing to stay for a scheduled second hour of hearings and declining to answer any questions from journalists as she departed. Fellow Conservatives defended Ms. Block, noting that as an MP she is not legally required to appear before committees at all.

Speaking of mail outs, for the last couple of years we have been inundated full of Tory caucus prepared mail outs warning us of scary coalitions, sex offenders getting out of jail early, and other bad and evil things that Liberals and the Bloc does.  Most ignore the NDP which is kind of ironic because that is her biggest challenger in the riding.  Perhaps she may have been better served hiring Russell Ullyatt’s firm to do her constituency mail outs.

As I looked over them over the past year I realized that she wasn’t representing me in Ottawa, she was busy trying to sell the Conservative agenda back here.  Maybe that is why she had to outsource her email.

So what are my options?

The Liberals are dead in Saskatchewan.  No offense to Darren Hill who is a great city councillor but the Liberal brand has been dead in Saskatchewan since the early 90s and outside of Ralph Goodale, there is no Liberal presence in the province.  Early on in the campaign I couldn’t even find active Liberal riding associations and the leader of the Saskatchewan Liberal Party goes offline for extended periods of time and only has 314 followers on Twitter and most of those are other politicians.  The Liberal Party in Saskatchewan doesn’t have a ground game and their fan base rivals that of the Phoenix Coyotes.  While it may or may not have made a difference, their campaign platform left me thinking, “this is it?”  You have Michael Ignatieff as leader, Bob Rae in the front benches, you have that thinkers conference and this is the best you can do?  A grant for college?  Yes I did like the Green Renovation Credit, it can hardly be called innovative and there isn’t what you would call much in the area of energy policy and while the Freshwater Strategy looked exciting, there really is nothing there.

Plus, as Chantal Hebert writes, they did this to themselves.

Liberal strategists did not factor a potentially surging NDP into their calculations because they presumed the Liberals were playing against the Conservatives in the major leagues and the NDP was not.

They approached the election with the mindset of a governing party but the physique of a third party.

When they plunged headlong in a spring campaign, the Liberals had been mired in the mid-twenties in the polls for an unprecedented length of time; they were at a historical low behind the NDP in Quebec and exhibiting little signs of life in the Prairies.

A base can only erode for so long — as the Liberal base has for decades — before it starts to disintegrate.

On a personal level, I am really disappointed in Michael Ignatieff.  I get disappointed when I hear the Liberals scream for a bailout package to help hurting Canadians, complain it isn’t enough and then point out the size of the deficit.  Tell me again how that works?  Or what about the stance against the CF-35s.  Now there is a debate that needs to be had over that programme and you would assume given Ignatieff’s background, he would see that?  Are 60 F-35s enough?  Can it compete against the new MiGs, Flanker H, PAK FA, and Chinese planes that are being designed for export (apparently not) and should Canada be purchasing air superiority planes or attack aircraft?  Should be looking at an interim purchase like Australia is until the F-35s can prove themselves?  Instead Ignatieff says, “Let’s have an open competition.”  Makes sense until you realize it would be between the F-35 and the equally over priced Eurofighter Typhoon and the F-35.  There are no other options unless we want to purchase Russian and that will go over well at the NATO meetings.

It was the NDP who made the most amount of sense on this issue.

Layton indicated that the country has not had a defence white paper since 1994 and that a new white paper needs to be developed setting Canadian defence priorities before decisions on new fighters can be made.

Jane Taber and John Ibbitson quote a “senior Liberal” complaining about Ignatieff’s performance on the campaign trail.

…for example, that while the party’s health-care ads were being run on television, Mr. Ignatieff was talking about “rising up” and calling the Tories anti-democratic. He was repeatedly blown off message and seemed to come up with new themes almost daily, from concern-for-democracy to health care to wasted spending on the G8 and G20 summits. This confused voters.

layton_official My other option is to vote NDP federally.  Whoa.  I need to think this through.  There is a difference in my mind between the Saskatchewan NDP and the federal NDP.  Since NDP in Saskatchewan often get elected, they tend to pragmatists.  Sure there is an ideology there but if the ideology doesn’t fit the problem, the NDP can adapt and change.  They also don’t do things like promise $70 billion in new spending.  They also think before speaking about credit card interest caps that would a) make it harder for the poor to get credit cards and b) encourage more consumer debt.  Brilliant.  What’s next?  Variable rate mortgages for the masses?

What’s the cause of all of this? 

I think part of it has been three consecutive minority governments.  It turns every day into an epic struggle to either defeat or survive the next confidence vote.  In many ways the campaigning non-stop since 2005 which keeps party from seeking grassroots renewal and input.  It also puts all three parties into a crisis mode where all policies and ideas have to work RIGHT NOW because one misstep could either give Stephen Harper a majority or alternatively cause a government to fall.  Once you get into that mode, it’s hard to get out of it.  The additional risk is that the next loss could end the career of Ignatieff (done like dinner), Harper (likely done) or Layton (we have a winner).  Of course if a majority government is elected, the other parties can enter into a renewal process.

So I am left to choose between three tired leaders who are promising the status quo, nothing interesting, or a World Bank/IMF bailout and intervention if elected.  What a choice to make.

4o5ke In the end, I am going to lend my vote to Nettie Wiebe.  I don’t think Jack Layton will win power and in the end the seat is probably already going to the NDP anyways.  I do value strong MPs and I think that Wiebe will be that voice for the riding.  I don’t agree with Wiebe and everything but she has run three campaigns now with a lot of integrity and that is worth something.  My hope is that by actually seeing the possibility of power for the first time, Layton and the NDP brain trust will rethink the next campaign in 2013 and put together an economic plan that is fiscally responsible.  Saskatchewan and Manitoba NDP do it all of the time. 

I guess the NDP have a choice.  Do this interpret this as a sign that Canadians want them to spend us into bankruptcy or is it a sign that they are truly frustrated with the Conservatives, Bloc, and Liberals and want to see what they will do as a government in waiting.  At the same time it may send a message to the Conservatives and the now third place Liberals that a different approach is needed.  Plus it may be fun to see Bob Rae go head to head with Jack Layton in the next campaign.

It’s not a decision I am comfortable with but right now I don’t see another realistic option. 

Why I Help Addicts Shoot Up

Great article in Christian Week about Insite

Insite Something about seeing people at their lowest and most desperate, half-clothed from turning tricks for drugs while hating themselves for it, opens into a profound level of intimacy. I am blessed to enter the darkest place of people whose sins are far more public than those of the rest of us. Constant humiliation makes the people I work with especially vulnerable, and vulnerable in almost every way: to violence, to exploitation, to false hope and finally to despair. When allowed into these dark places, it is my privilege, and that of all InSite staff, to communicate worth and love instead of judgment and scorn.

The day nurse asks me to keep an eye out for a specific participant—a regular who comes in several times a day. She hadn’t been seen yet. Later that night, the woman finally comes in, and she’s beaming. "I went to see my daughter today! And I didn’t use all day! F—, soon I’m gonna get off this s—!" We break out in applause and cheers, celebrating her triumphs with her—as she mixes her drugs to take in a few minutes in our facility. Other participants in the room are excited as well; two of them come over to hug her.

Another regular later chats with me in the treatment room as I dress his abscess, trying not to cringe away from the overwhelming odour he emanates. "It would have been my anniversary with my wife today, if she hadn’t gone missing. We’ve both been down and out, but she took care of me out here. Now, I got nobody to talk to. This is the first human touch I’ve had today." I look up, startled. I am wearing gloves, holding my breath, cleaning his sores with a 10-inch sterile Q-tip. Even this, my deficient attempt to heal, is taken as love by a man desperate for human connection. I am ashamed.

I finish dressing the wound, clean up, remove my gloves and give him a hug. I hop up on the treatment bench next to him and we sit together and talk for another 15 minutes: about life, love and faith. He says goodbye, and then asks for a referral to an exit program. I give it to him. He knows the referral is merely one point along our journey together, and that I will listen to his story whether he goes to the program or not. As a Christian, I know that his life is part of God’s real story of redemption. InSite is one of the few places where I get to hear it openly spoken, with trust, without judgment.

Having witnessed three generations of the same family shoot up in the same room, I have come to understand that injection drug use is far from being the result of one bad decision. It is the outcome of a complex of systemic, familial and individual influences that must not be oversimplified to "It’s their fault. They should just quit and get a job."

Update: My friend Scott has a great write up of his experiences here.