Talk:Supervised injection site/Archive 1

Untitled

I believe drug injection sites are not helping, they are promoting the illegal use of drugs. If the drugs were made legal, then the SIS's would make sense, but as it is, its simply hypocritical and illegal. There is the matter of harm reduction, however, i believe that harm could be reduced by making the drug legal, so it would not be so appealing and expensive, eliminating the underground market for drugs. It would save a lot of people time, money, and their lives if drugs were made legal and therefore less appealing.—Preceding unsigned comment added by 70.69.160.165 (talk • contribs) 16:46, May 1, 2006

I agree with the above, But in the meantime people need a safe, clean environment to be in. This adds to the plan of saving people time, money, and their lives. belive me I know. Vancouver—Preceding unsigned comment added by 199.175.65.31 (talk • contribs) 07:26, May 9, 2006

Remember, Wikipedia is a neutral encyclopedia. Any opinions should be of the general public or experts (preferably with citations). Therefore, this information cannot be included in the article.—Preceding unsigned comment added by 70.68.140.39 (talk • contribs) 22:01, June 2, 2006

It would be interesting to know the total amount the site is costing tax payers.—Preceding unsigned comment added by 64.180.217.100 (talk • contribs) 07:16, September 2, 2006

I would like to propose the changing of this site from "safe-injection site" to "supervised-injection site" to make it align with the terminology used by Insite: http://www.vch.ca/sis/ There is nothing "safe" about injecting heroin and the terminology regarding harm reduction should change to match this. Just because the media refers to them as "safe injection sites" does not mean it is correct. Canadianehme 19:52, 24 November 2006 (UTC)

Dead Link

The link to the Barrish article seems to lead to a broken site when I try to call it up using Firefox in Linux. Does it work for anyone else or should it be removed? KenWalker | Talk 20:23, 24 November 2006 (UTC)

It would be interesting to know the total amount of money the site is "saving" the taxpayer. Its got to be cheaper than health care by 911.—Preceding unsigned comment added by 70.66.19.20 (talk • contribs) 02:48, February 20, 2007

I believe this does make things more safe than doing it on the street. The fact that most drug overdoses are caused by the user not knowing the quality of the product assumes this. The SIS provides a more pure form of the heroin that is found on the street. I also believe that this should cut down on street deals which people are killed over, and robbery if it is not as costly as on the street. Needles are not shared in the safe injection sites either, which cuts down on the spread of sexually transmitted diseases, e.g Endocarditis, Group A Streptococcal Infections Hepatitis, Hepatitis A, Hepatitis B, Chronic Hepatitis B, Hepatitis C, Chronic Hepatitis C, Hepatitis D, HIV, AIDS, HTLV,HTLV-1,Invasive group A Streptococcal disease, Sexually Transmitted Diseases, Streptococcal Infections, Tropical Spastic Paraparesis, Tuberculosis. From my understanding of researching of these sites they keep other things safe, not just the users of heroin, but non drug using citizens as well. A person who has never done heroin in there life can have a sexual encounter with someone who contracted disease from using invegeous needles due to cost or supply of clean sterilized needles. What i wonder is if they give different dosages to different people according to body size, weight, tolerance etc.. —Preceding unsigned comment added by 68.192.41.242 (talk) 04:31, 20 April 2010 (UTC)

Merge of injecting room

The article on injecting rooms needs to be merged into this one. --151.201.24.17 (talk) —Preceding comment was added at 19:47, 8 May 2008 (UTC)

Hear Hear, I agree. Done. This is a better term for the concept, it encapsulates the aim of these sites better. Hope people are happy with my re-write of the injecting room article, I tried to reword it with my own understanding and references.--rakkar (talk) 14:49, 9 May 2008 (UTC)

Evidence & validity of Harm Minimisation as public health

Moved from Talk:Harm_reduction

I've just removed a large number of edits to the page. I've included below my specific reasons for each section, but in general it harks to wider debates about Harm Reduction. Wikipedia is not a battleground for this topic, but rather it should seek to portray each side as objectively as possible. I'm happy for the article to include the perspective Minphie wants to write, however it needs to have good references (as opposed to some of the bad ones pointed out below) and should avoid weasel words.

... Where Harm Reduction is used to alleviate the harms of illegal practices or behaviours, critics () of the approach cite concerns about its strategies sending a message of sanctioned acceptance of the very behaviours which the community, through its legislators, do not accept. (References?)

...

Critics of this intervention cite the high costs to any community providing heroin maintenance programs. For instance, the British heroin trial initiated in 2005 costs the British government £15,000 pounds per participant per annum. (Adam Baxter's article actually supports opiate treatment as having better financial outcomes for the community and psychosocial outcomes for the client. This article appears to have been deliberately misquoted by Minphie to say that heroin treatment is costing the community money when in fact the author says that prescription heroin has huge savings in the long run.)

The trial claims that the illicit heroin use of participants is reduced from £300 to £50 per week, that is from £15,600 acquisitive crime per year to £2,600 per year. Yet for the £15,000 investment, the community is still £2,000 worse off in terms of ongoing acquisitive crime.(This simplistic maths classes as original research. Academics spend months producing research to support claims like this, it's not verifiable to make assumptions like this.)

Alternatively, Sweden’s policy of compulsory rehabilitation of drug addicts has yielded the lowest illicit drug use levels in the developed world. (Firstly, on what page of this mammoth document is this fact drawn from? Secondly, Sweden is not opposed to harm reduction at all - http://www.ihra.net/Assets/1556/1/HarmReductionPoliciesandPractiveWorldwide5.pdf ) ... Critics of this harm reduction intervention reject the harm reductionists’ (What is a harm reductionist? Another weasel word) claims of ensuing lower rates of blood-born viruses on the grounds that there has never been a weight of scientific evidence which supports the claim. See Needle Exchange Programme for discussion of the evidence. (Needs to be referenced properly.)

... Critics of this intervention point to evaluations of safe injection sites.

For example, the 2003 evaluation of the Sydney Medically Supervised Injecting Centre[13] found:

○ that there was no evidence that the injecting room reduced the number of overdose deaths in the area (p. 60)

○ no improvement in ambulance overdose attendances in the area (p. 60)

○ no improvement in ambulance overdose attendance during hours the injecting room was open (p.60)

○ no improvement in overdose presentations at hospital emergency wards (p. 60)

○ no improvement re HIV infections (p. 71)

○ no improvement in Hep B infections (p. 72)

○ either worse or no improvement (depending on the suburb studied) in new Hep C notifications (p. 80)

○ discarded syringe counts on street reduced only in line with reductions in numbers handed out due to heroin drought (p. 123)

○ drug-related loitering and drug dealing worsened at the station entrance immediately opposite the centre (p. 147) (As for this section, I don't have the time to address each one, however the general consensus regarding the matter is that the first evaluation had methodological flaws which have been corrected in later evaluations. See Dr. Van Beek's book, Eye of the Needle [[1]] around page 85 for further info. Secondly, the centre has been running for seven years since that report came out and there is more evidence of the positive outcomes the centre achieves.)

An analysis of this evaluation by an epidemiologist, addiction medicine practitioner, and social researchers and practitioners found overdose levels in the MSIC 36 times higher than on the surrounding streets of Kings Cross, with clients averaging only one in every of their 35 injections in the room, evidencing low utilization rates in light of the ever-present risk of fatal overdose to each heroin user.[14] Testimony of ex-clients of the MSIC reported to the NSW Legislative Council[15] alleged that the extremely high overdose rates were due to clients experimenting with poly-drug cocktails and higher doses of heroin in the knowledge that staff were present to ensure their safety. (Hansard is a good source for references, however the section in question was a comment made by a former client. No analysis or research was included. There are many other comments from current and former clients who strongly support the centre however they are of no more value as references than my opinion or Minphie's)

The 2003 evaluation noted that, “In this study of the Sydney injecting room there were 9.2 heroin overdoses per 1000 heroin injections in the centre. This rate of overdose is higher than amongst heroin injectors generally. The injecting room clients seem to have been a high-risk group with a higher rate of heroin injections than others not using the injection room facilities. They were more often injecting on the streets and they appear to have taken greater risks and used more heroin whilst in the injecting room.[16] (Overdose does not equal death - the MSIC reports clinical overdoses which are very precisely assessed and recorded. Overdoses on the street are not. Also, see previous comment about the 2003 report.)

It is this injecting room effect of increasing the trade for local drug dealers that has been condemned by critics .

... --rakkar (talk) 13:41, 18 January 2010 (UTC)

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I am returning text vandalized by Rakkar on the grounds that there is no substance to his rationales for removing text. It is not enough to dream up some sort of fanciful rationale, not based in fact, as reason for removing carefully cited and factual information from Wikipedia.

1. Rakkar removes text because specific critics have not been named for a very general criticism of harm reduction. I point out that if a critique of a particular intervention is typed into Wikipedia that there is ipso facto 'critics' of the view. Thus the term 'critics' is accurate, not requiring further elucidation, where a valid criticism is entered into the text. Valid criticism is judged, of course, by the logic or evidence adduced. Therefore the paragraph "Where harm reduction . . . " is correct and needs no further citation. I could of course add some of the organisations, such as the many involved in the International Taskforce on Strategic Drug Policy, or the UN International Narcotics Control Board, that do make this critique, but it would be entirely superfluous to the argument.

2. Rakkar again appeals to unspecified 'critics', but because there is a criticism entered into the text 'critics' are in fact already validly implied.

Further Rakkar appeals to the private perspectives of a staff member in the program, Adam Baxter, wishing to promote his private views of cost effectiveness over the very clear mathematics that are related in newspaper articles elsewhere quoting John Strang, the leader of the project. It should be noted that until there is a peer-reviewed journal article on the outcomes (psycho-social or whatever else) on this project, we cannot take the private views of a staff member as guidance for Wikipedia. Presently, there is no journal article on outcomes, only Strang's financial comparisons in a media release.

3. It is not enough to remove a properly cited fact ie Sweden having the lowest drug use levels in the OECD, as found in the comparison figures of the UN World Drug Report (pages are given in the citiation). To remove this text, the onus is on Rakkar to disprove the UN World Drug Report data. And of course my statement is correct, so cannot be removed by whim or unfounded contentiousness.

4. See above on the use of word 'critics'. Again a clear and valid criticism is outlined, so there are ipso facto critics.

5. The term harm reductionist is an accurate title, used by the movement itself. Just as those who advance prohibition are called prohibitionists, with no concern about the labeling by its proponents, Rakkar's criticism of the term is unfounded. Of course, Rakkar is welcome to change the term to 'proponents of harm reduction' if he wishes, but to remove a whole paragraph is clearly vandalism.

6. Rakkar removes a section on needle exchange, in which the linked article on Wikipedia is very tightly and carefully referenced (at least for the critique part of the article). If Rakkar removes this section again I will take the right to reproduce ALL the needle exchange references on that other WIKIPEDIA page, making it a much more cumbersome article, but all the more damning of the intervention.

7. Critics of the safe injecting sites are many, but again who they are is not germane to the critiques. The critiques speak for themselves. Drug Free Australia's website carries a comprehensive critique, of course. Rakkar has removed the entire added text on suppositions simply not supported by fact. This is clear vandalism.

a. Stating that the first evaluation had 'methodological flaws' is no reason to remove the facts. In fact, every one of the cited facts from the evaluation, where each can be checked according to the page number listed, has not been contested by anybody. Dr van Beek has taken issue with the estimate of users in Kings Cross on a daily basis, from which overdose statistics are extrapolated, but has not taken issue with any of the data that Rakkar lists above his fanciful criticism (above).

b. If Rakkar wants to take issue with the overdose statistical comparisons he is welcome to add, in brackets, that Dr van Beek, Medical Director of the MSIC, has questioned whether the evaluation estimated too high a number of users in Kings Cross on a daily basis, but there is absolutely no justification for removing something which is entirely factual, as per the 2003 evaluation. Even when van Beek's concerns are taken into account the number of overdoses inside the room remain many times higher than on the streets. This discussion can be found on Australia's Update listserver.

c. Rakkar quite evidently has no idea whatsoever as to what is in later evaluations on the MSIC, guessing at their contents for the sake of contentiousness. There is only one, Evaluation 4, which has data which contradicts anything in the 2003 first evaluation. This is the statement that ambulance callouts have dropped by 80%, (but which is clearly the result of the heroin drought - heroin deaths AUSTRALIA-WIDE dropped by 75% in the same period, so we would expect ambulance callouts to drop similarly whether there is an injecting room or not in Kings Cross). Also there is data in Evaluation 4 that quite intriguingly conflicts with the first evaluation, whereby no. 4 states that the Kings Cross area had a greater drop in callouts than other adjacent suburbs. The 2003 evaluation said there was NO DIFFERENCE between Kings Cross and adjacent suburbs, while Evaluation 4 has a graph showing differences. Who are we to believe? This is not for Wikipedia to resolve. And there is no case for removal of a factual statement by Minphie.

d. The testimony of ex-users is extremely important. These are ex-clients who have gone to rehab, and who are more likely to speak with honesty and candour. The debate in NSW Parliament is as good a reference as is required for this kind of evidence, and Rakkar cannot remove the sentence simply because he doesn't like the reality.

e. Rakkar's intended rebuttal of overdoses inside and outside the room shows no basic understanding whatsoever of statistical comparisons. These comparisons were checked by one of Australia's most internationally renowned epidemiologists, Dr D'arcy Holman of WA Uni, and his e-mail to Drug Free Australia can be found on the Drug Free Australia full analysis website documentation.

Minphie —Preceding unsigned comment added by Minphie (talk •contribs) 11:30, 1 March 2010 (UTC)

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I've changed the article somewhat. Minphie has reverted the article again, so rather than start a revert war, I've tagged some of the weasel words in the article as well as some of the unverified claims. It's been good actually, I've tagged a few other unverified claims already in the article. I don't want to spend hours arguing every point above, and I don't want this to turn into an edit war. Minphie's edits have a place in this article, hopefully we can all turn this into a better article. --rakkar (talk) 02:21, 3 March 2010 (UTC)

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I have removed the spurious 'refuted' from the text re criticisms of SIFs because the cited evidence most certainly does not refute the statement that was previously written. I have also removed any reference to reduced hospital presentations because there was no data comparison available to make any such judgment.

Rakkar has cited an unpublished Addiction article which relies on the 4th Evaluation of the MSIC dated June 2007. This evaluation does claim that there were reduced ambulance attendances in the immediate area of the MSIC, a reduction of 80%, according to their figures, which also coincided with Australia's heroin drought during the period studied. It is noted that heroin deaths Australia-wide reduced by 67% over the period studied by the 4th evaluation due top the heroin drought. However it should be noted that Evaluation 4 contradicts Evaluation 1 despite purportedly using the exact same dataset. Whereas Evaluation 4 found a greater reduction in ambulance attendances in postcode 2011, which surrounds the MSIC, than in the 2010 postcode adjacent, the 2003 conclusion from exactly the same data contradicted the 2007 evaluation. The 2003 evaluation clearly says on p 49, commenting on Table 3.1 which compares ambulance attendances AFTER the MSIC opening against the heroin drought effects between January 2001 and May 2001 that "Analysis of the postcode areas 2010 and 2011 separately showed no different pattern of results" and yet the graph in Evaluation 4 shows a recognizable difference. This contradiction has yet to be explained.

Also Evaluation 4 was not able to compare Kings Cross hospital presentations with the rest of NSW and clearly says that no conclusions can be made in light of the heroin drought. —Preceding unsigned comment added by Minphie (talk • contribs) 11:51, 24 March 2010 (UTC) Signed ---minphie

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Hi Minphie, I have removed your new headings and combined each reply into a single discussion. Helps other editors know this is an ongoing conversation. You obviously fundamentally object to Harm reduction on principle, but it would be helpful if you could acknowledge that it does have it's strengths as well as weaknesses. It would be good to work together on this, I certainly acknowledge that it has failings. You're obviously fairly well up on the debate here in Australia, do you work in a related field?

1. I have removed the sentence "See Needle Exchange Programme for discussion of the evidence." again because it is not in keeping with [[[wikipedia:Summary style#References,_citations_and_external_links|http://en.wikipedia.org/wiki/Wikipedia:Summary_style#References.2C_citations_and_external_links]] Summary style]. We don't reproduce all information on a topic whenever it is mentioned, we direct readers to the main article to read further. As you noted, reproducing it would make the article cumbersome and unreadable.

1 - I have removed the sentence "(but it is also noted that data from this later study uses the data for the same ambulance services as the 2003 evaluation, but with obviously conflicting data for the years 2001 and 2002)". It obviously references something from the Salmon, van Beek et al article, but I don't know what. As noted on the edit summary, its possible to analyse the same data with different methodology and get valid results. Plus, it's probably a bit long to be in brackets.

2 - In regards to ambulance call outs, I changed the word balanced to corrected, as the conflict was not in opinion but in statistical analysis. It didn't balance the old analysis, it replaced it.

3 - Removed mention of claim in DFA pamphlet that on average users only visit MSIC for 1 in 35 injections. The maths underlying the statement is BAD, and has not been reproduced by anyone else. It assumes that EVERY client of the centre uses 3 times a day, every day. Some would use more, some would use less.

4 - Removed sentence - "and drug-related loitering and drug dealing worsened at the station entrance immediately opposite the centre (p. 147). This claim has been disproved - "[The] results suggest that setting up an MSIC does not necessarily lead to an increase in drug-related problems of crime and public loitering" from From "Freeman K., Jones C. G. A., Weatherburn D. J., Rutter S., Spooner C. J., Donnelly N. The impact of the Sydney Medically Supervised Injecting Centre (MSIC) on crime. Drug Alcohol Rev 2005; 24: 173–84. Here's the whole abstract "The current study aimed to model the effect of Australia’s first Medically Supervised Injecting Centre (MSIC) on acquisitive crime and loitering by drug users and dealers. The effect of the MSIC on drug-related property and violent crime was examined by conducting time series analysis of police-recorded trends in theft and robbery incidents, respectively. The effect of the MSIC on drug use and dealing was examined by (a) time series analysis of a special proxy measure of drug-related loitering; (b) interviewing key informants; and (c) examining trends in the proportion of Sydney drug offences that were recorded in Kings Cross. There was no evidence that the MSIC trial led to either an increase or decrease in theft or robbery incidents. There was also no evidence that the MSIC led to an increase in ‘drug-related’ loitering at the front of the MSIC after it opened, although there was a small increase in ‘total’ loitering (by 1.2 persons per occasion of observation). Trends in both ‘drug-related’ and ‘total’ loitering at the front of the MSIC steadily declined to baseline levels, or below, after it opened. There was a very small but sustained increase in ‘drug-related’ (0.09 persons per count) and ‘total’ loitering (0.37 persons per count) at the back of the MSIC after it opened. Key informant interviews noted an increase in loitering across the road from the MSIC but this was not attributed to an influx of new users and dealers to the area. There was no increase in the proportion of drug use or drug supply offences committed in Kings Cross that could be attributed to the opening of the MSIC. These results suggest that setting up an MSIC does not necessarily lead to an increase in drug-related problems of crime and public loitering."

--rakkar (talk) 06:32, 25 March 2010 (UTC)

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In light of not being able to find the Wikipedia convention that would point readers in the Harm Reduction page to the evidence against the effectiveness of needle exchanges on the Needle-exchange programme page, I have reproduced the relevant evidence in the Harm Reduction page.

If Rakkar wants to provide a correct link to the Needle-exchange programme page he could help readers to find the information they need there rather than be reproduced on the Harm reduction page. But the removal of the link that was there serves to remove any reference to evidence whatsoever when the evidence is indeed against any claims of proven effectiveness. --- Minphie —Preceding unsigned comment added by Minphie (talk • contribs) 11:53, 26 March 2010 (UTC)

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Rakkar has removed, again, sections which are factual and cited, and I have reinstated these for the following reasons.

1. Rakkar's statement, "Later research corrected these initial findings, noting that "the Sydney MSIC reduced the demand for ambulance services, freeing them to attend other medical emergencies within the community" immediately follows my paragraph citing 4 conclusions in the 2003 MSIC evaluation which showed no evidence of change after the commencement of the MSIC.

It is a distortion to say that Evaluation 4, in 2007, corrected all of these four findings because Evaluation 4 studied only two of the 2003 conclusions, failing once again to demonstrate an effect on overdose deaths in the area, and secondly stating that there was a 20% drop in ambulance attendances which applied to the postcode surrounding the MSIC. Note that they did not make conclusions in the 2007 evaluation on ambulance attendances over every 24 hour period, and did not have comparative data to judge hospital presentations. Curiously the 2007 evaluation used the same dataset as the 2003 evaluation, and the 2003 evaluators had compared postcodes at that date without seeing any comparable differences in postcode attendances (p 49) as per the 2007 evaluation. So I have changed the wording to reflect the reality of the two evaluations.

2. Rakkar removed, in an act of vandalism, the Drug Free Australia analysis conclusion that injecting room clients had only one of every 35 injections in the room. His rationale is that Drug Free Australia worked on a multiplier of 3 injections per day to get that figure. He also stated that some users have less injections per day and some more. Drug Free Australia has surveyed users and find use of between 1 and 6 injections per day are quite normal.

What Rakkar needed to do was read the full Drug Free Australia documentation before hitting the delete key. The Drug Free Australia detailed documentation clearly states (and reproduces in screen copy from the evaluation document) that the MSIC's own 2003 evaluators used three injections per day as the realistic daily injections multiplier in their calculations. As now stated in the text, Drug Free Australia used precisely the same methodologies and data as did the 2003 evaluators. The Drug Free Australia analysis was conducted by an epidemiologist, an addiction medicine practitioner with one of the largest practices in Australia, a medical doctor/social researcher, another senior social researcher and a welfare industry senior manager.

Furthermore, the Drug Free Australia analysis was verified by one of Australia's best known epidemiologists internationally, Dr D'Arcy Holman of WA University. D'Arcy is reportedly sympathetic to Drug Law Reform, so his verification is notable. His e-mail confirming the same is reproduced in the very reference which is given for Drug Free Australia's conclusions. There really is no excuse for Rakkar to unilaterally assume what he thinks is correct without being able to soundly refute Drug Free Australia's analysis. Rakkar, read the evidence before you swing into print.

3. Rakkar further claimed that "Numerous health professionals working in the addiction medicine field have pointed out the errors in the various calculations and extrapolations in the Drug Free Australia report." There is absolutely no truth to this statement. Of course professionals in support of injecting rooms will say anything - what counts is whether they can falsify the Drug Free Australia analysis or not, verified as it is by a very eminent Australian epidemiologist. This has never been done.

The only issue of note is that Dr van Beek has taken issue with the EVALUATOR'S assumptions regarding the number of heroin users in Kings Cross on a daily basis. Drug Free Australia uses the evaluator's assumptions and data, and so Dr van Beek has claimed that the Drug Free Australia conclusions (which are absolutely and correctly deducted from the evaluation data) are based on evaluator's assumptions which may distort the picture somewhat. Even using Dr van Beeks's own revised estimates, the injecting room still has 9 times the street rate of overdoses, still hugely greater than on the street.

4. In a clear act of vandalism, Rakkar has removed a conclusion he may not like, but which is a clear deduction from the quote immediately above which comes from the 2003 MSIC evaluation itself. If the evaluation says that injecting room clients are injecting higher doses of heroin, and drug dealers are at the station opposite (as per p 147) then the clear deduction is that the drug dealers opposite the injecting room, or elsewhere for that matter, are being paid more money for the extra heroin sold which is consumed in greater quantities in the injecting room. Please leave the statement where it is - it is an absolutely correctly-deducted statement.

5. The removal of the statement about the station opposite the MSIC being a site for drug dealers and loitering is unconscionable and is an act of vandalism once again. Rakkar, please desist.

Here is the evidence with quotes directly from the 2003 evaluation.

“We’ve got problems at the entrance [of the train station] with people just hanging around. We’ve got members of the public complaining about drug users, homeless and drunks hanging around the entrance on Darlinghurst Road.” (City Rail worker, 12 months interview – p 146)”

“The police who participated in the twelve-month discussion group commented that they had received complaints from the public and the City Rail staff about the increase in the number of people loitering at the train station. They noted that, while other factors, such as police operations, would have contributed to the increase in loitering outside the train station, there was a notable correlation between the loitering and the MSIC opening times.” (MSIC Evaluation p 146)

“The increase in loitering was considered to be a displacement of existing users AND DEALERS (my emphasis) from other locations.” (MSIC Evaluation p 146)

“The train station never featured as a meeting place before. It used to be Springfield Mall and Roslyn Street.” (Police 12 month interview – p 147)

Rakkar, if you make changes like this again I am going to take this further. —Preceding unsigned comment added by Minphie (talk • contribs) 11:32, 27 March 2010 (UTC)

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Minphie, First, please be civil to me and assume that my edits are in good faith, as per wikipedia policies, WP:AGF & WP:CIV. Threatening to "take this further" doesn't make it sound like you're trying to reach a consensus here. I also moved the opening sentence that had just been written into the safer injection sites as it pertained only to SIFs. I'll have a look at the rest later.--rakkar (talk) 09:02, 30 March 2010 (UTC)

Naming

I'd like to propose the renaming of this article to Safer Injecting Facilities. Firstly, I think this represents the fact that injecting drugs is not safe, but these are facilities to make it less harmful or "safer". Secondly, Safer Injecting Facilities (SIFs) is a more recognised term that encompasses the medical model (Australia & Canada) as well as the social model (Europe). Thoughts?

Proposed rename

The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.

The result of the move request was: No consensus to move. Ucucha 06:24, 30 May 2010 (UTC)

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Safe injection site → Safer injection facility — Relisted. Vegaswikian (talk) 01:11, 22 May 2010 (UTC)

• better name for sites as outlined in talk page. --Figs Might Ply (talk) 12:06, 13 May 2010 (UTC)

Above request has been up for some time, no objections, any problems with the bot renaming article?--Figs Might Ply (talk) 14:50, 14 May 2010 (UTC)

• EMCDDA calls the same for "drug consumption facilities" in this monograph (Part III, Chapter 11). That is not to exclude people smoking their drug (heroin or crack) - something increasingly usual in Europe. As an European I kind of favor EMCDDA's term, but I'am neutral (they say the alternate name is "safer injecting facilities", note "injecting" rather then "injection") Steinberger (talk) 15:17, 14 May 2010 (UTC)
• Dang it, good point. I kinda like the work safer as opposed to safe being the title, but whatever?--Figs Might Ply (talk) 15:33, 14 May 2010 (UTC)
• I kind of dislike the "safe"/"safer"-thing altogether. In Scandinavian discourse it is usually omitted (there is a taboo on notion that injection drugs can be anything approaching safe, if it is breached it is rather to cast doubt over the practice). So we just call it "injecting facility" or "injecting room" (literally translated). Steinberger (talk) 15:45, 14 May 2010 (UTC)
• :Googling "Safer injection facility" is way more common then "Drug consumption facility", so the latter should be an alternate name given in the rewritten (cleaned up) lead and not as an article name whatever we do. However, "Supervised injection facility" is even more common the the two first. (Far most hits have "Safe injection site", but lets ignore that fact. I also think that name is used less and less, especially in academia.) Steinberger (talk) 12:31, 17 May 2010 (UTC)
• Oppose WP:COMMONNAME 70.29.210.155 (talk) 04:32, 22 May 2010 (UTC)
• "Injection site" is ambiguous :: "the place on the skin where the needle goes in" and "where he is (room, building, field, etc) when he injects himself". Anthony Appleyard (talk) 05:31, 22 May 2010 (UTC)
  • "safe injection site" is common usage for the concept in the article. 70.29.210.155 (talk) 04:18, 23 May 2010 (UTC)
• Oppose In Canada, the common name is Safe injection site or supervised injection site. --Labattblueboy (talk) 22:50, 23 May 2010 (UTC)
• The official homepage of Insite call it Supervised injection site. The expert committee tends to favor Supervised injection site (only in one instance is it called Safe injection site) and in its reference list "Safer injection facility" dominates (sometimes with the prefix "Supervised", eg "Supervised safer injection facility" or even "Medically supervised safer injection facility"). Steinberger (talk) 11:29, 25 May 2010 (UTC)

The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

Reinstatement of Evidence-based Opposition section

I have reinstated the section on Evidence-based opposition re safe injection sites because all of the text is fully cited and factually correct. Steinberger has removed the text on the grounds that the article is now 70% criticism of safe injection sites and this breaches a Wikipedia objective of balance via equal weight.

Of course this begs the question as to whether any page that has 70% of its text given to entirely valid and fully cited criticism is now by that very fact now 'biased' or by its weight of text now incorrect in what it asserts. Of course it is not. The fact that there might be more to criticize in some political actions than commend does not make the criticisms wrong simply because there are more negatives than positives to the intervention. I should add that the United Nations Office of Drug Control sees more negatives than positives. If it were asked to do an objective, dispassionate summary of SISs, it too might likely have 70% criticism.

I would encourage Steinberger to add as much positive material as he can find on SISs and put that in a section entitled 'Evidence-based Positives' or some such heading.

Merely removing solidly evidence-based, factual and cited text which the public has a right to see and know cannot be justified by the rationales used by Steinberger and Pigs Might Fly. Minphie (talk) 06:40, 9 May 2010 (UTC)

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Minphie, it doesn't need to be that long. Of course there are problems associated w/ SISs and it's fair and right that they be included. But there is a lot to be said for a concise article. Look at the length of the rest of the article and condense your content. it could read something like:

"Opponents of SISs are concerned that tolerating drug use within the centers sends a message to the community that drug use is acceptable (REFERENCE1, page X). They also raise concerns that the safer environments provided by SISs encourage experimentation and further drug use (REFERENCE2, page Y). Concerns have also been raised that SISs do not meet their stated objectives (REFERENCE3, page Z)."

I've just tapped that out based on what you included in the article. Could we include something like that for now, and together work out a better, extended format for the article?--Figs Might Ply (talk) 07:03, 9 May 2010 (UTC)

Figs Might Ply, Wikipedia is an encyclopedia and therefore should aim to be encyclopedic. Of course Wikipedia should not reproduce the many journal articles and evaluations, which run to thousands of pages. The SIS page, with your deletions of 2500 words of important information on SISs that is entirely relevant for someone wanting to inform themselves on these facilities, now tells a person very little indeed. As it looks after your deletions it is far from encyclopedic. My concern, Figs Might Ply, is that the mass deletions of carefully cited and relevant text on this page amounts more to censorship of information that any person has every right to know. I will be very concerned if the Opposition section keeps disappearing with rationales that have no substance. But I am happy to work with you on this page. The page at present is not long by the standards of any other drug policy page and so your objection could not be construed as reasonable, nor can I reasonably be asked to give agreement on shortening the opposition section. I am not willing to censor my own information, all of which is entirely relevant and crucial to an understanding of these facilities. I am happy to see more work done on the front end of the article, but the opposition section is a succinct and meticulously cited piece on a what critics see as a very problematic intervention. Minphie (talk) 23:32, 16 May 2010 (UTC)

Minphie, here's the thing, I think you're wrong. I think Harm Min is an important plank of drug policy, as a safety net for when abstinence approaches don't reach people. You appear to have a view that rejects this and believes that Harm Min is inherently destructive. You take this view and load it up with selective evidence and then refuse to cooperate with the rest of us. That's not what this place is about, if you want to have your view heard without criticism, try writing on conservapedia. I'm reverting the edits back to the balanced version and lets talk here about a more Wikipedia:WEIGHT article. If you won't agree to this simple step then we really do have a problem.--Figs Might Ply (talk) 10:25, 17 May 2010 (UTC)

SISs a World Minority View When Considering Due Weight

Steinberger, in March 2009 the United Nations body, the Committee on Narcotic Drugs, met in Vienna to review any changes that might be made to the international Conventions which guide drug policy world wide. With much pressure from the harm reduction and drug leagalization lobbies, they decided not to include harm reduction as a world-agreed drug policy plank, maintaining the historical emphasis on supply and demand reductions. There were 70+ member countries voting on this issue and harm reduction was defeated by a majority. Safe Injection Sites are a sub-category of harm reduction which therefore does not have majority support world-wide. The INCB, the United Nations body that monitors drug control, has also issued statements saying that injecting rooms do not fit with the international Conventions. Given that this is the case I can see no place for any contention of undue weight. Nor is there original research or synthesis as you continue to erroneously assert. I have already given citations for the Australian, Canadian and European critiques.Minphie (talk) 06:17, 23 May 2010 (UTC)

It is valid to say that various UN-bodies oppose SIS, but not to write a novel essay on the 'evidencial' ground for this without explicit support in the sources used. You have failed to produce such, so, it is a original synthesis and should therefor go. Steinberger (talk) 14:08, 23 May 2010 (UTC)

Up to date MSIC data

I'd also like to provide evidence for not accepting any content referenced to the sources "Drug Free Australia "The Kings Cross Injecting Room - The Case for Closure" and "Drug Free Australia "The Case for Closure: Detailed Evidence"". These self published documents are not peer reviewed and have not been referenced by any book or journal. Their evidence is based solely on the 2003 report and make a number of unverifiable claims. Anyone wishing to read more on this matter could start with the following hansard record. A few key lines to summarise from Ian Cohen MLC:

• The book entitled The Kings Cross Injecting Room: a case for closure , written by Gary Christian of Drug Free Australia, confines itself to analysis of the centre's first 18-month evaluation period, which ended in October 2002. Over the past four years the centre and a range of respected health professionals working in the addiction medicine field have pointed out the errors in Gary Christian's various calculations and extrapolations based on this initial evaluation period. It is disappointing to learn that Mr Christian has been unwilling to accept any of this expert advice or integrate any of the new information as it has come to hand. Instead, he has continued to convey misinformation to political decision makers at this crucial time.

Here is some content from the executive summary of the most recent MSIC report which rather trounces Minphie's claims from the first report in 2003. The 2003 report was stated to contain methodological flaws by a number of key figures and these were corrected in later evaluations such as the one included below. This is my justification for removing Minphie's edits.

Client Profile

• 9,778 IDUs had registered with the service
• monthly average of 138 new clients registered.
• Most were male (74%)
• average age of 33 years
• been injecting for an average of 14 years.
• Over 70% of clients had not completed high school,
• over 60% were not employed,
• 24% were in unstable accommodation and
• 23% had been imprisoned in the previous 12 months.
• Drug treatment had been previously initiated by 60%;
• 13% were currently receiving some form of drug treatment
• nearly 40% reported daily or more injecting.
• Seven percent of clients had shared a needle and/or syringe at least once in the preceding month,
• 17% had shared other injecting equipment,
• 49% indicated that they would have injected in public had they not been able to access the Sydney MSIC on the day of registration.
• Based on these data an estimated 191,673 public injections were averted by the presence of the MSIC (i.e. approximately 89 per day of MSIC operation).

These client statistics show that the Sydney MSIC has continued to reach long-term, high frequency injecting drug users (IDU), who are highly socially marginalised and likely to inject drugs in public settings.

Visits, services & referrals

• the service was open on 2,163 days (approximately 361 days per year for 10 hours per day),
• during which 391,170 visits to inject were made with an average 181 daily rising to 212 in the last year.
• Heroin (62%), other opioids (12%),cocaine (14%) and meth/amphetamines (6%) were the drugs most commonly injected on-site.
• In addition to the supervision of injecting episodes, staff provided 44,082 other occasions of service (113 per 1,000 visits)

• including drug and alcohol information (approximately 5,000 occasions)
• advice on drug and alcohol treatment (more than 3,000 occasions).
• On over 21,000 occasions staff provided vein care and safer injecting advice.
• A total of 6,243 referrals to other services were provided (16 per 1,000 visits).
• Forty-five percent of referrals were to drug treatment, most frequently to opioid substitution therapy.

These results indicate that the MSIC continues to act as a gateway for treatment for this highly marginalised population of drug users.

Overdose related events

• MSIC managed 2,106 overdose-related events on-site without fatality,

• including 93% which involved heroin or other opioids.

• It is likely that substantial proportions of overdoses managed at the site would have resulted in significant morbidity had they occurred elsewhere,

• approximately half would have otherwise occurred in public places.

• Coincident with the opening of the MSIC there was a decline across New South Wales in events related to opioid-related overdoses that have been sustained over the past six years and attributed to a reduction in heroin availability and subsequent changes in patterns of drug use.
• Based on ambulance attendances, the reduction in opioid-related overdoses was much more substantial in the immediate vicinity of the MSIC than in other neighbouring areas and in New South Wales in general.
• This finding suggests that the Sydney MSIC provided an environment where injecting drug users at risk of overdose were able to receive early intervention and thereby avoid the need for ambulance services.
• It also suggests that supervised injecting facilities are most effective in preventing drug-related morbidity and mortality in areas of concentrated drug use and not in broader geographical areas.

Needle and Syringe Disposal

• Monthly counts of discarded needles and syringes collected locally indicated a decrease of around 50% following the establishment of the service that has been sustained over six years.

Cost analysis:

• The overall cost of the Sydney MSIC increased from the set up of the service to 2007 primarily due to increases in client visits and staffing costs.
• On the other hand, the cost per client visit decreased and utilisation rates increased both overall and per unit of time that the MSIC was open.

Conclusion

There are many scientific, practical, and ethical challenges involved in evaluating complex public health interventions such as supervised injecting facilities, and accurately quantifying their effectiveness. However, the available evidence, including the international peer-reviewed literature and previous evaluation reports by the NCHECR and BOCSAR, together with the data presented in this report, indicates that the MSIC has provided a service that: reduces the impact of overdoserelated events and other health related consequences of injecting drug use; reduces public injecting and the community visibility of injection drug use; provides access to drug treatment and other health services to people who are highly socially marginalised; and, has not lead to increases in crime or social disturbance in its immediate vicinity.

--Figs Might Ply (talk) 16:24, 23 May 2010 (UTC)

Minphie’s Reply

Figs Might Ply, I have reverted my text due to your listed concerns failing to engage or even being relevant to my edits. I will calmly and dispassionately tell you why.

In your conclusion you appear to be giving me an argument which says that if you can show a few positives for the MSIC that this then cancels any criticisms of the service, no matter how well-evidenced or factual they are. But criticism is criticism, and it is crucial to the role of science or programming. A sanitized Wikipedia is not the aim. And criticisms all come back to how well-evidenced and cogent they are. Your personal opinion that the centre has done good things does not invalidate criticisms of the MSIC.

Here is why your concerns don’t engage my edits, or are not relevant to them.

Reports published by Drug Free Australia

1. Your claim is that the Drug Free Australia (DFA) material does not come from published sources. But this is demonstrably false. The clearly published 12 page booklet was sent by DFA to every Federal, State, and Territory politician in Australia and has also gone worldwide. This makes it of crucial importance to the discussion of SISs internationally.
2. You cite the unevidenced assertions of Ian Cohen, the NSW Green MP who by virtue of his party affiliation, is an advocate for drug legalization/liberalization. His speculations about who wrote the booklet have no basis whatsoever in fact. Had Cohen looked at page 12 of the booklet he would have seen 5 people named as writing the booklet and I am reliably informed that a significant number of DFA Board members and Fellows were likewise involved.
3. You further cite Cohen’s assertion that ATOD professionals have criticized DFA’s analysis. DFA has answered this charge by demonstrating that these professionals are either injecting room staff or activists for more injecting rooms Australia-wide and/or general drug law reform. This is what you would expect them to say, is it not? The criticisms of DFA are best judged by the cogency and the evidenced data of the criticisms and not by the criticisms of people who have their own agendas.

Not peer reviewed?

1. Wikipedia recognizes that not all citations can come from peer-reviewed literature, which while preferable, is not determinative for sourcing. You appear to be telling me that Wikipedia will only take peer-reviewed sources, but this is not true. Additionally, the conclusions of the DFA booklet have been reproduced in mainstream newspapers anyway, which is an acceptable published source.
2. The government-funded evaluations of the MSIC are not peer-reviewed documents either, excepting one article summarizing conclusions from Evaluation 4. Yet these documents are nevertheless crucial to any international assessment.
3. There were many peer-reviewed articles addressing various aspects of Insite’s operation which were heavily criticized by the Expert Advisory Committee of the Canadian Government, where various of their assumptions or conclusions were criticized as invalid. Peer-reviewed articles are only as good as the reviewers themselves, and if they miss things that other critics see, it does not make the peer-reviewed article beyond question.
4. Many of the objections of DFA concerning the MSIC also appear in the article I have cited from the Int. Journal on Global Drug Policy which is a peer-reviewed journal.

Data not up to date?

1. You have asserted that the page of client characteristics you have reproduced is more up to date than my data, but this is totally irrelevant on two grounds. a. I have not contributed any discussion of or data on whether the MSIC did or did not reach a representative target population (which is a kind of tautology anyway), and so 2007 data is totally irrelevant and b. the PERCENTAGES of client characteristics are almost, to the category, identical to the 2003 percentages anyway. It is true that client characteristics must be taken into account when making conclusions on the number of overdoses in the centre, but DFA’s detailed evidence document demonstrates that this has most certainly been done with comparisons to other high-risk groups. So this again illustrates the irrelevance of a baseless assertion.
2. You have given another page of data on referrals, but there is nothing in my edits criticizing referrals (although the DFA document does make the point that referrals from the MSIC could possibly be matched by a soup kitchen). So all those referral stats are not addressing anything I have written at all. They are totally irrelevant to my edits.
3. You fail to note that the heroin drought was responsible for the decreases in syringes on the street, something which is clear in any of the evaluations, but which the evaluators conveniently left out of their Executive Summaries, which the politicians read. That is something to be severely criticized in itself. The heroin drought continues, and any later data or studies have never shown that the injecting room has reduced public nuisance perceptibly beyond the heroin drought effects on drug use patterns. So your assertions are again erroroneous. Later data changes nothing.
4. In your cost analysis you have introduced considerations that have absolutely NOTHING to do with my edit’s cost comparisons. My statement addresses the low number of lives saved by the centre for the substantial cost. Your later data doesn’t address the argument in any way – it is totally irrelevant.

In summary, your later data does not give any information that impacts in any way on the DFA reports' 2003 and 2006 data. DFA has only used data from the 2003 evaluation which was not matched by comparable data in later evaluations.

In conclusion, you have given me a list of baseless reasons for keeping 2500 words of evidenced and factual text off the page. I cannot take these seriously unless they have some substance or relevance to my edits. My concern is that such baseless and irrelevant assertions may be being used as red herrings merely to keep properly evidenced and important material from Wikipedia’s readership. This could amount to a caviling, carping, obfuscating and obstructionist form of censorship.

I continue to be concerned about your block deletions of everything I have added to the page, when your discussion addresses only a few points in those 2500 words of text. There is plenty of cited and factual evidence on Canada and Europe which disappears each time. And that all has citations for critics of them. Please desist.Minphie (talk) 04:16, 24 May 2010 (UTC)

This gets so boring. A quick reply- My searching on Ulrichs show that the Int. Journal on Global Drug Policy is not a peer-reviewed journal. it appears to be Drug Free America's own publication. I'll provide a screen cap if required.--Figs Might Ply (talk) 04:50, 24 May 2010 (UTC)

Viola. The Int. Journal on Global Drug Policy is not a peer-reviewed journal according to Ulrichsweb, the self proclaimed "authoritative source of bibliographic and publisher information on more than 300,000 periodicals of all types".--Figs Might Ply (talk) 08:42, 24 May 2010 (UTC)

---

Reports published by Drug Free Australia

1. Your claim is that the Drug Free Australia (DFA) material does not come from published sources. But this is demonstrably false. The clearly published 12 page booklet was sent by DFA to every Federal, State, and Territory politician in Australia and has also gone worldwide. This makes it of crucial importance to the discussion of SISs internationally. NOT TRUE

You either are not paying attention or you are seeking to misrepresent words. Look closely. I said self-published, not unpublished. Sending it to every politician in Australia doesn't give it any credibility, either. Politicians get mailed all sorts of crap.

1. You cite the unevidenced assertions of Ian Cohen, the NSW Green MP who by virtue of his party affiliation, is an advocate for drug legalization/liberalization. His speculations about who wrote the booklet have no basis whatsoever in fact. Had Cohen looked at page 12 of the booklet he would have seen 5 people named as writing the booklet and I am reliably informed that a significant number of DFA Board members and Fellows were likewise involved. FALSE & LIBELLOUS

Please see the Greens drug policy. policy Principle #1 - The NSW Greens do not encourage drug use. If you want to try and prove that point, go take it up on the Greens page first. Although I believe that making statements like that about Ian Cohen would run contrary to WP:Libel.

1. You further cite Cohen’s assertion that ATOD professionals have criticized DFA’s analysis. DFA has answered this charge by demonstrating that these professionals are either injecting room staff or activists for more injecting rooms Australia-wide and/or general drug law reform. This is what you would expect them to say, is it not? The criticisms of DFA are best judged by the cogency and the evidenced data of the criticisms and not by the criticisms of people who have their own agendas. SELF JUSTIFYING ARGUMENT

DFA has proved that everyone who disagrees with their point of view is not to be trusted? Evidence please.

Not peer reviewed?

1. Wikipedia recognizes that not all citations can come from peer-reviewed literature, which while preferable, is not determinative for sourcing. You appear to be telling me that Wikipedia will only take peer-reviewed sources, but this is not true. Additionally, the conclusions of the DFA booklet have been reproduced in mainstream newspapers anyway, which is an acceptable published source. NOT TRUE

Absolutely - but it does not justify the equality of all sources? No. I have provided excellent peer reviewed academic articles that contradict DFA's self published unreviewed unquoted document.

1. The government-funded evaluations of the MSIC are not peer-reviewed documents either, excepting one article summarizing conclusions from Evaluation 4. Yet these documents are nevertheless crucial to any international assessment. IRRELEVANT

As you pointed out above, peer reviewed are not the only sources allowed. They are certainly preferable to self published papers, because as wikipedia policy says, Anyone can create a website or pay to have a book published, then claim to be an expert in a certain field. What makes the reports different to DFA's self published material is that the MSIC reports were published by the National Centre in Epidemiology and Clinical Reseach, which is a partnership between the Federal Department of Health & Ageing and the Faculty of Medicine, UNSW. They have also been quoted by numerous other peer reviewed papers since their publication.

1. There were many peer-reviewed articles addressing various aspects of Insite’s operation which were heavily criticized by the Expert Advisory Committee of the Canadian Government, where various of their assumptions or conclusions were criticized as invalid. Peer-reviewed articles are only as good as the reviewers themselves, and if they miss things that other critics see, it does not make the peer-reviewed article beyond question.

Can't speak for Canada, but would you care to produce evidence from academia that MSIC is inneffective?

1. Many of the objections of DFA concerning the MSIC also appear in the article I have cited from the Int. Journal on Global Drug Policy which is a peer-reviewed journal. NOT TRUE

See above. It isn't peer reviewed. It's Drug Free America's private press (REF: The Lancet, Volume 372, Issue 9636, Pages 354 - 355, 2 August 2008).

Data not up to date?

1. You have asserted that the page of client characteristics you have reproduced is more up to date than my data, but this is totally irrelevant on two grounds. a. I have not contributed any discussion of or data on whether the MSIC did or did not reach a representative target population (which is a kind of tautology anyway), and so 2007 data is totally irrelevant and b. the PERCENTAGES of client characteristics are almost, to the category, identical to the 2003 percentages anyway. It is true that client characteristics must be taken into account when making conclusions on the number of overdoses in the centre, but DFA’s detailed evidence document demonstrates that this has most certainly been done with comparisons to other high-risk groups. So this again illustrates the irrelevance of a baseless assertion.

I only included that section for future reference. I could argue the point, but my God I have spent so long on this. I'm doing this as a volunteer but you seem to be on the payroll of DFA and must quite enjoy this filibustering.

1. You have given another page of data on referrals, but there is nothing in my edits criticizing referrals (although the DFA document does make the point that referrals from the MSIC could possibly be matched by a soup kitchen). So all those referral stats are not addressing anything I have written at all. They are totally irrelevant to my edits.

See preceding comment.

1. You fail to note that the heroin drought was responsible for the decreases in syringes on the street, something which is clear in any of the evaluations, but which the evaluators conveniently left out of their Executive Summaries, which the politicians read. That is something to be severely criticized in itself. The heroin drought continues, and any later data or studies have never shown that the injecting room has reduced public nuisance perceptibly beyond the heroin drought effects on drug use patterns. So your assertions are again erroroneous. Later data changes nothing.

No doubt the heroin drought changed the game in Australia. But they've analysed the effect and proved that MSIC was still effective.

1. In your cost analysis you have introduced considerations that have absolutely NOTHING to do with my edit’s cost comparisons. My statement addresses the low number of lives saved by the centre for the substantial cost. Your later data doesn’t address the argument in any way – it is totally irrelevant.

Again, it was just there for reference.

So, the argument contintues. Let it be here noted that there is not consensus on the issue. Let it here be noted that I fully expect Minphie to revert the changes again and refuse to discuss an interim version of the article with Steinberger and I.--Figs Might Ply (talk) 13:55, 24 May 2010 (UTC)

Figs Might Ply, thank you for first admitting that your pages of statistics were irrelevant to our discussion. I in turn will acknowledge that I have checked with the Journal of Global Drug Policy and confirmed that it is not peer-reviewed but guided by an editorial committee of many well known luminaries within the research and drug policy world such as DuPont and Voth. Your concerns now demonstrably reduce only to the publication status of Drug Free Australia’s analysis of the Sydney MSIC.

Before dealing with the credentials of those chiefly involved, you might look at Ian Cohen’s 2003 policies. http://stopthedrugwar.org/chronicle-old/277/nswgreens.shtml There is no case for libel where truth is the defense.

The credentials of the team that completed the analysis of the 2003 MSIC evaluation and who each actively contributed to the 2006 Drug Free Australia publication on the injecting room are:

Dr Joe Santamaria Epidemiologist, Former Head of St Vincents Hospital (Melbourne) Public Health Unit. Published in peer-reviewed journals such as ‘Drug Therapy’, ‘Patient Management’, ‘Australian Family Physician’, Australian Annals of Medicine, Medical Journal of Australia. These were in the 60’s and 70’s.

Dr Stuart Reece Addiction Medicine Practitioner, Brisbane. Associate Professor, Uni of WA. Published in peer-reviewed journals Proceeedings of the National Academy of Sciences of the USA, New England Journal of Medicine, British Medical Journal, Addiction Biology, British Dental Journal.

Dr Greg Pike Director, Southern Cross Bioethics Institute and Surgeon. Published in peer-reviewed journals such as European Journal of Pharmacology, Journal of Physiology, Brain Research and seven others.

Dr Lucy Sullivan Previously Professor at NSW University, Researcher for Centre for Independent Studies and Menzies Research Institute. I have not got a list of her peer-reviewed articles but see for example her work. http://www.mrcltd.org.au/research/population-policy/population_equity_influence.pdf

Gary Christian Welfare senior manager with Mission Australia, Australia’s second largest welfare organisation and ADRA Australia with 17 years in welfare senior management roles.

Figs Might Ply, you have cited the criticisms of professionals of the Drug Free Australia report. The only true engagement by professionals with the Drug Free Australia report was in two forums – on the Australian nationwide listserver ‘Drugtalk’ run by the Australian Alcohol and Other Drugs Council of Australia dated 21-26 July 2006 and in letters to newspaper where there is no evident engagement of the one life saved statistics of Drug Free Australia (you must remember that the Canadian Expert Advisory Committee findings of only one life saved per year shows that Drug Free Australia is correct on this issue, not the injecting room Director, despite her attempt to say otherwise as per her letter printed below). So outside of the Drugtalk correspondence by Bernadette O’Keefe of the MSIC regarding their estimate of user numbers in Kings Cross, where they differed with their evaluators, there is no other engagement of the Drug Free Australia report other than what you see below in Van Beek’s letter, which is representative of any others she had written.

http://opiateaddictionrx.blogspot.com/2007/05/safe-injection-sites-substantively-and.html

The Daily Telegraph (Sydney, Australia) Piers Akerman May 02, 2007 (excerpts from a wider-ranging letter focused mainly on marijuana policies)

The most obscene evidence of the state’s softly-softly approach to drugs remains the NSW Government’s embrace of its Kings Cross shooting gallery despite the absence of any hard evidence that it serves any purpose other than to ensure that addicts will always have a place to legally shoot-up if they so choose when they happen to be in the area and in possession of illicit drugs.

Put simply, the reports produced by the heroically named Medically Supervised Injecting Centre fall apart when examined by competent and genuinely independent experts.

A review of the statistics by Dr Joe Santamaria (former head of community medicine, St Vincent’s Hospital, Melbourne); Dr Stuart Reece (addiction medicine specialist, Brisbane); Dr Lucy Sullivan (social researcher); Dr Greg Pike (director of Southern Cross Bio-Ethics Institute, Adelaide) and Gary Christian (senior manager, welfare industry) demonstrate that despite the claims of the shooting gallery’s advocates, it is unlikely to have saved even one life.

Dr van Beeks letter to Daily Telegraph May 03 (Dr Ingrid van Beek, Medical Director, MSIC)

Mr Akerman cites Drug Free Australia’s “review of the statistics” of the first 18 months’ operation until October 2002, of the Medically Supervised Injecting Centre (MSIC) in Kings Cross, as evidence that it has “failed” (DT 3/5/07) despite a range of health professionals respectfully pointing out the various flaws in its extrapolations over the past several years.

The irrefutable statistics are that in the 6 years the MSIC has now been operating, around 400,000 injecting episodes have occurred in this clinical facility instead of public parks, back alleys and public toilets etc, improving public amenity; more than 2,000 drug overdose cases have been successfully treated undoubtedly saving lives and drug users have been referred to treatment and other relevant services on more than 6,000 occasions. Meanwhile the number of drugs users in the Kings Cross area has decreased 40%, the number of ambulance callouts to overdoses has decreased 86% and drug-related crime has decreased 30 – 40%. These facts perhaps explain why 80% of local residents living in the area over these past 6 years support the MSIC.

Please also note that the MSIC is funded by the confiscated proceeds of crime and not tax payer revenue and that I am employed by the Area Health Service and not the Medical Faculty of the University of NSW, which employs the MSIC’s evaluation team. —Preceding unsigned comment added by Minphie (talk • contribs) 02:06, 25 May 2010 (UTC)

I have looked in the evaluations and contrary to what you state none of the above have contributed to the evaluations of MISC in Sidney. [2] And quoting from your own cut-and-paste above: "a range of health professionals respectfully pointing out the various flaws in its [the DFA papers] extrapolations over the past several years." Steinberger (talk) 09:06, 25 May 2010 (UTC)

Steinberger, the introduction to the 5 authors clearly says that they were the writers of the Drug Free Australia document being discussed. Now that you have been told you have no reason to revert text.Minphie (talk) 10:58, 25 May 2010 (UTC)

Yes, they are the writers of Drug Free Australia much criticized paper, but have not been involved in the evaluation of MISC as you implied. Steinberger (talk) 11:14, 25 May 2010 (UTC)

Conflicting sources

I was about to fact check and update the article when I found a discrepancy. The source that is used say that the Netherlands was first with DCR in 1970. It is undoubtedly a WP:RS so that is not the problem, but so is EMCDDA's latest review and they say that the Netherlands begun in the 1990s. When it comes to Switzerland they are concurring, they both say the first where opened in 1986 (not 1985 as stated in the article). I rather trust EMCDDA's review but do anyone have access to de Kler H, van der Zande I. "Alternatieve hulpverlening. Teksten en kritiek." Amsterdam: SUA, 1978. and know dutch so we can go further and double check on Dolan et al? Steinberger (talk) 11:50, 25 May 2010 (UTC)

First warning for blanking vandalism – censorship

Steinberger and Figs Might Ply, I am issuing my first warning for blanking vandalism which is defined as:

"Removing all or significant parts of a page's content without any reason, or replacing entire pages with nonsense. Sometimes referenced information or important verifiable references are deleted with no valid reason(s) given in the summary. However, significant content removals are usually not considered to be vandalism where the reason for the removal of the content is readily apparent by examination of the content itself, or where a non-frivolous explanation for the removal of apparently legitimate content is provided, linked to, or referenced in an edit summary."

I have specifically stated, two days ago, that there is no reason to be removing blocks of text on the SIS page which are not in any way disputed on the Discussion page. At no time have you given a rationale for deleting anything above the ‘evidenced-based opposition’ line in the text. Since I wrote ‘Please desist’ you have reverted three times without even a hint of attempted explanation on Discussion (which has only ever referenced text in the Evidenced-based Opposition section). I have clearly stated that continual removal of evidenced and factual text for no offered rationale amounts to blanking vandalism more akin to censorship. I believe that any review of your reverts of this section of text since it was first placed on the page to give more equal weight to a description of SISs (as against the weight of argument against them) may well suggest a censorship motivation. This is the first warning.

I now turn to the issue of the growing list of baseless red herrings which have been used to keep factual and evidenced text off the page.

1. article of 2500 words too long and should be shortened - 16 May
2. Figs thinks HR is good - 17 May
3. charge of biased beliefs by Minphie - 17 May
4. selective evidence - 17 May
5. undue weight – minority point of view - 23 May
6. a bunch of irrelevant positive data should cancel the DFA criticisms - 23 May
7. data from 2003 too old - 23 May
8. unverifiable claims - 23 May
9. the work of one individual – 23 May
10. possible insinuation of use of publication self-published by individual mentioned above - 23 May
11. DFA criticisms not peer-reviewed – 23 May
12. Minphie cited as claiming that DFA writers of their own publication also wrote the original MSIC evaluation in 2003 - 24 May
13. original research (Harm Reduction Talk)- 24 May
14. incorrect formatting of citations - 25 May

I have done my job of patiently and dispassionately demonstrating that all of these are indeed baseless and obstructionist red herrings.

You have now enjoined a battle where you are inferring that the criticisms by Drug Free Australia of the Sydney injecting room have no importance or real relevance to the ongoing international debate on the effectiveness or otherwise of injecting rooms, which of course any Wikipedia page on SISs must discuss to be credible.

First, let’s talk about who Drug Free Australia is. As you might have hoped it is not some obscure and unknown organisation in Australia. It is the most publicly attested and best known drug prevention organisation in Australia, member of the International Taskforce for Strategic Drug Policy, known for scrutinizing and critiquing the drug policy evidence base of the country.

Further, the importance of Drug Free Australia’s criticisms re the Sydney injecting room is not for you to judge, as two Wikipedia editors, who keep trying to delete any reference to the content of one of the most significant, most public, and well attested Australian drug policy debates of the last decade, a claim for which many, many sources of evidential weight can be brought to the table.

Drug Free Australia’s analysis, written by some of the best qualified people in the country who have analyzed the evidence-base of the Sydney injecting room and found it severely wanting, has been at the epicenter of the Australian debate. It has been at the centre precisely because of the credibility of those doing the analysis, which I patiently outlined for you yesterday. So significant has been the Drug Free Australia analysis that it has on many occasions generated media interest from a number of most-read newspapers in Australia, prompted commentary by one of the most read journalists in the country, been at the center of the criticisms launched on myriad occasions by the most listened-to radio talk show host, been the most discussed document in Australia’s Drugtalk drug policy debate forum for half a decade, been referenced dozens of times by Liberal Party and Independent politicians in NSW Parliament as central to the political debate and has been cited by a Federal Parliamentary inquiry. Searches on Google demonstrate that the DFA publication is reproduced or referenced on websites worldwide. Drug Free Australia’s analysis is further credited with stopping the ACT injection room from proceeding, something which is of international significance.

The decision as to whether Drug Free Australia’s criticisms arising from its analysis are important enough to be recorded in Wikipedia has been made for you by the mass of commentary, discussion and debate about it. And in light of the most evaluated SISs worldwide being the Vancouver and Sydney sites, any failure by Wikipedia to mention these evaluations in an article on Safe Injection Sites, or conversely to cover criticisms of the same will only significantly damage Wikipedia’s reputation as a comprehensive record of knowledge on these facilities. Wikipedia will be judged as having censored information which is of crucial knowledge to the world community it seeks to reach.

If you continue to obstruct the well-evidenced text which summarizes the critiques of the DFA analysis which has had such a high profile in the Australian injecting room debate I will move this discussion to a second warning for vandalism, based on obstruction via baseless and indefensible claims about the lack of significance or credibility of the Drug Free Australia analysis and documentation.

Given the importance of the Drug Free Australian criticisms for the Australian debate, your role is to do your best to show that their analysis is factually or inferentially wrong, but of course you must quote the arguments that are already in the public domain as per our ‘original research’ discussion previously. —Preceding unsigned comment added by Minphie (talk • contribs) 01:47, 26 May 2010 (UTC)

Stop WP:Gaming the system. We are not vandals, you will never convince any administrator that we are vandals and we will never get sanctioned as vandals. Steinberger (talk) 15:34, 26 May 2010 (UTC)

Steinberger, you have not given any reason for removing well-evidenced and factual text from this site. Your comment above speaks to a dispute issue you have initiated against me on process rather than content. But regarding removal of 2500 words of content, you have given NO RATIONALE at all. Blanking text without rationale is indeed blanking vandalism, and I am not prepared to allow this to go on. Replacing it with a shortened summary has not been given a rationale.

I am having to construe the edits you have just completed as an attempt to shorten the previous more comprehensive descriptions of injecting rooms so that you can claim that the 'Evidenced-based Opposition' is too long by comparison to the rest and claim Undue Weight to rid the page of it. I respectfully submit that such a tactic, if true, is not respecting the right of the Wikipedia reader to have the information which was there which is very important information. I recognize that my summaries of the two most eminent evaluations on SISs were not as positive as some might wish, but this is no reason to wipe all out, positive and negative, for a couple of sentences of positive gloss which you have added. Remember that the negatives that were there were not MY negatives but the negatives of the evaluators.

I am reverting the Evaluation section which has been sitting above the Evidence-based Opposition section because I am concerned that you are trying to censor the truth about these rooms, especially the fact that evaluators do not attribute many lives saved to their presence. But this is what the evaluators have said, and we should not be sanitizing information because we don't like it.Minphie (talk) 00:39, 27 May 2010 (UTC)

You don't seem to understand that you can't WP:Cherry-pick selective findings, distorting reliable sources. That is specifically breaching WP:NPOV and that is a very good reason for removal. Where do you have the source that say that the Canadian and Australian drug consumption rooms "have been more rigorously evaluated"? There may very well be that the Australian and Canadian centers might be the two single most evaluated centers, but the biggest body of research is made on European centers as they are so vastly more numerous. Moreover, EMCDDA is in fact also reviewing the findings of Sidney and Vancouver. Nevertheless, any such speculations without sources is WP:OR and makes a reason for removal. I would also recommend you to read WP:RSN#Drug Free Australia, where it is said that DFA's "evaluation" can't be considered a reliable source on scientific subjects. That does not mean that it can be cited, but if so it have to be properly attributed, preferably noting that Drug Free Australia is a advocacy group. As you frivolously mix those sources with others, mostly without attribution, that is also a justifiable reason for removal. Coming back to the ratio between Europe and the rest of the world, it is unjustifiable to have more the half of the article is made out of criticism stemming from fringe evaluations of an Australian center. I can give you further reasons, such as when you speculate that DFA are as good evaluators as the appointed evaluators, having "used precisely the same assumptions". But all these would only be variations of WP:NPOV and WP:NOR, and those are in fact fundamental policies of Wikipedia and it is not acceptable to frivolously breach them WP:PUSHING a particular point of view. Also note that WP:Criticism-sections is discouraged, at least one-sided criticism sections. What is recommended is "reception"-sections as when "there are valid counter-arguments to the evaluations, then these must be fairly included." Your "Evidenced based opposition" miserably fails that criteria. Steinberger (talk) 05:32, 27 May 2010 (UTC)

Steinberger, Minphie, could we agree to reword the articles around this "Reception" model? I believe that it would be appropriate for the criticisms of DFA to be included as the perspective of an an abstinence advocacy group. This should not allow untrue criticisms, however.--Figs Might Ply (talk) 02:04, 29 May 2010 (UTC)

Steinberger, I have added a more comprehensive section with greater detail on SIS evaluations, which covers Europe, Canada and Australia. I have done some work on European consumption rooms but will add some more a little later. I note that you have access to Hedrich and there may be a little more that you might wish to add on European consumption rooms yourself. This gives a balanced and more comprehensive article.

I have clearly stated that Drug Free Australia is a drug prevention advocacy organisation, removing any concern you may have about attribution.

Your concern that Drug Free Australia’s analysis of the Sydney MSIC’s evaluation reports is original research is invalid, as would be abundantly clear to any reader of this discussion page. Drug Free Australia’s analysis is a secondary source which is defined:

Secondary sources are second-hand accounts, at least one step removed from an event. They rely for their material on primary sources, often making analytic or evaluative claims about them.[3] For example, a review article that analyzes research papers in a field is a secondary source for the research.[4]

So Drug Free Australia’s analysis which has been so central to the debate in Australia due to its conclusions by three medical researchers who have papers in more than 20 peer-reviewed medical journals between them (I have already outlined these before on this Discussion page) is cited as a publication which has been referenced many times in debates in the country, including Parliaments. There is no original research in a secondary source, even though you might wish to characterize it thus.

Your concern that Drug Free Australia criticisms take up 50% of the article are simply untrue. I have done a very specific word count and it is 26%. The Drug Free Australia analysis is a very detailed analysis covering numerous areas of inaccuracy in the MSIC evaluations, and is absolutely justified in light of the state of the debate in Australia. Again, Drug Free Australia’s analysis was instrumental in the ACT injection site not proceeding, so its importance to the subject is very, very clear.

In the past you have done block reversions of a whole slab of material that was not in any way referencing Drug Free Australia, but was merely outlining the results of SIS evaluations. This slab, for which I gave a warning if it was reverted again, has now been placed throughout the text in response to your request that a criticism section be melded into the overall text rather than be separate. I will be giving a second warning re blanking vandalism - censorship if this material is again removed without discussion as it has been so many times before. This text is factual and cited, crucial to any assessment of the success or otherwise of these interventions.

Here is that important text for which you never gave a rationale when deleting, which is now of course infused through the larger text as per Wikipedia best practice.

Evaluations of safe injecting centres

In the late 1990s there were a number of studies available on consumption rooms in Germany, Switzerland and the Netherlands. “The reviews concluded that the rooms contributed to improved public and client health and reductions in public nuisance but stressed the limitations of the evidence and called for further and more comprehensive evaluation studies into the impact of such services.” To that end, the two non-European injecting facilities, Australia’s Sydney Medically Supervised Injecting Centre (MSIC) and Canada’s Vancouver Insite Supervised Injection Site. have been more rigorously evaluated.

The NSW Government has provided extensive funding for ongoing evaluations of the Sydney MSIC, with a formal comprehensive evaluation produced in 2003, 18 months after the centre was opened. Other later evaluations studied various aspects of the operation - service provision (2005), community attitudes (2006), referral and client health (2007) and a fourth (2007) service operation and overdose related events.

The first 2003 Evaluation found that the MSIC had “made service contact with its target population, including many who had no prior treatment for drug dependence”, “had no detectable change in heroin overdoses at the community level”, a small number of opioid overdoses that might have been fatal if managed elsewhere, “made referrals for drug treatment, especially among frequent attendees”, not increased blood-borne virus transmission”, “no overall loss of public amenity”, “no increase in crime” locally and “the majority of the community accepted the MSIC initiative”.

The Vancouver Insite facility was evaluated during the first three years of its operation by researchers from the BC Center for Excellence in HIV/AIDS with published and some unpublished reports available. In March 2008 a Final Report of the Expert Advisory Committee appointed by the Canadian Ministry of Health was released, evaluating the performance of the Vancouver Insite against its stated objectives. Its findings were that:

• 8,000 people had visited INSITE, with 18% accounting for 80% of all visits to INSITE, less than 10% using the site for all injections, a median number of 8 visits across all clientele, and 600 visits per day, of which 80% were to inject, showing that the facility was near capacity.
• Two surveys of approximately 1,000 users established some key user characteristics – clients averaged 15 years of drug use, 51% injected heroin and 32% cocaine, 87% were infected with Hepatitis C virus and 17% with HIV, 20% were homl;ess with numerous others living in single resident rooms, 80% had been incarcerated, 21% were using methadone and 59% reported a non-fatal overdose during their lifetime.
• Users rate the service as highly satisfactory and health professionals, local police, the local community and the general public have positive or neutral views of the service, with opposition decreasing over time.
• Insite had referred clients such that it had contributed to an increased use of detoxification services and increased engagement in treatment.
• There were no overdose deaths in the facility and mathematical modeling on the 336 overdose events in the year 2006 suggested that INSITE saves about one life per year via its intervention in overdoses.
• Mathematical modeling by researchers from self-reports of users generated a wide range of estimates for HIV cases averted, but the Expert Advisory Committee was not convinced that the assumptions were valid.
• Observations before and after the opening of Insite indicated a reduction in public injecting, and there was no evidence of increases in drug-related loitering, drug dealing or petty crime in the area.
• There was no evidence that the facility influenced drug use in the community, but concerns that Insite ‘sends the wrong message’ to non-users could not be addressed from existing data.
• Insite cost $3,000,000 per annum to run. Mathematical modeling showed cost to benefit ratios of one dollar spent ranging from 0.97 to 2.90 in benefit. However the Expert Advisory Committee expressed reservation about the certainty of Insite’s cost effectiveness until proper longitudinal studies had been undertaken. Mathematical models for HIV transmissions foregone had not been locally validated and mathematical modeling from lives saved by the facility had not been validated.Minphie (talk) 00:23, 4 June 2010 (UTC)

Steinberger, I have removed your tag which suggests that the Davies study cited does not support his view that the Sydney and Vancouver evaluations are more rigorous than the others. The quote is on his first page and reads,

Only 10 years ago, there were virtually no English publications on SIFs (1). Six years later, it was still possible to contend that no well-designed, scientific studies or systematic evaluations empirically documenting the extent to which SIFs had achieved any of their goals had yet been published (3). At that time, the evidence that was available consisted largely of descriptive reports and process/implementation studies of SIFs operating in Europe. Since then, the situation has begun to change quite rapidly. Proposals to establish SIFs, first in Sydney and then in Vancouver, sparked widespread interest in evaluation research. As well, because the initiatives were so controversial, explicit evaluation protocols were required before the proposals could be adopted.

I have also removed the erroneous statement that Drug Free Australia's analysis has in any way ever been 'refuted' by injecting room staff or anyone else for that matter. I have removed it because it is simply not true, as are some of the other claims of the particular politician you cite. For instance, Drug Free Australia has NEVER claimed that heroin injections were only 26% of the total injections at the MSIC - this was just political misinformation and I would challenge you to go and find if you can see such a statement in any DFA media release or other statement. Also, I would also challenge you to place on this discussion page whatever it was that had been 'refuted' in Drug Free Australia's analysis. Remember that I have already described two issues beforehand in this discussion page - the new capture/recapture figures for heroin injectors in Kings Cross daily where the injecting room staff claimed that their own 2003 evaluators overestimated the numbers (not Drug Free Australia). The other was the ambulance callouts previously discussed with Rakkar/Figs Might Ply where the 2007 evaluation showed big reductions for Kings Cross but failed to mention the sniffer dogs introduced 1 year into the 5 year period they were studying. If you can find anything else it would be valuable to this page. But without some evidence other than a chest-beating and inaccurate politician's words, there can be no truth to the claim of 'refuted'.Minphie (talk) 11:59, 6 June 2010 (UTC)

Yes I read just that. And note that Davies do speak of "English publications" and that Sydney and Vancouver "sparked widespread interest in evaluation research" indicating that mush of that research was made in Europe. So no, that does not verify that Insite and Sydney MSIC is the most evaluated. But I had already written that here so I will not go further in the reasoning.

Robyn Parker do say that she have spoken to the representatives of the center and that they refute DFA, not only on the 26 per cent figure, but also other specific claims (DFA do say that 38% of the visitors use heroin and that the center operate at 2/3 capacity - 0.38 x 2/3 is 0.25333 - so Robyn Parker is correct when she say that DFA contend that approx. 26% of the centers capacity is used by heroinists). Also note that it is the center that republished her speech that I linked to. Steinberger (talk) 13:21, 6 June 2010 (UTC)

Steinberger, you are quite incorrect. The quote specifically says that "Six years later, it was still possible to contend that no well-designed, scientific studies or systematic evaluations empirically documenting the extent to which SIFs had achieved any of their goals had yet been published (3). AT THAT TIME, the evidence that was available consisted largely of descriptive reports and process/implementation studies of SIFs operating IN EUROPE." Then, says my citation, "Proposals to establish SIFs, first in SYDNEY and then in VANCOUVER, sparked widespread interest in evaluation research. As well, because the initiatives were so controversial, explicit evaluation protocols were required before the proposals could be adopted." Are you now telling me that all the European consumption rooms were closed around 2003 and only allowed to operate once they had shown 'explicit evaluation protocols" so that they could exist in a controversial environment. No the European rooms just happened to have been there all along, with their 'less well-designed evaluations', so goes the citation. Please do not manufacture something which is not in the text.

Re the good NSW politician that you continue to quote who can't get her facts right - you need to demonstrate to me that Drug Free Australia EVER said that 38% of the injecting room injections were heroin injections throughout the previous 6 years of its operation (to 2007). Can't find it? That's because DFA never said such a thing. Go and have a look at what the Detailed Evidence document actually says and you will see that the good politician indulged in a bit of fancy in what she said about DFA, and if DFA can prove that she was most definitely making things up then there is no place for her quote in Wikipedia. You have the ability to assess the truth or error of her assertions by going to the original DFA source - the Detailed evidence document, page 2.

So too with her fanciful boast that injecting room staff had said they had refuted various things in the DFA analysis. What things, Steinberger? What was refuted. Please do your homework and dertemine specifically whether theis boast is any less fanciful than her 26%. Wikipedia is no place for unsubstantiated claims or boasts that have no evidence backing them. Be specific, and then we have the basis of establishing truth or error, which is in fact important to Wikipedia's credibility.Minphie (talk) 11:24, 7 June 2010 (UTC)

Davies do not say that Vancouver and Sydney are the most evaluated sites, so that is not in the text either. Moreover, read the "Supervised Injection Room" chapter in Injecting drug use and you will see that European politicians accepted DCF at first without any other evidence then that they where effectively targeting problem drug users. That changed however, and research programs was mandated.

See page 41 in DFA "Detailed Evidence" for the figures. It's there. Steinberger (talk)

Steinberger, let me deal with the issue from 'Detailed Evidence' first. Page 41 of the Drug Free Australia document very clearly states that the 38% of injections being heroin is for the year 2006 only, and the quote on p 11 of the DFA document, which page 41 refers the reader to, CLEARLY says that these figures were January to June 2006, as does the cover of the shorter DFA publication 'The Case for Closure'. Your Hansard quote from the NSW politician clearly alleges that DFA was asserting that heroin injections made up only 26% of all injections in the Sydney MSIC from May 2001 to early 2007 and you are using the 38% heroin injection figure here to creatively justify her error, but the facts speak for themselves. She is very clear wrong and so you cannot quote her where the DFA evidence so clearly refutes what she alleged. It is very difficult for me to hold your trite and non-specific replies on this issue as being in good faith, and if you continue to change accurate text I have written into Wikipedia for frivolous and unevidenced rationales such as your one immediately above, I will start building a case for tendentious editing, taking of course your history of undiscussed block reverts and inadequate rationales as outlined in my 'response from the subject' to your Request for Comment here.

The second issue is your unwillingness to address my questions about your interpretation of the Davies citation. It is abundantly clear that Davies cannot possibly be speaking of European consumption rooms as being more rigorously evaluated simply because:

1. he has just described the previous European evaluations thus - "At that time, the evidence that was available consisted largely of descriptive reports and process/implementation studies of SIFs operating in Europe."
2. he is very clearly speaking of injection sites which have better evaluation protocols as a result of being required to show more rigorous protocols before they were given the go-ahead to open. This clearly applies to the Sydney and Vancouver sites he specifically nominates in his text - "Proposals to establish SIFs, first in Sydney and then in Vancouver, sparked widespread interest in evaluation research. As well, because the initiatives were so controversial, explicit evaluation protocols were required before the proposals could be adopted."

My question to you was, "What European rooms were opened since 2003 (four years before Davies' cited article, just as he describes in his opening sentences) that were required to propose explicit evaluation protocols before they could be opened in controversial circumstances?" I need clear answers on this before you go changing my text again.

It is quite clear that the reason you may not wish to accede to the very clear interpretation of this Davies citation is because you want to later argue that there should be less written about the Sydney and Vancouver sites, with all the well-substantiated criticism that pertains to their more comprehensive evaluations. I understand that the picture for these sites is not pretty and that there are many weighty negatives in the critiques of them, but if your motivation is censorship of what is the reality about them, and your continued seeming obtuseness regarding the Davies quote is a means to a censorship end, then there should be no place for this in Wikipedia. Please desist from tagging this citation as if the interpretation is not abundantly clear. If your concern is the word 'rigorous' then of course we can use the words 'more comprehensive' but rigour well describes Davies description of 'explicit evaluation protocols'.110.175.209.31 (talk) 02:09, 9 June 2010 (UTC)

Parker do not say that DFA's figure is over a six year period. You misread her. Try again.

Davis does not say that Vancouver and Sydney are more rigorously evaluated. Thus, "verification failed". One should never have to interpret sources used, its content should directly support any statement in the text according to WP:NOR Steinberger (talk) 08:54, 9 June 2010 (UTC)

About your Third Opinion request:

Disclaimers: Although I am a Third Opinion Wikipedian, this is not a Third Opinion in response to the request made at WP:3O, but is merely some personal observations and/or information about your request and/or your dispute.

Comments/Information: One particularly wise Third Opinion Wikipedian, RegentsPark, once succinctly put the purpose of Third Opinions like this, "It's sort of like if you're having an argument on the street in front of City Hall and turn to a passer-by to ask 'hey, is it true that the Brooklyn Bridge is for sale?'." Third Opinions are more suited for simple, not complex disputes, but sometimes complex–appearing ones aren't as complex as they appear when distilled down to their essence. In order to find a Third Opinion Wikipedian who is willing to give an opinion, it would be very useful if the disputants in this dispute would, just below this note, precisely but briefly summarize the dispute (preferably illustrating it with diffs) and their respective positions.

Note to other 3O Wikipedians: I have not yet "taken" this request, removed it from the active request list at the WP:3O page, or otherwise "reserved" it, so please go ahead and opine on it if you care to do so. —TRANSPORTERMAN (TALK) 13:34, 9 June 2010 (UTC)

Clarification for 3O

I believe that Minphie think these are the two most urgent problems:

1. If "To that end, the two non-European injecting facilities, Australia’s Sydney Medically Supervised Injecting Centre (MSIC) and Canada’s Vancouver Insite Supervised Injection Site have been more rigorously evaluated" is supported by the following excerpt (Minphies view) or if it is over-interpretation as defined in WP:NOR (my view).

"Only 10 years ago, there were virtually no English publications on SIFs. Six years later, it was still possible to contend that no well-designed, scientific studies or systematic evaluations empirically documenting the extent to which SIFs had achieved any of their goals had yet been published. At that time, the evidence that was available consisted largely of descriptive reports and process/implementation studies of SIFs operating in Europe. Since then, the situation has begun to change quite rapidly. Proposals to establish SIFs, first in Sydney and then in Vancouver, sparked widespread interest in evaluation research. As well, because the initiatives were so controversial, explicit evaluation protocols were required before the proposals could be adopted."

— Garth Davies "A Critical Evaluation of the Effects of Safe Injection Facilities" The Journal of Global Drug Policy and Practice July 3, 2007

1. If " They [Drug Free Australia] released their findings to the media and to politicians, leading to a robust debate in Australia regarding the effectiveness of aspects of the Sydney MSIC." is supported by the hansart from NSW legislature (Minphies view) or if it takes gross interpretation of that WP:Primary source to reach that conclusion and thus that such statement is breaching WP:NOR (my view).

There might be more, as you see above we disagree on many specifics about this article. But lets start with this. Steinberger (talk) 19:41, 9 June 2010 (UTC)

This dispute can now be closed. I have found text in the latest EMCDDA 2010 Review, now referenced in the SIS page text, which says exactly what I had written ie "There have been relatively few rigorous evaluations of DCRs, with evidence reviews relying primarily on analyses of descriptive data, cross-sectional survey data, and ecological indicators from a larger number of less sophisticated studies. This is especially the case in Europe, where DCRs emerged as a local service response with questions of evaluation arising subsequently. However, the Sydney and Vancouver facilities were established as scientific pilot studies, and thus incorporated more rigorous research designs (see below)."110.175.209.31 (talk) 23:56, 9 June 2010 (UTC)

Dispute removed from Third Opinion project active dispute list per above. If any editors disagree, please feel free to relist the dispute. — TRANSPORTERMAN (TALK) 13:15, 10 June 2010 (UTC)