Thursday, May 29, 2008

The Harm Reduction Haters' Club.....Is That All They've Got?


I'll have more to say on it when I have time (on the road in a science geek bunker at the moment*)....

Kady O'Malley live blogged the InSite hearings in Ottawa today.

According to her report, after a slightly suspect 'no-show', the only thing the Haters' Club really had going for it today was a very fine fellow named Colin Mangham:

".......there is still one anti-InSite witness willing to testify: Dr. Colin Mangham, who huffs and puffs over the “bad science” and sloppy journalism behind support for the program. He also seems to suggest that he too has been threatened, but is nonetheless willing and able to speak out.

At one point, he mentions in an offhand way that he’s a graduate of UBC, but his accent is glaringly American. Not that there’s anything wrong with that, of course.

“I’ve been called many names on this,” he says. “The intolerance just makes me sad.” He then goes into a rant about how people who support InSite, including some in this very room, are, in fact, part of a larger movement towards drug policy reform. He demands that “elected representatives” stop these “activists......"


Dr. Mangham?

Where have we heard that name before?

Oh, yes.....

Here it is, from my collaborative post with Cathie last fall titled 'The Ladder Of Science.....Has A Top And A Bottom", which I'm going to re-post in its entirety because it is important to point out the difference between rigourously peer-reviewed science and the exact opposite:


And the 'Journal Of Global Drug Policy And Practice' is definitely at the bottom of that ladder.

It appears to have little in the way of peer review. It's editorial boord is stacked with hardline 'war on drugs' types, many of whom appear to be living off the avails of Bush administration abstinence fantasy programs. It has 'published' exactly two issues the latest of which serves entirely to pushback (ie. bash) any and all programs that involve harm reduction.

Oh, yes, and just so you know, it is also funded by:

Grant No. 200-JL-FX-0128 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice.

That would be Alberto Gonzales' very fine apolitically political department of flack-hackery.

Why does this matter?

Cathie has the story.

Oh wow, this sure does look like a really big story from Canadian Press: New report suggests Vancouver's safe-injection site a failure. But folks, it's tripe. Overblown, inaccurate, poorly researched, ideological tripe. Canadian Press should be ashamed of themselves.
Here's the story:

A new study suggests a safe-drug-injection site in Vancouver that has been hailed by scientists as a success is really a failure.
The study, published Wednesday in the Journal of Global Drug Policy and Practice, says there are serious problems in the interpretation of findings about Insite - the first such facility in North America - which opened as a pilot project over three years ago.
. . . report author Colin Mangham, director of research with the Drug Prevention Network of Canada, refutes such claims, saying positive findings about Insite have been overstated while negative ones have been ignored.
"(The findings) give an impression the facility is successful, when in fact the research clearly shows a lack of program impact and success."
First, the study's author Colin Mangham has been publishing reports for years against "harm reduction" drug policies -- which, briefly, are policies which tolerate drug use rather than try to prevent it. The safe injection site is a prime example of just such a policy in action -- and therefore, in this man's opinion, it must be stopped. What's the harm? Well, the problem seems to be that the harm reduction "ideology" makes us "vulnerable to the drug legalization movement". Can't have that, I guess.
Second, the Journal of Global Drug Policy and Practice is an on-line journal which has published only two issues, with articles like "The Lure and the Loss of Harm Reduction in UK Drug Policy and Practice" and "Is it Harm Reduction Or Harm Continuation?"
Third, the Drug Prevention Network of Canada is a pretty small organization which takes a fairly conservative approach to social problems. On their website, they post articles with titles like "In defense of the drug war" and "Cannabis - A General Survey of it's (sic) harmful effects" .
Fourth, though Canadian Press acts like Mangham's article is a research study itself, it's not. It is actually a personal critique of ten research studies which Mangham says are biased, weak, overstated, misleading. Here's the list:

Wood E, Kerr T, Montaner JS, Strathdee SA, Wodak A, Hankins CA, et al. Rationale for evaluating North America’s first medically supervised safer injecting facility. Lancet 2004;4:301-6.
Wood E, Kerr T, Lloyd-Smith E, Buchner C, Marsh D, Montaner J, Tyndall M. Methodology for evaluating Insite: Canada’s first medically supervised safer injection facility for injection drug users. Harm Reduction Journal 2004; 1-5.
Wood E, Tyndall M, Li K, Lloyd-Smith E, Small W, Montaner J, Kerr T. Do supervised injecting facilities attract higher-risk injection drug users? American Journal of Preventative Medicine. 2005; 29: 126-130.
Wood, E., Tyndall, M., Qui Z., Zhang, R., Montaner J., & Kerr T, Service Uptake and Characteristics of Injection Drug Users Utilizing North America’s First Medically Supervised Safer Injecting Facility. American Journal of Public Health, 2005, 5, 770-73.
Kerr T, Stoltz J, Tyndall M, Li K, Zhang R, Montaner J, Wood E. Impact of a medically supervised safer injection facility on community drug use patterns: a before and after study. BMJ 2006; 332:220-222.
Wood E, Kerr T, Stoltz J, Quia Z, Zhanga R, Montanera SG, & Tyndall MW. Prevalence and correlates of hepatitis C infection among users of North America’s first medically supervised safer injection facility. Public Health (2005) 119, 1111–1115
Wood E, Tyndall M, Stoltz J, Small W, Lloyd-Smith E, Zhang R, Montaner J, Kerr T. Factors associated with syringe sharing among users of a medically supervised safer injecting facility. American Journal of Infectious Diseases 2005, 50-54.
Wood E, Tyndall MW, Lai C, Montaner JG, & Kerr T. Impact of a medically supervised safer injecting facility on drug dealing and other drug-related crime. Substance Abuse Treatment, Prevention, and Policy 2006, 1:13.
Wood E, Tyndall M, Stoltz J, Small W, Zhang R, O’Connell J, Montaner J, Kerr T. Safer injecting education for HIV prevention within a medically supervised safer injecting facility. International Journal of Drug Policy 2005; 281-284.
Kerr T, Tyndall M, Li K, Montaner J, Wood E. Safer injection facility use and syringe sharing in injection drug users. Lancet 2005; 366:316-8.
Wood E, Kerr T, Small W, Li K, Marsh D, Montaner J, et al. Changes in public order after the opening of a medically supervised safer injecting facility for illicit injection drug users. Canadian Medical Association Journal 2004; 171:731-4
Tyndall MW, Kerr T, Zhang R, King E, Montaner JG, Wood E. Attendance, drug use patterns, and referrals made from North America’s first supervised injection facility. Drug and Alcohol Dependence 83 (2006) 193–198.
Wood E et al. Attendance at Supervised Injecting Facilities and Use of Detoxification Services. New England Journal of Medicine, June 8, 2006.

Just thought I'd highlight four of the ten studies that were bashed by Abu Gonzo's propaganda arm.

Have a look at the journals they were published in......The Lancet.....The American Journal of Public Health.....The British Medical Journal......The New England Journal Of Medicine.

Those are all journals that actually have a real editoral board, rigorous and unbiased peer review (ie. not your friend who is also at the wingnut welfare trough down the hall), a track record of publishing actual research that can be repeated by others, and citation indexes which indicate that other researchers of some repute actually cite what you have published.

So how come the Canadian Press and all the other news outlets that so eagerly spun themselves into knots flinging this story into the whirlitzer didn't mention any of this?

Because they wanted the headline and because they are lazy - that's why.

And those two things, as Little Johnny Baird has demonstrated repeatedly over the last couple of weeks, are what the professional obfuscators count on.

It also demonstrates why it is so important for people to call them on it.

And Cathie did a very fine job of that.



The upshot?

I know a little bit about science.

And I also know at least a wee bit about rigour.

And no matter how you slice it, in my opinion at least, there is very little of either in "The Journal Of Global Drug Policy And Practice".


*And for the record, I'm actually on a peer reviewing mission at this very moment....