Evidence, Heroin, and Ideology Addicts

This week Sun Media pundit Brian Lilley wrote an opinion piece titled: 'Tax dollars for Heroin".  

Harm reduction models of addiction treatment are nothing new.  Typically harm reduction models for opiate addiction have focused on methadone treatments.  There has however been some support recently to expand harm reduction treatment to include the limited use of prescription heroin for patients who are at the end of other treatment options and where methadone treatment has not been effective.

Leaving aside the spin put on the issue by Lilley heroin treatment is not about tax dollars but about evidence based policy.

In the recent Speech From the Throne the Conservatives stated:

"Canadian families expect safe and healthy communities in which to raise their children. [...] Our Government will [...] Close loopholes that allow for the feeding of addiction under the guise of treatment."

The question is: does closing loopholes that would allow heroin based treatment make Canadians healthier and safer?

As a excellent starting point Arron Wherry has written a fantastic series of articles (here, here, here) on the issues.  As Wherry points out Health Minister Rona Ambrose told the CBC:

There is no evidence at this point that heroin—giving heroin to heroin addicts—is any way an effective treatment...

Wherry goes on to detail some of the evidence that supports heroin treatment,  including a lengthy report by the European Monitoring Centre for Drugs and Drug Addiction.

Is our Health Minister not aware of this research or is she ignoring it?  Quite frankly I am not sure which is worse?  Either way Ambrose's views are entirely consistent with the Conservatives' abandonment of any pretense of evidence based policy decisions.

In his piece Lilley quotes Justin Trudeau as saying, “I respect science, I respect scientists who have done studies".  Lilley goes on to say:

"Except not all scientists, not all doctors agree with this sort of study. Trudeau and Davies don’t just want to portray those who oppose giving heroin to addicts as anti-science, which we are not."

I am not sure exactly what studies Lilley is referring to (I assume possibly this opinion) but he is quite right - there is rarely a consensus by all experts on any issue. 

The real issue is not that there can be disagreement amongst experts but that the Government must honestly evaluate all evidence before making decisions, something Ambrose has utterly failed to do. 

The same experts who disagree with heroin treatment do seem to support other harm reductions methods such as methadone treatment.   Lilley makes it clear that although he supports addiction treatment (which is commendable), he does not support harm reduction:

"I use my own money to support drug treatment centres that don’t believe in the harm reduction method but still have great success in helping people with strong addictions and criminal backgrounds to turn their lives around. "

It is well and good for individuals to discount evidence when allocating their personal funds. It is another matter when elected officials and policy makers ignore evidence.  

Trudeau is not as Lilley suggest using science to 'whitewash' his ideology.  In fact the opposite seems to be true.  The Conservatives continue to ignore evidence to justify their ideological position. 

Lilley is correct that when the Government ignores evidence courts can often become involved in litigation about policy issues.  Perhaps if the government took its obligations to Canadian's seriously and actually considered all evidence (not just the evidence that supports their positions) we would hear less outrage about interventionist courts.   

As Lilley says: Don’t say you weren’t warned.