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Opinion
  |  
Health

Rod Rosenstein’s Cheap and Dangerous Shot at Vancouver’s Insite

Deputy U.S. attorney general argues for same old failed tactics in dealing with opioid crisis.

By Crawford Kilian 31 Aug 2018 | TheTyee.ca

Crawford Kilian is a contributing editor of The Tyee.

Canadians, like Americans, know Rod J. Rosenstein, the deputy attorney general of the United States, only because he appointed Robert Mueller as special counsel to investigate possible Russian meddling in the 2016 election. That makes him something of a hero, one who often comes under attack from Donald Trump.

On Monday, Rosenstein went from hero to zero just by publishing an op-ed in The New York Times. “Fight Drug Abuse, Don’t Subsidize It,” he urged — and especially don’t fight it by establishing safe injection sites.

Rosenstein may be a great lawyer, but as a public health expert he’s just another charlatan. The great 19th-century German doctor and politician Rudolf Virchow famously observed that “Medicine is a social science, and politics is nothing else but medicine on a large scale.” Or, in Rosenstein’s case, malpractice on a national scale.

Rosenstein notes that drug overdoses are now killing over 60,000 Americans a year (and doesn’t mention that’s almost twice as many as die by gunshot). He laments that “remarkably, law enforcement efforts actually declined while deaths were on the rise… The Trump administration is working to reverse those trends. Prosecutions of drug traffickers are on the rise, and the surge in overdose deaths is slowing.”

He gives no source for “slowing.” The most recent information from the U.S. Centers for Disease Control is from 2016, when the CDC reported that overdoses killed 63,632 Americans — two-thirds of them involving opioids. And that was a 21.5-per-cent increase from 2015.

Injection sites ‘dangerous’?

Rosenstein is alarmed that “some cities and counties are considering sponsoring centers where drug users can abuse dangerous illegal drugs with government help. Advocates euphemistically call them ‘safe injection sites,’ but they are very dangerous and would only make the opioid crisis worse.”

He goes on to describe how these sites’ “staff members help people abuse drugs by providing needles and stand ready to resuscitate addicts who overdose.” Clean needles! Resuscitated overdose cases! The horror!

After a litany of American cities considering such sites, Rosenstein says “they’re illegal,” and threatens the cities “should expect the Department of Justice to meet the opening of any injection site with swift and aggressive action.” He frets about the obvious — drugs may be laced with fentanyl or carfentanil — and warns that “a bystander or emergency medical worker who comes in contact with such drugs can be gravely harmed.” Perhaps so, but bystanders and first responders are more likely to come in contact with such substances in some dark alley than in a safe injection site.

And it’s precisely Insite that Rosenstein attacks. He cites just one source, a scandalized city councillor in Redmond, Washington, who visited the Downtown East Side last year and said “It was the most depraved scene I’ve witnessed in person.” He derided “Seattle’s far left politicians” for wanting safe injection sites there.

Rosenstein certainly didn’t check with Vancouver Coastal Health, which helps run Insite and reported last year:

“From Jan. 1 to Nov. 30, 2017, there were 119,395 visits to the supervised injection room at Insite. Among those, 1.2 per cent visits resulted in an overdose. 10,534 visits used the injection room in November 2017, that was 4.1 per cent decrease over the average number of visits in the previous three months (10,980) visits, and nine per cent decrease over the number of visits in November 2016 (11,544 visits). 94 visits resulted in an overdose in November 2017, a 19 per cent decline over the average overdoses during the previous three months (117 overdoses), and 61 per cent decrease over the number of overdoses in November 2016 (239 overdoses).”

Sure, the DTES is a grim place, and all of B.C. suffers a growing number of overdose deaths. The B.C. Coroners Service recently reported 134 suspected drug overdose deaths in July, a 25-per-cent increase over June. We are now running an average of 125.4 overdose deaths a month in 2018, up from 120.8 last year, 82.8 in 2016, and 30.7 in 2014.

But there were no deaths at supervised consumption or drug overdose prevention sites.

Rosenstein claims that “injection sites destroy the surrounding community. When drug users flock to a site, drug dealers follow, bringing with them violence and despair, posing a danger to neighbours and law-abiding visitors.” He ignores the fact that dealers and injection sites tend to congregate where the users are. If anything, Insite and similar sites are a sign of health in their communities, not a symptom of malaise.

With casual citation that would earn him a rebuke from any judge, Rosenstein mentions “some estimates” that only 10 percent of safe injection site users get treatment. But zero percent of fatal overdose cases get treatment, and we would have far more deaths than we do without Insite. If nothing else, drug users can walk away from Insite having bought a little more time to get a grip on their lives.

As an intelligent and highly educated lawyer, Rosenstein must know how “swift and aggressive action” has abjectly failed to stop the opioid catastrophe, just as it failed against cocaine and heroin and psychedelics and marijuana. Yet here he is, wading into a public health crisis even deadlier than gun violence, prescribing yet more of the same swift and aggressive action.

Especially given his sycophantic reference to “the Trump administration,” Rosenstein’s op-ed looks more like a move to please his boss than a sincere effort to address a health disaster. Perhaps he has good reason to fear Trump will fire him and then get rid of Mueller, and thinks some swift and aggressive claptrap in The New York Times will buy him some time — just like an Insite user.  [Tyee]

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