The authors of a Reflection and Reaction comment in the March issue of The Lancet Infectious Diseases take a hard line on some health policy research posted on the Internet, especially regarding evidence based drug harm reduction. In particular, they focus on a website posted as the Institute on Global Drug Policy (IGDP) which prevents itself as”an online open access journal,” but also happens to be a part of the Drug Free America Foundation, a non-profit organization that supports “efforts to oppose policies based on the concept of harm reduction.”According to the authors, politicians must beware the misleading intentions of sites such as this one to prevent making improperly informed decisions about health policy.

Harm-reduction programs attempt to address the issues related to illegal drugs by means other than total abstinence, such as needle exchanges. According to the authors, Drs Evan Wood, Julio Montaner, and Thomas Kerr, British Columbia Centre for Excellence in HIV/AIDS, St Paul’s Hospital, and Department of Medicine, University of British Columbia, Vancouver, Canada, there is indeed a formidable (and expanding) mass of evidence that these harm reduction measures are beneficial. However, groups such as IGDP have focused their efforts in agains this effort, including the above mentioned website, which claims to exist for the dissemination of “opinion essays.”

The authors say that this has influenced Canada’s health policy already: “The DFAF seems to have had some recent success with this approach. In an apparent effort to persuade Canada’s Prime Minister Stephen Harper that his government should withdraw support from North America’s first medically supervised injecting facility (SIF) in Vancouver, the website recently published a critique of the SIF…The website has also posted a range of articles against needle exchange and other evidence based harm reduction programmes. The conclusions of the needle exchange articles clearly contradict scientific consensus documents, such as a recent report by the US Institute of Medicine.”

Since these IGDP articles were published online, Canada’s new federal government announced a new anti-drug strategy that increases law enforement efforts while perhaps endangering the future of the Vancouver SIF. According to the authors, it is troubling that Canada’s federal health minister recently publicly referred to the IGDP report while claiming there is “growing debate” about SIF, despite all studies in conventional scientific publications indicating multiple benefits with negligible negative effects.

The authors conclude, attempting to analyze the public popularity of such actions. “It remains to be seen whether what has been described as the Canadian federal government’s new ‘ideological’ opposition to harm reduction will win them votes. Unlike in the USA, where surveys suggest the public supports the country’s ‘war on drugs’, recent surveys in Canada suggest that the Canadian public is catching up to science when is comes to support for harm reduction programmes. Although the Canadian public may be gaining wisdom, advancing evidence-based public health will now require that politicians are able to tell the difference between valid peer-reviewed science and essays posted on the websites of lobby groups.”

Illicit drug addiction, infectious disease spread, and the need for an evidence-based response
Evan Wood, Julio S Montaner, Thomas Kerr
The Lancet Infectious Diseases, Vol 8, March 2008
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Written by Anna Sophia McKenney