Talk:Harm reduction/Archive 3

Reinstatement of Sweden having gained lowest drug use levels in developed world
Removal of the statement about Sweden having the lowest levels of drug use in the developed world is inappropriate because the statement is indeed evidenced by the UN World Drug Reports since the year 2000, when figures were first comprehensively released for 2000, then 2002, then annually. An aggregated average of drug use for OECD countries (opiates, cocaine, amphetamine, cannabis) in 2000 gives the percentages below.

Australia 5.9 Austria	1.0 Belgium	1.6 Canada	2.3 Czech Repub.1.0 Denmark	1.4 Finland	0.7 France	1.4 Germany	1.3 Greece	1.3 Hungary	0.5 Ireland	2.4 Italy	1.6 Luxembourg 1.3 Mexico	0.5 Netherlands 1.6 New Zealand 4.4 Norway	1.2 Portugal 1.3 Spain	2.7 Sweden	0.2 Switzerland 2.6 UK	3.0 USA	4.2

For the 2009 report the averages across 5 drug types (ecstasy added) are:

Australia	4.0 Austria	1.2 Belgium	1.8 Canada	4.4 Czech Repub. 2.8 Denmark	1.6 Finland	1.1 France	2.1 Germany	1.3 Greece	0.5 Hungary	0.8 Ireland	2.0 Italy	3.8 Luxembourg	2.1 Mexico	0.9 Netherlands	1.6 New Zealand	3.9 Norway	1.5 Portugal	1.1 Spain	3.1 Sweden	0.8 Switzerland	2.7 UK	3.5 USA	3.7

Across the decade of reports Sweden has had the lowest levels, with Greece achieving a lower level of drug use from the 2006 - 2009 reports. Sweden is the second lowest in 2009.

The citation does indeed support the statement that rehab has yielded for Sweden the lowest levels of drug use in the developed world. However the footnoting of 9 UN Drug Reports is daunting, so I have referenced the last report as citation indicating that the figures are found in the UN Drug Reports. Minphie (talk) 12:59, 3 May 2010 (UTC)


 * Compulsory treatment was introduced in 1982, since then the numbers of problem drug users have more then doubled. It is inappropriate to suggest a link between the two, where the former depresses the latter. Steinberger (talk) 13:06, 3 May 2010 (UTC)

But Steinberger's rationale does not have any relevance here. Drug use is established by the percentages of surveyed population using various illicit drugs from survey to survey. This is the standard measure, rather than country estimates of drug user numbers which have differing assumptions involved as to what constitutes a problem drug user. And we have some idea as to the levels of drug use back in the early 80's from school surveys, which are directly comparable to now.

I also doubt whether Steinberger can give a figure for problem drug user numbers pre 1982 when Swedish Drug Policy came into effect. I have never seen such a number, or what percentage of the population it was. So I figure this is just an uncited response that has no substance.

Added to this is the issue that if Sweden moves from an average of 0.2% of its population to 0.8%, but still experiences amongst the lowest levels in the developed world then the statement that its drug policy has worked remains correct despite a rise off a very low base. Minphie (talk) 01:30, 4 May 2010 (UTC) -- Minphie's data, made more readable

--Figs Might Ply (talk) 08:40, 4 May 2010 (UTC)


 * Minphie, your criticism of Steinberger's observation is equally valid against the original sentence. "Alternatively, Sweden’s investment in a policy of compulsory rehabilitation of drug addicts has yielded the lowest illicit drug use levels in the developed world" is original research. I see the point you are trying to make, however, your aggregate data does prove this, the section you referenced only makes one unrelated mention of rehab.  I'm going to delete the sentence again and await a properly researched piece of evidence that proves the point.--Figs Might Ply (talk) 08:48, 4 May 2010 (UTC)

Deletion of speculation and untrue assertion re Sweden
I have deleted Steinberger's false statement about illicit drug use increasing in Sweden when the data shows exactly the opposite.

1. Have a look at pp 26,27 of the UNODC publication 'Sweden's Successful Drug Policy' and you will see that it has been decreasing for a number of years after rises during the time when Sweden allocated less funds to its drug policy. Antonio Samaranche makes this point in his Preface to the document and there is indeed a correspondence between funding and decreasing use levels.

2. An appeal to the UNODC World Drug Report is not valid either because, despite its time-lagged figures for all countries, it too shows a decrease in drug use for Sweden in the 2009 report. My aggregate average for all OECD countries was based on the upper level of ranges, where there is a range calculated by the UNODC. Taking the lower range for Sweden the decreases in the 2009 report are more marked than the decrease using the upper levels of the ranges calculated.

I have also deleted the speculative rationales given by Steinberger regarding Sweden's low rates of illicit drug use on the following grounds.

Sweden has had, despite Steinberger's listed rationales of lower unemployment and temperance culture, illicit drug use levels on their student surveys in 1971 that only began to be matched by other European countries in the 1990s with the increases in illicit drug use experienced world-wide. See the EMCDDA Annex for its 2000 Annual Report for European figures on student lifetime prevalence. All this despite Sweden having lower unemployment and a temperance culture, as Steinberger and others have speculated. But Sweden brought these levels back to 3-4% by the early 90s via a restrictive drug policy - nothing else explains the drop - not changing employment levels or changes in the temperance culture. I might note that Australia's lifetime prevalence for young people was 52% for the same late 90s period as is addressed in the EMCDDA report for 2000. Australia is not on the drug trafficking routes (another explanation used by critics of Sweden), and has employment levels lower than many other countries, as with Sweden. But Australia, despite these benefits, has had the highest levels of drug use in the developed world for a decade. So arguments about causes can be easily falsified by other country's data or by Sweden's previous high levels of drug use. Minphie (talk) 01:11, 5 May 2010 (UTC)


 * The youth unemployment is a better explanation then the policies, at least according to the widely cited sources I have given. That most Sweidsh politicans and UNODC thinks different might be notable but is not true. Steinberger (talk) 12:32, 5 May 2010 (UTC)

--- Hi Minphie and Steinberger,

Minphie, you're probably going to hate me, but I took out the criticism section of Heroin maintenance programs. The content was either inconclusive or original research/synthesis.

Firstly, who are the critics you mention? Regarding the RIOTT program, the reference given was highly supportive of said programs, and made a point of the savings it made to government spending.

Secondly, the second point about Sweden has not addressed my point above: ''...[It] is original research. I see the point you are trying to make, however, your aggregate data does prove [that compulsory rehab affects levels of drug use ], the section you referenced only makes one unrelated mention of rehab. I'm going to delete the sentence again and await a properly researched piece of evidence that proves the point''

Minphie, unless you find a valid source that addresses the above points, I don't think we should include your claims in the article.


 * Included below are the sections I removed for ease of reference.


 * Minphie's section, removed as the assertions are questionable and are backed up with original research/synthesis
 * 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. This is roughly equivalent to average heroin user habits of £15,600 pounds per annum which were funded significantly by crime, and yet participants still average a continued use of illegal heroin of £2,600 per year, again funded significantly by crime despite the provision of free heroin. Alternatively, and according to UNODC, Sweden’s investment in, and commitment to, a drug free society where a policy of compulsory rehabilitation of drug addicts is integral, has yielded the lowest illicit drug use levels in the developed world. 


 * Steinberger's section, no longer needed as the point it was responding to was not valid.
 * However, UNODC findings have been criticized for using selective data to prove their point. Nils Christie, have among others, pointed out Sweden as the hawk of international drug policy, being a welfare alibi and giving legitimacy to the US drug war. Adding that the two countries have an extraordinary influence on UNODC as the biggest donor countries. Some more common explanations to Swedens low prevalence rates are socioeconomical and cultural factors, such as a strong temperance culture and a very low youth unemployment - the latter known to be correlating strongly with drug experimentation among youths, elsewhere, such as in most of Europe and Australia, as well as in Sweden.  Drug use is presently on the rise again. 

Finally, I think we are including this debate on the wrong page. The Harm Reduction page is almost too long, and nitpicking over Sweden might be better done on a page like Drug policy.

--Figs Might Ply (talk) 14:05, 5 May 2010 (UTC)


 * Fair enough. Steinberger (talk) 20:25, 5 May 2010 (UTC)

I have retained the previous wording re Critics of the heroin trial on the following grounds.

1. User Pigs Might Fly is only using frivolous and needless objections to keep a properly cited and evidenced section of text off the page. Therefore my adding a citation for the source of such criticisms is gratuitous on my part - there are hundreds of pages in Wikipedia where the word 'critics' is used without citing any individual or organisation and I won't tolerate this clear obstructionism in the future.

2. The texts on costs of the heroin program in Britain cited the actual costs of the program as released by the program organisers themsleves. The rest of the text is a straight logical deduction. Go to any manual on logic and you will find that deduction is not synthesis in any shape or form, rather the opposite. So Pigs Might Fly obstructs on indefensible grounds here. Of course the organisers of this trial see it as saving money, but the cost of 15,000 pounds per annum is correct in terms of the cost to the government. The savings they speak of are in less acquisitive crime, but they point out that few have ceased using street heroin altogether, meaning that there will be ongoing acquisitive crime, though at a lesser level for as long as any government keeps funding such a program. In stark contrast is the International Taskforce's assertion that a restrictive drug policy such as Sweden's, where coerced rehab actually reduces the number of active drug users (this is DEFINITIONAL of the word 'rehab' and not synthetic or otherwise. When a person is successfully rehabilitated from drug use they no longer commit ANY acquisitive crime.  Some acquisitive crime as per the heroin trial in the UK is worse than no acquisitive crime.  This is not original research, or synthesis.  This is linear logic. So Pigs Might Fly's deleting of my text is only based on a carping obstructionism that has no basis in either logic or validated observation and I am noting this as an instance of such if I later want to take this matter further.

I have removed Steinberger's speculations about Sweden's success with their drug policy because as Pigs Might Fly has noted, it makes the text overly long over a point (of current rises and falls in drug use) which makes not one bit of difference to whether Sweden had the lowest drug use levels as per my proven citation, which they indeed did. Steinberger has appealed to the 6% figure for school student 12 month prevalence in 2008, up from 5% for 2006 and 2007, going back to match the 2005 6%. Steinberger needs to note that one swallow doesn't make a summer, and that one year of increase does not constitute a trend.

Pigs Might Fly objects that he can't find sufficient proof of Sweden having a coerced rehabilitation policy. A simple typing of 'coerce' into the pdf search for that same document will produce numerous references. And my text is not saying that coerced rehab is the only thing in Swedish policy that might have led to its success - their policy is much broader than that. But coerced rehab stands in stark contrast to heroin maintenance, which maintains an addiction in their ongoing drug use, as against rehab which ends it. The argument is ipso facto. Minphie (talk) 00:22, 6 May 2010 (UTC) —Preceding unsigned comment added by Minphie (talk • contribs) 00:20, 6 May 2010 (UTC)


 * As UNODC is a heavily criticized organization, its findings should not stand alone without the criticism that exsits. That would breach NPOV. Either with or not at all. And moreover, the critique of the criticizers it is not more speculative then UNODC and others critique. Steinberger (talk) 11:51, 6 May 2010 (UTC)

Steinberger, this deletion is intolerable in that it is, primarily, mostly deletion of text which has nothing whatsoever to do with the argument you have mounted. Deleting properly cited and factual text is vandalism and I a not prepared to put up with your vandalism of properly cited and factual text. I am reverting the text on Sweden on two grounds.

1. Virtually the only criticisms of the UNODC come from the drug legalization lobby and of course they are very vociferous but out of step with the world at large. . . in 2009 when the UN Committee on Narcotic Drugs (CND) was pressured by the international drug legalization lobby to alter the illicit drug conventions to include 'harm reduction' as a policy plank, it declined to do so, representing the vote of the vast majority represented on that UN committee of more than 70 countries. They had faith in the UNODC and its resistance to certain harm reduction interventions (eg injecting rooms), and backed it up with a UN majority vote. The drug legalization lobby was mightily upset, as I can demonstrate from their commentaries during the whole 2009 process, but their discontent with the UNODC is expected but not necessarily valid just because they voice something. Their criticisms come moreso from a different starting assumption - individual rights - while the UNODC gives more weight to the community's rights to protect itself from harms. We know where the community stands on this issue because no country has legalized drugs anywhere but US' Alaska some decades back, and they reverted that as a bad idea once their school-kids' use skyrocketed.

2. Here is the reason I won't tolerate any further deletions on the Sweden issue. The point that you have deleted, the sentence on Sweden's success, has absolutely nothing to do with the UNODC. I have demonstrated from the World Drug Report of 2000 that Sweden has had the lowest drug use in the developed world. These are not UNODC statistics but figures from each country's own population surveys that just happen to be in the UNODC document. The point about coerced rehab being one of their central strategies can be backed up from a thousand other sources. If the UNODC states something abundantly factual about Sweden having coerced rehab, then you can't change the facts. You may try to delete the facts from the page because you do not like something about this, but that again is vandalism. I will take this matter further if you delete this section again. —Preceding unsigned comment added by Minphie (talk • contribs) 22:58, 6 May 2010 (UTC)

CEDRO of Amsterdam was an state-sponsored but independent research institute. Stockholms University is a ordinary university (Lenke and Olsson). Nils Christie got his salary from Oslo University but now he is retired. Non represents "the legalization lobby" and their findings can not be considered to be politically motivated. Contrary to UNODC who is a political organization and has as it stated goal to suggest policies. That our queen and "drug minister" voted no to harm reduction in Vienna, together with the lot does not change that. Nor was that is a scientific vetting of the "harm reduction" ideas. If CEDRO and others find the link between forced treatment and low drug prevalence numbers to be bull, that is relevant. Regardless of what UNODC and other hawkish organization find with their selective data. I will delete it again. Provide peer-reviewed articles if you really what to make the point. Steinberger (talk) 08:13, 7 May 2010 (UTC)


 * Minphie, we are changing your contributions to the article because we believe they are inappropriate or wrong. You are changing our contributions to the article because you believe they are inappropriate or wrong.  This process is not vandalism if we make a reasonable attempt to discuss it on the talk page, as we are doing.  Please assume good faith in us.  Also, I think we should all read this, from WP:TE
 * It is important to recognize that everybody has bias. Whether it is the systemic bias of demographics or a political opinion, few people will edit subjects in which they have no interest. Bias is not in and of itself a problem in editors, only in articles. Problems arise when editors see their own bias as neutral, and especially when they assume that any resistance to their edits is founded in bias towards an opposing point of view. The perception that “he who is not for me is against me” is contrary to Wikipedia’s assume good faith guideline: always allow for the possibility that you are indeed wrong, and remember that attributing motives to fellow editors is inconsiderate.
 * I also think that we should bear in mind the considerations raised in WP:WEIGHT regarding the amount of criticism being raised here.
 * Regarding your comment about the tagging of critic, I agree with your point, there are other articles where the word has not been tagged where it might need to be. I invite you to rectify this problem by tagging any instance where you see it occurring.  You can't claim that I am being obstructionist by editing this page in accordance with the guidelines.
 * Regarding the section about Sweden, I realise that I actually was looking in the 2009 WDR, not the 2000 edition. However, a simple typing of 'coerce' into the pdf search for that same document will not produce a single mention of the word.  So, I support Steinbergerger's decision to remove the section as you haven't really addressed my earlier points.

--Figs Might Ply (talk) 14:37, 8 May 2010 (UTC)

Figs Might Ply, I am reverting your edits with small sections unreverted on the grounds that you are looking at the wrong UNODC document. Go to the one on Sweden Drug Policy previously cited above (easily found on the net) and type in 'coerce'. Re the bias question taking an evidenced point of view is not evidence of bias, but rather of dispassionate evidence being lodged on the page for one side of an argument. That is not bias, or else I would have to say that Rakkar and Steinberger are biased because they have not entered one criticism of harm reduction initiatives or policies in the many pages they have contributed to - I have reviewed all of them. Re critics, my comment was about pages on Wikipedia where the collective term 'critics' is used on any of the pages of Wikipedia, not drug policy pages. I could hardly do as you ask. But the point remains that they do not cite critics on those other pages simply because the criticism demonstrates that critics exist or there would be no criticism, if you understand. I take this point up further in the Talk page with Rakkar).

Steinberger, as I said, CEDRO has a history of demonstrated drug legalization activism. My comments stand. Also see my comments at Wikiquette alerts Minphie (talk) 02:16, 14 May 2010 (UTC)


 * Demonstrate that with sources thanks. Moreover, you misinterpret kingshealthpartners.org; they suggest that it is cost-effective as the alternative to the 15k£ of heroine maintenance is 44k£ of prison. Infact, what you are doing is called WP:Original research and that is forbidden according to policy. Steinberger (talk) 04:43, 14 May 2010 (UTC)

Steinberger, have a look at the publications of CEDRO outside of their epidemiological studies and it is abundantly clear that they are into the strongest advocacy against prohibition. If they are wanting to end prohibition they are ipso facto promoting drug legalization. Go to http://www.cedro-uva.org/lib/index.html. Minphie (talk) 12:19, 16 May 2010 (UTC)

References

Harm reduction and Sweden
Minphie seems to believe that Sweden have fared well without harm reduction, persistently citing it as an example of non-harm reduction success. However, that is a strange view for me that is a Swede as I know it is wrong. In fact, some harm reduction measures have indeed already been introduced to lower the embarrassingly high death rate among drug addicts, albeit under other names. But that will soon change. According to the governments special investigator on abuse, the next SoU-report (that is to be published in December) will recommend the explicit introduction of harm reduction measures. Or as it is written in the discussion-PM :
 * "Missbruksutredningens kartläggningsarbete hittills indikerar att så kallade skadebegränsande åtgärder (harm reduction) av olika slag kan vara en underutnyttjad strategi i Sverige. Utredningen kommer närmare att analysera orsakerna till detta samt lämna förslag som innebär att insatser enligt denna strategi kan utnyttjas i större omfattning i hela landet."
 * "The abuse investigations surveys have so far indicated that so called harm reducing measures (harm reduction) of different types is a underutilised strategy in Sweden. The survey will further analyse the reasons to this, and come with recommendations that will involve measures according this strategy that can be used to a larger extent in the whole country."

So, Sweden is not an good example of non-harm reduction. Steinberger (talk) 12:24, 14 May 2010 (UTC)

Steinberger, you might kindly point to where I have allegedly said that Sweden's success is due to having no harm reduction. I believe you will not find any such statement. My statement, which you continue to debate, is a very simple one which talks about the success of Sweden's restrictive drug policy (their own term) and the correlation between its implementation in the early 80's and the sharp decreases in drug use. You also need to know that it has always been freely acknowledged by organizations questioning the claims of harm reduction that Sweden has some level of harm reduction. I would prefer not to be spending time on straw men or inaccurate allegations which seem to be clutching at straws to keep an adequately demonstrated argument off the page. Minphie (talk) 12:31, 16 May 2010 (UTC)


 * "...a drug free society where a policy of compulsory rehabilitation of drug addicts is integral, has yielded the lowest illicit drug use levels in the developed world" you wrote in the article at a place that made Sweden an alternative to "Heroin assisted treatment" or implicitly harm reduction in general. The SoU-investigator say specificity about cohesive treatment that it is ineffective, inconsistent and fails due process. He further say that it is unethical to commit people to a treatment that have a neutral if not bad outcome. He is recommending either scraping the special law on cohesive treatment of abusers (and an corresponding reworking of the standard law on involuntary commitment) or a major rewrite of that law. Steinberger (talk) 19:36, 17 May 2010 (UTC)

Steinberger, I have very clearly and unmistakably juxtaposed the costs of heroin maintenance versus the costs of a drug free ex-user on society and commented that critics of heroin maintenance support the indubitable and uncontestable fact that it is a far cheaper long-term strategy to get users clean, something which one country, Sweden, is committed to with its coerced rehab. This is not the place to discuss the ethics of coerced rehab - it is irrelevant. This is not the place to have a discussion as to whether Sweden has harm reduction or not - it is irrelevant to the costs of a rehabilitated drug user. The only relevant argument is whether my statement that Sweden's restrictive drug policy, which includes the relevant notion of coerced rehab, has been successful because of its restrictive drug policy (which may include some harm reduction but where the emphasis in harm reduction is still to get their users drug free). I have given the UNODC document as citation - UNODC documentation that drug legalizers won't accept, but neither do they accept the world's consensus against illicit drug use (called prohibition - ratified again in Vienna CND March 2009) either. So that was not a valid argument. Minphie (talk) 00:39, 18 May 2010 (UTC)


 * Read WP:OR for god sake, I am not going to try to convince you about something that I don't have to. You can't "juxtapose" facts and make an argument, that is specificity breaching WP:SYN. There is nothing in the sources that you use that say that heroin maintenance is cost-ineffective. Then you can̈́'t make that argument. End of story. Steinberger (talk) 09:49, 18 May 2010 (UTC)

Steinberger, to the contrary, a contrast is not a synthesis in any shape, form, or book of logic. A juxtaposition is decidedly not a synthesis, quite the opposite. If I find that tomatoes at my local supermarket cost $30.00 per kilo but that I can get them for $2.00 a kilo elsewhere, my conclusion that the cheaper tomatoes are indeed cheaper are in the nature of a deduction, certainly not a synthesis. If you are hoping that Wikipedia should not allow straightforward deductions or contrasts to be made from two carefully cited and factually correct sources, then I suspect that Wikipedia could have no existence, because deductions are important to every work. You say you are a student in Sweden. I urge you to go and clarify these two terms of logic, 'synthesis' and 'deduction' with a professor of philosophy and then take your flag off the page. It is incorrect, and this is indubitably demonstrable. Minphie (talk) 22:40, 18 May 2010 (UTC)


 * It is quite evident that you have not read WP:OR. Try again. Steinberger (talk) 08:50, 19 May 2010 (UTC)

Steinberger, having added additional citations to remove any doubt that you might have that these criticisms have actually been voiced by various organisations or individuals amongst the International Taskforce, I have also removed the Original Research tag you added to the British Heroin Trial statement. There is nothing that can possibly be construed as synthesis in this statement. The weekly costs of heroin and weekly costs of crime have been shown as per annum figures rather than the weekly figures published, but our calculations are not synthesis in any shape or form, rather a deduction which can only yield one conclusions (ie there are 52 weeks in a year and 52x300 equals roughly 15,000 pounds). I have placed the cited cost of the trial into the text because the reader will have no idea of costs unless I cite them. And facts are facts. I could, of course, go on to say that Strang says that there is a saving to the community from the 15,000 pounds shelled out yearly by the UK government, but any saving he cites does not change the fact that the community still spends 15,000+ per year per participant. The Taskforce organisation's alternative - an insistence on rehabilitation/treatment to abstinence - is very evidently the cheaper option because the cost of once-off rehab is followed by zero burden on the community year after year while the UK is spending its 15,000 pounds ad infinitum per person. Its logic is clear, and Strang's views (unlike his figures) are superfluous to the Taskforce argument.Minphie (talk) 03:06, 20 May 2010 (UTC)


 * No, that is still a wp:synthesis and you can only make that argument if it is made explicitly in the source you cite. Neither can you imply that someone have cited Sweden's policies as an alternative to heroine maintenance if they explicitly have not. As you did now, bringing sources that make similar, yet not the same criticism, does not make it legitimate to indulge in it. I will now remove the original research once and for all. However, I will retain your new sources and further them. That is quite okay. Steinberger (talk) 09:14, 20 May 2010 (UTC)

Steinberger, I have added an additional citation of a critic of the UK Strang heroin trial to my existing citation list to remove your erroneous objection of synthesis. The citation from the Centre for Policy Studies does not reference MY words but HER words so therefore is not original research. The cited costs of the British heroin trial are not my words and are cited, so this is not original research. Neither is there any synthesis involved in citing the exact figures of the Strang trial, because there is no new proposition being added to the idea of 'expensive' to create a new synthesized conclusion. Rather the Strang citation is only adding detailed costs from a cited source which illustrate the proposition 'expensive'. Again, there is nothing remotely like synthesis because there is no new proposition.

Likewise, your concerns about critics juxtaposing the costs of maintenance with the non-ongoing costs of rehabilitated ex-users are simply based on another error in your thinking. There is no hint of synthesis if the critic I cited states concern about the costs of harm reduction, where he specifically mentions maintenance programs which don't try to cure the addiction, and where heroin maintenance is mentioned as a sub category of maintenance in his discussion. There is no requirement that this critic specifically mention the UK trial - his general criticism of the costs to society and government of maintenance hold true for the subcategory of heroin maintenance. Again there is no new proposition or synthesis involved. Go and read wp:synthesis again. Likewise, if critics mention Sweden as an example of a successful policy, this is a separate point to the others made and introduces no synthesis. It is a new criticism added which is relevant to the question of heroin maintenance, but only furthers the critics opinion on the more successful outcome of a rehabilitated user and a drug policy which seeks the same. No synthesis whatsoever. No new proposition. Just an extra facet of criticism.Minphie (talk) 01:10, 21 May 2010 (UTC)


 * Sorry, I have read WP:NOR and it is quite clear on this issue and the folks at WP:NORN concur with my interpretation. And the new source you bring does not directly support your synthesis so it should go. Swedens drug policy is not mentioned as a counter-example to heroin prescription, as they explicitly must do, so it should also go. If you have problems with this, try consverapedia. They might have another standards for inclusion. Steinberger (talk) 08:08, 21 May 2010 (UTC)

Steinberger, I have reordered the sentences of the heroin prescription trial section such that it cannot possibly be construed as synthesis or as original research. This simple reordering demonstrates that even as ordered before there was absolutely no question of synthesis or original research. There is no original research because the British heroin trial is cited. There is no synthesis because the critics are only commenting on the facts of the trial, as is their right. I further have to take issue with the information you sent to the NOR forum, which failed to make mention of my critic citations which supported EVERY assertion. You did not tell them that, and this is seeking decisions on something where half the truth has been told.

So there are citations: 1.for who the critics are, including Taskforce member citations 2. showing that these critics are criticizing heroin trials and not something else 3. for the criticisms of harm reduction programs, including heroin prescription which is mentioned in the citation and which is a sub-category of the maintenance programs criticized 4. critics' support for the Swedish drug policy 5. UNODC's support of Swedish drug policy 6. UN figures showing lowest levels of use. No original research here. All cited as they were when you made your last deletions. If you want to link ECAD to pro-Swedish drug policy go to http://www.drugfree.org.au/fileadmin/Media/Global/WFAD_InfoLetter.pdf. It is quite explicit. Minphie (talk) 08:23, 23 May 2010 (UTC)


 * Have you read what other editors said on WP:NORN as I suggested on your talkpage? If not, they said that it was original research. Steinberger (talk) 14:13, 23 May 2010 (UTC)

I have added a citation which removes any of your asserted concerns about original research etc. The actual text of this post by Drug Free Australia’s Secretary to Australia’s Update list-server which is read by more than 1,000 AOD professionals in Australia and indeed worldwide. The archive is password protected but you can get the ADCA administrator to confirm the post. It reads as follows:

I must point out the enormous cost to society of heroin use.

We have people here with 300 pounds per week habits, which comes mainly from acquisitive crime. That means that society is footing 15,600 pounds per year for a heroin user’s habit.

With the trial they now foot 15,000 pounds plus an extra 2,600 pounds per annum for continuing acquisitive crime. Total 17,600 pounds per year. Do the math.

Drug Free Australia’s position is compulsory rehab, where the results in Sweden have shown the lowest drug use levels in the developed world, down from the highest levels in Europe back when they did do their 1970’s prescribed morphine/amphetamine trial.

Rehab costs far less than prison, and less than 15,000 pounds per year, with the benefit that once a user is off heroin they have far better health than they have on it, prescribed or illicit, and no 15,000 pounds per annum into eternity. That is a huge societal saving. Minphie (talk) 01:10, 4 June 2010 (UTC)


 * Note that mailing-lists, newsgroups and other internet forums are WP:SPS and not good for verification. Steinberger (talk) 09:44, 4 June 2010 (UTC)

Steinberger, I have done some changes to the ordering of the sentences re heroin maintenance and removed some tags after changing wording. I should also note that the Update list-server is the official Australian communication mechanism for the entire Australian ATOD industry, with 1,000 industry professionals who access it daily. The Drug Free Australia criticism of heroin maintenance is therefore on a thoroughly verifiable source which is regulated by ADCA, Australia's peak body for ATOD issues. Wikipedia does not rule out, in any way, such an official mechanism such as this one, particularly when all that needs to be verified is whether Drug Free Australia did make a public criticism of heroin maintenance or not.

Please see discussion for Safe Injection Site for the Davies quote which clearly says that up until 6 years ago there were 'no well-designed scientific studies or systematic evaluations' but that 'since then the situation has begun to change rapidly'. He then specifically cites the evaluation protocols of the Sydney and Vancouver centres.Minphie (talk) 12:28, 6 June 2010 (UTC)


 * Internet forums postings, however official forums are, are in most cases banned for usage for verification altogether. That is totally clear. If you can establish that poster is a "established expert" on the subject (drug policy) that is readily quoted by WP:RS it might be used on Wikipedia, but "[c]aution should be exercised ...: if the information in question is really worth reporting, someone else is likely to have done so [in a proper RS]." On Davies, see at the bottom of this page. Steinberger (talk) 13:48, 6 June 2010 (UTC)

Steinberger,


 * 1) Drug Free Australia is the leading drug prevention advocacy organisation in Australia, and is regarded as the 'established expert' organization on drug policy matters. For example, see the Federal Parliamentary Inquiry report 'The Winnable War on Drugs' which references Drug Free Australia critiques on more than 70 occasions.
 * 2) The organization is on record as critical of any proposed heroin trial in Australia, as might well be expected from a drug prevention organization. I have already given a reference to the document previously in this Discussion page.
 * 3) The organization is likewise critical of the RIOTT heroin trial in the UK, as already verbatim quoted on this Discussion page.
 * 4) A verifiable source can indeed be found for Drug Free Australia's criticism on Australia's official ATOD listserver which 1000 Australian and international ATOD professionals access on a daily basis - it is written by the organization itself - not something someone has said about the organization.  Therefore the statement cannot in any way be deemed unreliable in any way, the organization is the epitome of the type of organization that would be critical, and the source eminently verifiable, even though password protected (but the administrator can be asked for a copy).
 * 5) You are trying to tell me that Wikipedia unequivocally rules out any statement from an official organization on an ATOD listserver but you know that it does not.  You constantly cite to me their equivocation on the issue, where you say 'in most cases' but not 'in all cases' it is ruled out.  Rather it is the appropriateness of the source to the assertion made in Wikipedia that counts.
 * 6) The statement by Drug Free Australia juxtaposes the costs of the trial with the costs of getting users off drugs, as per the Swedish core philosophy.

The argument I think you are trying to mount here is that Drug Free Australia knows nothing about drug policy, or that it knows nothing about maintenance regimes, but the aforementioned Parliamentary report demonstrates otherwise. You argument therefore does not work.

Therefore the statement must remain.Minphie (talk) 12:44, 7 June 2010 (UTC)


 * Nope. If it only is posted on a forum it should not remain. If you can find a better source, it might, but then with attribution. Not "some think". Steinberger (talk) 13:02, 7 June 2010 (UTC)

Safe Injection Site Evaluations
Steinberger

I am making some small changes to your text re evaluations of SISs simply because the two most rigorously evaluated sites did not reliably show a decrease in blood-borne diseases. The MSIC did not show any demonstrated positive effect and Insite's evaluators questioned the validity of the assumptions in the journal studies asserting any proven BBV success for Insite. I am happy to leave the bit about public disorder because it is generally true (but not always) for the Euro rooms, but is balanced by the evidence in my Critics section.

I have reverted the Critics section because there is no evidence of original research. Your quibbles about the credibility of Drug Free Australia's analysis have been well and truly answered on the SIS Discussion page. Given that credibility, I invite you to do your best to find arguments out in the public domain that have attempted to specifically fault the Drug Free Australia analysis which was done by researchers who are themselves peer-reviewed authors in dozens of other journals. You will need to identify cogent arguments against the DFA analysis, and then we can discuss their validity. But you cannot blank this section on false grounds that have been thoroughly refuted previously on the SIS Discussion page.Minphie (talk) 02:33, 27 May 2010 (UTC)


 * WP:RSN - DFA should be used with attribution. There is also speculation, such as when you are implying that the most evaluated centers are those in Australia and Canada. There is also blatant misrepresentation of sources, such when you say the Vancouver expert panel summarize the European picture as haven been mix when it comes to loitering and crime in the vicinity. Steinberger (talk) 13:52, 27 May 2010 (UTC)

I have added citations for the Sydney evaluations, thus nullifying any rationale you have cited in this regarding the criticisms recorded not referencing evaluations listed in the paragraph above.

I have also added a citation for Sydney and Vancouver being the most evaluated sites. As well as the Canadian Government Hansard statement that says that the cost of running Insite would be better spent elsewhere. Drug Free Australia is now described correctly as a drug prevention organization. Now that’s cooperation!Minphie (talk) 01:11, 4 June 2010 (UTC)


 * The source you added did not verify the claim that most evaluations are made on Sydney and Vancouver. It say that the projects in Sydney and Vancouver sparked of an increase in the number of evaluations, but not of which sites. In fact I read it as if the projects in Sydney and Vancouver spurred studies in Europe - or maybe only translations. I'd noticed that Davies spoke of "English publications", although looking trough EMCDDA's reference list there are quite considerable amount of studies in German, French and Dutch and some in Spanish. Wikipedia has a systemic bias and its English-language site gives undue weight in favor of information available in English and involving the Anglophone world. That is natural, although considered a problem (NPOV). If you can't find a source that explicit say that the most rigor evaluations have been done on Sydney and Vancouver such statement should go. Steinberger (talk) 10:07, 4 June 2010 (UTC)

EMCDDA report fails to engage critics of SIS
Steinberger, I have read the new chapter by Hedrich and co. which fails to engage the criticisms that I have detailed by Drug Free Australia, The Canadian Government's own Expert Advisory Committee or Real Women of Canada. Unless it engages the critiques it is of no more use than the previous Hedrich document by EMCDDA in 2004. To illustrate, a problem with this new chapter by Hedrich is that it accepts at face value the original palpably false claims of lives saved by the Sydney and Vancouver centres. Notably, the methodology of the Drug Free Australia critique which demonstrates that only one life can be saved every two years in the Sydney MSIC is identical to Hedrich's own methodology which he cites to calculate lives saved by German consumption rooms. If he applied his own methodology to Sydney and Vancouver he would have to delete his paragraphs claiming what the spurious original evaluations claimed. There is a real place for proper criticism of these overly optimistic claims about injecting rooms, and just wiping them via a naive new source that doesn't bother to engage the critiques does not remove the validity of the critics' critiques.Minphie (talk) 01:02, 10 June 2010 (UTC)


 * First, Dagmar is a female name, so Hedrich is a woman. Hedrich does not have a methodology "to calculate lives saved by German consumptions rooms". She herself have not calculated the saved lives in her 2004 review. She compiled studies that indicated that. Second, I know that DFA'a claimed that MSIC "demonstrably failed to save even one life", "had very poor referral rates to treatment or rehab", that "it in no way reduced the problem of discarded needles and therefore of public injection" "demonstrated that safety was not a concern for clients [letting them experimenting, ect]". Instead they stood by their fears that MSIC would "increase drug taking", "increase drug trafficking" and "create a honey-pot effect for drug dealers around the injecting room". All these specific claims of DFA'a is refuted by EMCDDA, or rather, they find no evidence to support those notions. The Expert Advisory Committee had critique on a methodological, scientific level. But they where not critical of Insite per se. Some of the same methodological criticisms reaper in EMCDDA's review, for example healthful doubt in the mathematical models used to demonstrate saved lives (!) or the lack of reliable evidence in decreasing HIV or HVC. Both of those where disclosed. Real Woman of Canada only repeats cherry-picked parts of the Canadian EAC report. So I would be glad if you where more specific on what criticism you mean EMCDDA did not take on. Steinberger (talk) 10:50, 10 June 2010 (UTC)


 * Steinberger, who calculated the estimates of lives saved for German DCRs is immaterial (although you might tell me who Hedrich was referencing for her estimates, and don't tell me it was Poschadel because her estimates are based on Poschadel combined with Kimber figures) because it is the methodology that is important. And it is identical to Drug Free Australia's, except that Hedrich calculates a 2% overdose mortality rate whereas Australia (and Canada) is 1%. Hedrich does not reference in any way the lower estimate of the Expert Advisory Committee re lives saved, which from memory was 1.08 lives.  Rather she goes with the unsupportable 2 - 11 lives saved, which is very easily falsified.  And the fact that she does not engage Drug Free Australia's criticisms means that all that I have written about those findings must stay because she doesn't even look into them.  That is her problem, because the Drug Free Australia criticisms are so well evidenced. So it is very clear that the EMCDDA review does not override the valid criticisms I have recorded.  Your attempts to get these off the page with carping and baseless objections appear to be motivated more by censorship and is contrary to WP:TRUTH.110.175.209.31 (talk) 08:17, 11 June 2010 (UTC)


 * What valid criticism that is lacking? Be specific! Steinberger (talk) 08:51, 11 June 2010 (UTC)

Point for point
Drug prevention advocacy organizations, such as Drug Free Australia and Real Women of Canada point to material used in EMCDDA's review evaluations of safe injection sites. Two of the centers, in Sydney, Australia and Vancouver, Canada cost between $2.7 million and $3 million per annum to operate respectively, yet Canadian mathematical modeling, where there was caution about validity, indicated just one life saved from fatal overdose per annum for Vancouver, while the Drug Free Australia analysis demonstrates the Sydney facility statistically takes more than a year to save one life. The Expert Advisory Committee of the Canadian Government studied claims by journal studies for reduced HIV transmission by Insite but “were not convinced that these assumptions were entirely valid." The Sydney facility showed no improvement in public injecting and discarded needles beyond improvements caused by a coinciding heroin drought, while the Vancouver facility may have had some small level of impact. Drug dealing and loitering around the facilities were evident in the Sydney evaluation, but not evident for the Vancouver facility, but this is likely due to more than 60 extra police assigned to the area. The European experience has been mixed.

References

First, the 3 million figure for Insite is too high as it include counsellings and other non-SIF-related services at Insite. The SIF-part of the project cost 1.5 million Canadian. (see "A cost-benefit and cost-effectiveness analysis of Vancouver's supervised injection facility" in International Journal of Drug Policy) Second, that the "Sydney facility showed no improvement in public injecting and discarded needles beyond improvements caused by a coinciding heroin drought" is a DFA's POV and should be attributed. And that Insite "may have had some small level of impact" lacks support in the sources. Nowhere is it said that the impact was small. How big the impact was was undisclosed but the expert committee say it clearly had an impact. Third, "Drug dealing and loitering around the facilities were evident in the Sydney evaluation" is true, but the report it relies on say that the opening of MSIC had an positive effect in breaking a preexisting trend and that it was less loitering after then before. On the other side, there was loitering in Vancouver, but they also saw a decrease. That where also the case on most European sites, according to the 2010 EMCDDA report. Although a "few facilities" had some problem, so "mixed picture" is to somewhat overstate the problems in Europe. Steinberger (talk) 11:19, 10 June 2010 (UTC)

As the above was a quagmire of opinionated misunderstandings and misrepresentations I have summarized Drug Free Australia's findings (see at the center of the relevant section in the article) and deleted the rest. Some of the more relevant findings such as the "validity" of the evidence when it comes to HIV is in the present text. What have disappeared is the cost and "lack" of lives saved in Vancouver and Sydney. Although, not fully; First, DFA have some specific criticism on that matter that's in the article. Second, the more general idea that DCR reduces morbidity is in the article with a disclaimer that it builds on models and that further research is needed to verify them. So the only thing that is totally gone is the cost of two centrers. Steinberger (talk) 12:17, 10 June 2010 (UTC)


 * Steinberger, I have to ask why, if you are concerned that a sentence referencing evaluations which are no longer mentioned because you or someone else had removed the previous sentence, do you think you should remove the entire statement rather than showing good faith and correcting it? Also, if you have found a better figure for the Vancouver site, why not just put that in the text after explaining it on this page?


 * Re the DFA data on discarded needles, there has never been a refutation of this conclusion by MSIC staff and so it remains demonstrated. Re your comment about the MSIC impact on loitering, perhaps you might give a reference from the 2003 evaluation which backs your assertion. Drug Free Australia's description of loitering is quite correct.  Re the Vancouver centre, the Expert Advisory Committee specifically says that injections in Insite make up only 5% of total injections in the Downtown Eastside and they further clearly state in reference to public injecting that SISs do not have the ability to accommodate all injections.  So there is clearly only a small impact.  And this is not original research because the 5% relates exactly to the injections which are taken off the street.Minphie (talk) 11:00, 11 June 2010 (UTC) 08:42, 11 June 2010 (UTC)


 * DFA assertion that there is not decrease in discarded needles is in the article. The info on loitering is on the same page as you referenced it too, 147. DFA is not referenced to say anything about loitering. The expert advisory committee did not expect any big change (for the reasons you state) but there clearly was a change. That it "may have had some small" effect indicate that it was smaller then what could be expected and that there is insecurity about the numbers - not so. That, before Insite, 100% of all injection was done on the street is speculation from your part. It is more probable that only a small part where done in public so the change can be quite big after all (if say 15% was taking drugs in public, if then 5% is taken of the street it would mean a very visible decrease of 33%.) Steinberger (talk) 09:13, 11 June 2010 (UTC)


 * I have moved your section on the EMCDDA review above the critics section because it does not engage the critics. As it was, below the critics section, a reader could be led to think that Hedrich had reviewed the Drug Free Australia analysis, but this was never the case.  Nor was there the reflection of the Expert Advisory Committee's lives saved estimate.Minphie (talk) 11:00, 11 June 2010 (UTC)


 * Stop it now! If DFA would have their "well founded" criticism into some journal that is indexed trough Medline EMCDDA would have to engage it, or at least say why they did not do so. But now when DFA failed to do so, why should EMCDDA search for and engage junk reassessments of peer-reviewed reports? Steinberger (talk) 11:41, 11 June 2010 (UTC)

EMCDDA say that Vacouver saw less loitering after Insite, even after adjustment for police activity and weather. So, "but this is more likely..." is therefore directly challenged. Moreover Magnham's study have been questioned for dismissing the findings of peer-reviewed articles and is said to be "fraught with a host of outright factual inaccuracies and unsubstantiated claims". Steinberger (talk) 18:41, 12 June 2010 (UTC)

Interesting paper
Here is an interesting paper  Doc James  (talk · contribs · email) 07:02, 19 June 2010 (UTC)

What is an IDU?
I looked it up and I think, in this context, it means either "intravenous drug user" or "injecting drug user," but I can't be sure that was the intention of this author. IDU *definitely* needs to NOT be abbreviated and to be spelled out fully. If *I* don't know what it is, most people won't. —Preceding unsigned comment added by Demeter (talk • contribs) 06:19, 23 June 2010 (UTC)


 * EMCDDA uses it as a short for "injecting drug user". You have a fair point, that it is jargon that should be rubbed away. Steinberger (talk) 15:13, 23 June 2010 (UTC)

Two different papers on false NEP conclusions
Sorry, Ohiostandard, but these are not both the same paper or, for that matter, by identical authors. Sources are according to Wikipedia standards.Minphie (talk) 05:18, 30 May 2011 (UTC)


 * Does not look like MEDRS compliant source. Looks like a "journal" created to promote a specific agenda.-- Doc James (talk · contribs · email) 06:10, 30 May 2011 (UTC)
 * This paper here is not even indexed by pubmed . Check out its Wiki page Journal of Global Drug Policy and Practice Doc James  (talk · contribs · email) 06:18, 30 May 2011 (UTC)


 * Unfortunately the above contributor has failed to reference BOTH citations for the sentences regarding Kerstin Kall et al's various reviews on needle exchange programs, taking issue with one citation while ignoring the other. They are clearly not the same article, with different titles and different reviewers while sharing the same conclusions. I have thereby reinstated the content because there is no validity to what is written above.


 * Regarding comments on the Journal of Global Drug Policy and Practice, there is nothing in WP:MEDRS which would disqualify Kall's needle exchange article for inclusion in Wikipedia. The journal is peer-reviewed, as has been established by e-mail to the most authoritative source of that information, the journal's own chief editor here. Furthermore, arguably the world's most prestigious MEDICAL body, the US Institute of Medicine, called upon two needle exchange reviewers, Kerstin Kall and Alex Wodak to present at their Geneva 2005 deliberations on needle exchange here which are published here with Kall's work cited in the document.  Kall's verbatim speech to the IOM Geneva Conference is recorded on pages 65-89 here where content comparison with my citations can easily be made. This authoritative review by 24 of the US's most eminent researchers and reviewers is one of three reviews relied upon by the Palmateer et al study in its review of reviews, so its authority cannot be doubted.Minphie (talk) 07:52, 30 May 2011 (UTC)
 * A speech is NOT a peer reviewed publication regardless of who it was too. We need review articles published in reliable sources. Doc James  (talk · contribs · email) 17:41, 30 May 2011 (UTC)

Reinstatement of Käll et al study into article
The grounds upon which the crucial Käll et al study, published in the Journal of Global Drug Policy and Practice, have been removed from the needle exchange section in the past have nil validity and the deleted section needs to be maintained in the text if Wikipedia readers want to know an accurate portrayal of the current state of the debate. The text below will demonstrate that the reviewing of Käll et al’s review from the Journal of Global Drug Policy and Practice (JGDPP) by the reviewer of reviews, Norah Palmateer et al, in the European Monitoring Centre’s (EMCDDA) publication on Harm Reduction in May 2010 now puts to bed all objections about the reliability or notability of the Käll et al review. Objections that this journal is not peer-reviewed likewise need to be put to bed.

Demonstrably false objection that journal is not peer-reviewed
I have previously taken the time to carefully demonstrate above that the assertion that the Journal of Global Drug Policy and Practice is not peer-reviewed has no basis whatsoever in fact, and that the charge has only been maintained by a spurious appeal to the clearly un-evidenced OPINION of commentators who obviously have not asked the relevant question of the journal or read its submissions page. To that end: In conclusion on this issue I believe that any deleting of the text about Käll et al by other contributors on spurious objections about peer-review from this point forward will only represent a retreat into absurdity, and I will pursue whatever avenue of Wikipedia recourse appears best.
 * 1) I had previously reproduced an e-mail from the journal’s editor, Dianne Glymph, here stating very clearly that the journal is indeed peer-reviewed.  There is no higher authority on this question than the journal’s own editor and any assertion to the contrary is simply absurd.
 * 2) The attempt in the Reliable Sources Forum and various discussion pages to elevate commentators’ or protagonists’ opinions above the testimony of the journal’s own editor are rationally vacuous and would not be entertained in any forum elsewhere, so why is it even advanced at all on Wikipedia?
 * 3)  The attempt by a contributor http://en.wikipedia.org/wiki/Talk:Journal_of_Global_Drug_Policy_and_Practice here] to elevate the unedified opinion of two researchers, Wood and Kerr, in the Canadian Medical Association Journal, where they asserted that the Journal of Global Drug Policy and Practice “POSES as an open-access, peer-reviewed scientific journal”,  thereby claiming that the word of this medical association has more credibility than the journal’s own editor and webpage’s own statements fails on two grounds a. nothing is more authoritative than the journal editor’s own word b. the contributor failed to note that the two researchers he quotes as authoritative are the very researchers whose work is being criticised by Colin Mangham in the JGDPP – hardly a case for a neutral point of view by these two.  This appeal to their ‘greater credibility’ on drug policy issues is akin to someone quoting the UK Tories’ views against the UK Labour party’s social policies as authoritative, rather than merely being an opposing view in a conflicting argument.
 * 4) The final fall-back position for another contributor, where he/she says here about the journal’s own indisputable claim to be peer-reviewed - “ I really read it as a token to mislead the unsuspicious, then something that should be taken for real. Steinberger (talk) 23:01, 10 March 2011 (UTC)” is an appeal to suspicion. If suspicions are not valid content for any Wikipedia page because they are not verified, it is abundantly clear that suspicion can never be used as an excuse to delete properly evidenced text.
 * 5)  Another contributor’s here misunderstanding of my discussion page text, where he thought that I was trying to claim a conference speech as a peer-reviewed journal article, must be treated for what it was – a misreading by that contributor of a quite transparent paragraph that was making an entirely different point.

Käll et al a core review for second Palmateer review of reviews
In May 2010 Norah Palmateer et al published a review of reviews for the European Monitoring Centre for Drugs and Drug Abuse (EMCDDA) which was far more comprehensive in scope than the study already cited on the Needle Exchange and Harm Reduction pages, additionally reviewing interventions such as safe injection sites and substitution regimes. Chapter 5 of the EMCDDA publication here reviews 4 core needle exchange reviews, Gibson, Wodak/Cooney, Tilson and Käll.

The arguments that have been advanced by Wikipedia contributors who have deleted text on the Käll et al review have argued that any study in the Journal of Global Drug Policy and Practice must be disqualified because it cannot meet certain imagined medical standards. The second Palmateer review of reviews promotes its ‘core reviews’, including the Käll et al review, as meeting more rigorous standards than various other discarded reviews not included, clearly discounting this spurious objection. Further, Palmateer does not concur with the other spurious objection that the review derives from an unreliable source – no such criticism is entertained by her team. Nor are any NPOV issues stated. The reliability and notability of the Käll et al review is clearly established, and from a source over which there can be no quibbles regarding reliability as Wikipedia defines it.

Lastly, I note that contributor asserts that the unreliability of JGDPP has been established. I have found no consensus on Wikipedia that agrees with this assertion, and the Palmateer study establishes the opposite, that the journal cannot be carte blanche dismissed. Again, the text on Käll et al must remain.Minphie (talk) 02:40, 5 June 2011 (UTC)


 * These are not sufficiently compliant sources. Please use better sources. Thanks Doc James  (talk · contribs · email) 03:30, 5 June 2011 (UTC)


 * As stated above, the very fact that Palmateer reviews the Käll et al study as one of her four core reviews MAKES her review, unquestionably, a reliable review and a reliable source. The EMCDDA, which produces the Harm Reduction publication of 450 odd pages, is the most authoritative source in Europe, equivalent to NIDA in the US, albeit with a harm reduction ideological bent. Furthermore I find the explanation above by Doc James devoid of rationale, particularly when the Käll et al review has been shown to be so central to an EMCDDA review of reviews.Minphie (talk) 12:34, 5 June 2011 (UTC)


 * The journal that it is published in does not appear legitimate. It is not indexed in pubmed. Read comments here  Doc James  (talk · contribs · email) 13:24, 5 June 2011 (UTC)


 * I have added to the section on Palmateer's reviews of reviews, reinstating some text removed by DocJames on the grounds that a reader needs to understand that the review of reviews is not just another review to add to the 44 others that already exist, but is something which attempts to find the best and most reliable reviews before concluding from them. I believe this is important to a reader. I have also removed the sentence about successes in two cities, because there are solid studies that show that HIV increased in various NSPs in other cities, nullifying this claim to success. Indeed, if the science on needle exchange re preventing HIV transmission is in fact inconclusive, as Palmateer's own EMCDDA text would most certainly imply (they did indeed note that the Wodak/Cooney and Gibson et al reviews had conclusions not consistent with the evidence), it would be wrong to cite successes from poorly designed journal studies that did not pass the tests of rigour applied by the best reviews. Minphie (talk) 02:31, 15 June 2011 (UTC)

Legalized Prostitution Section
The section on Harm Reduction in the context of sex work is, at this point, so POV that it is offensive and, ironically, anti-Harm Reduction. For one, Harm Reduction re: sex work does not imply legalized prostitution. And one paragraph about prostitution in the Netherlands (edited several times by someone with a clear anti- sex work and anti- harm reduction bias) does not in any way explain what Harm Reduction means in relation to prostitution (sex work); it simply asserts that legalizing prostitution is harm reduction, and it didn't reduce harm, therefore harm reduction shouldn't be applied to prostitution (that bit is implied, but still). And that implies a misunderstanding of what Harm Reduction is, or what it means to apply it to sex work. Look at the International Harm Reduction Association website. There are articles dealing specifically with Harm Reduction applied to sex work, like this one from the Scarlet Alliance (a Sex Worker advocacy organization in Australia): http://www.ihra.net/files/2010/05/13/WottonWarsaw2007.pdf or this one: http://www.ihra.net/files/2010/05/13/CusickWarsaw2007.pdf. There are tons of Sex Worker activist groups out there now that are taking a Harm Reduction approach. This could be its own article. To conflate it with "Legalized Prostitution" and then strawman the whole thing is ridiculous.

So, just a warning, I'm overhauling that section, unless someone objects.184.38.16.249 (talk) 12:28, 4 June 2012 (UTC)


 * You're right. The section is outrageously POV, and needs a major overhaul.Ajax151 (talk) 00:38, 14 August 2012 (UTC)
 * I am not objecting to the recent overhaul, but I just wanted to add that it may be useful if a copyeditor with expertise on the subject reviews the section. If that has already been done, then I apologize.--Soulparadox (talk) 14:26, 10 June 2013 (UTC)

Criticism of harm reduction unbalanced.
Given that scientific evidence repeatedly and ultimately supports harm reduction, why is the balance of the harm reduction criticism section about 90% against? To have it this way distorts the issue in favor of the anti-harm reduction viewpoint, which is a disservice to encyclopedic readers? It should at least be 50 % criticism and 50 % counter support, in order to not distort the EVIDENCE -BASED PRACTICE, which all medical issues should be based in.


 * Peace and Passion &#9774; ''("I'm listening....") 01:16, 1 April 2012 (UTC)

There are many statements in this section which are merely opinions. it is not presented in a matter-of-facto way ie "There can be no other goal than a drug-free world" "'Harm reduction' is too often another word for drug legalization"

also there appears to be some missing or inadequate references for this area. — Preceding unsigned comment added by 216.174.136.2 (talk) 15:05, 7 February 2014 (UTC)

Lifeline Publications
In the UK, since 1971 Lifeline has produced a large range of booklets - Peter McDermott from a users perspective & Dr. Nuke from a highly trained & experienced background. http://www.lifeline.org.uk/ now distribute booklets for casual users, dependant users, prisoners & prison staff. It was the first project of it's kind in the UK.

Right now, a simple test for fentanyl is being developed with the help of Michel Linnell. A solid-state card has a small amount of solution added and only fentanyl & it's derivatives give a strong yellow/orange colouring. — Preceding unsigned comment added by 213.106.56.145 (talk) 15:55, 5 December 2014 (UTC)

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Electronic cigarettes
Current text: "In recent years, the growing use of electronic cigarettes for smoking cessation, whose long-term safety remains uncertain, has sparked an ongoing controversy among medical and public health between those who seek to restrict and discourage all use until more is known and those who see them as a useful approach for harm reduction, whose risks are most unlikely to equal those of smoking tobacco. "

Previous text: ", research on the safety and efficacy of e-cigarettes use for smoking cessation is limited. There is no evidence they are better than regulated medication for quitting smoking, but there is tentative evidence of benefit as a smoking cessation aid. The usefulness of e-cigarettes in tobacco harm reduction as a substitute for tobacco products is unclear, but in an effort to decrease tobacco related death and disease, they have a potential to be part of the strategy. "

Comments on electronic cigarettes
Backstory: I removed unsourced text. I then added this and then it was replaced with this.

Is there a way to include both in Harm_reduction? QuackGuru ( talk ) 21:46, 22 November 2015 (UTC)


 * Much of that was outdated, and somewhat off the central topic. The main article is Tobacco harm reduction and additions should be made there first. Johnbod (talk) 12:28, 23 November 2015 (UTC)
 * The additions have been made to Tobacco harm reduction.
 * I think more can be added here. See "Their usefulness in tobacco harm reduction as a substitute for tobacco products is unclear, but in an effort to decrease tobacco related death and disease, they have a potential to be part of the strategy. " QuackGuru  ( talk ) 19:18, 23 November 2015 (UTC)

Well, actually...
Albeit controversial, harm reduction works to shift the focus of our nation’s drug policy is shifted from criminalizing addiction and accept that there are those who are intravenous drug users who need education and needle exchange programs readily available to reduce the number of addicts who are contracting fatal blood borne diseases. Harm reduction is not "another word for drug legalization", but is a pragmatic approach to treating the blood borne diseases that are spread through intravenous drug use. Many intravenous drug users are uneducated and have grown up in abusive homes or in extreme poverty. While obviously choices are made that lead to a life of intravenous drug use, many of these users do not have access to the same knowledge as an educated person may have and even if they do have access, they may not have the ability to understand it. The abstinence only approach to helping drug users or sex workers is one of ignorance. Harm reduction is practiced globally and is based in scientific research that shows a serious improvement in the number of blood borne diseases contracted from intravenous drug use.

Jrdanmichele (talk)jrdanmichele —Preceding undated comment added 02:59, 29 July 2016 (UTC)

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Generalize the term
This article should offer a disambiguation against a definition that is more generalized. I agree that the most prevelant usage is with public health, but this phrase has applications elsewhere (eg. security tactic). Thoughts? 100.14.143.225 (talk) 23:52, 30 September 2017 (UTC)

Relatively Recent US and UN Changes
I believe this article absolutely needs to include relatively recent changes introduced by both the US Surgeon General, and UN Drug Policy. I would do it now, but I would have to review thoroughly - and I'm not at all anywhere near an expert in either area.


 * I agree that this article needs to incorporate policy changes occurring in the US and plan to contribute to the Safe Injection Sites section over the next few weeks. --Quynhkieu (talk) 17:47, 12 October 2017 (UTC)

External links modified
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Neutral point of view?
The submission was definitely from a neutral point of view. Everything that was stated was referencing facts that included viewpoints from both sides. It was a very informative read and at no point did any sort of biased words or phrases come through.

Saman Pashtoonwar 05:48, 5 November 2017 (UTC) — Preceding unsigned comment added by Sf659323 (talk • contribs)


 * Thank you for reviewing the edits and making sure that they reflect a neutral point of view. --Lagunasunset (talk) 05:00, 15 November 2017 (UTC)

Wikipedia:Manual of Style/Medicine-related articles
1. The exceptional quality and effectiveness of edits made provided a good deal of background for SIS in the US on a state-by-state basis. The edits seamlessly add to the article's Safe Injection Sites section. 2. Safe Injection Site edits are formatted in accordance to the Wikipedia:Manual of Style/Medicine-related articles. This section is written to the correct audience, writing in an appropriate style and avoiding technical jargon. There is no conflict of interest. Suggestion: Consistently use "SIS" throughout the section. Suggestion: Use sub-headings to break up the section and to focus the paragraph(s).Akliu (talk) 07:32, 8 November 2017 (UTC)


 * Thanks for the compliments and the helpful suggestions! Our section is now under the new sub-heading "United States" under the Safe Injection Site heading. We also made sure to keep the use of "SIS" consistent throughout our section; however, we left DCR or "Drug Consumption Rooms" un-edited in the section preceding us because these facilities are more commonly known as DCRs in Europe. -Quynhkieu (talk) 06:07, 15 November 2017 (UTC)

Copyright/Plagiarism Evaluation
The edits made to this Wikipedia page contribute greatly to the understanding of Safe Injection Sites with numerous examples of what some cities across the United States are doing to address the issue. It provided a lot more context to the situation, and described what the current climate is like. It did feel as though the additions focused more on Washington and San Francisco, which is helpful, but not very comprehensive of the entire landscape across America. This is understandable however, given how diverse states are in addressing the issue of SIS. The edits provided information regarding the legal aspects, but also specific examples of organizations and their efforts in advocating for SIS.

Suggestions: 1. I would try to use less quotations, for it doesn’t align with the Wikipedia culture to include a lot of quotes (although I do see previous versions of the article contained quotes by other authors). These quotes were cited well, but I believe in some instances, paraphrasing the key ideas would have been adequate. 2. The last paragraph added stating efforts from various cities to gather data regarding the impact of SIS provided great examples; however, what were the results of these analyses? This is information readers would like to know.

Upon reading the edits, it did not appear as through the group added plagiarized or copyrighted statements. I went through and checked each source listed, trying to see where they got their information, but also checking sentence structure and comparing to see if anything was closely paraphrased. This was not the case, which is really great. In addition, there were sentences that made general statements with multiple citations used throughout, indicating less likelihood that the sentence was closely copied from a source. Carolyn.hua (talk) 15:46, 8 November 2017 (UTC)


 * Thank you for the feedback and suggestions! I agree with your suggestion regarding quotations and have paraphrased the key points for the paragraph regarding criticism of safe injection sites.  --Tht001 (talk) 02:39, 15 November 2017 (UTC)


 * Thank you for your feedback! I agree that the use of direct quotations should be limited. I paraphrased the quotation describing the underground SIS in the United States. --Lagunasunset (talk) 06:08, 15 November 2017 (UTC)


 * I agree with your suggestion to reduce the use of quotations throughout our section; however, I think the quoted portion of the CSA is very relevant to the first paragraph. The quote allows us to pick apart the rhetoric of this specific law and see how the legality of SIS can be open to interpretation. -Quynhkieu (talk) 06:14, 15 November 2017 (UTC)


 * Thank you for the suggestions on including the results of the analyses conducted by U.S. cities on the impact of SIS. The text has been updated to include some of these findings. --Erchan19 (talk) 14:52, 15 November 2017 (UTC)

Student 2
1. The quality and effectiveness of the edits made are outstanding. Everything is well cited and the information is neutral.

2. "Are the points included verifiable with cited secondary sources that are freely accessible? If not, specify." Overall, the edits have verifiable secondary sources. However, there are two articles that are directly cited, but these are REVIEWS rather than actual studies with METHODS, INTERVENTIONS, etc.


 * 1) 25 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2376869


 * 1) 34 - http://linkinghub.elsevier.com/retrieve/pii/S0749379717303161

Thus, these are secondary sources since the authors were not their at the time of the things they are reporting. They have received their information from the people truly involved or other literature. — Preceding unsigned comment added by Tranallens (talk • contribs) 19:32, 5 November 2017 (UTC)


 * Thank you for reviewing the citations and ensuring that they are compliant with Wikipedia's guidelines. --Erchan19 (talk) 14:55, 15 November 2017 (UTC)

External links modified
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 * Added archive https://web.archive.org/web/20091029190140/http://www.druginfo.nsw.gov.au/__data/page/1229/NDARC_final_evaluation_report4.pdf to http://www.druginfo.nsw.gov.au/__data/page/1229/NDARC_final_evaluation_report4.pdf
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External link: MacMaster, S. A. (2004). Harm Reduction: A New Perspective on Substance Abuse Services. Social Work, 49 (3), 356 - 344. — Preceding unsigned comment added by 206.123.177.161 (talk) 04:22, 21 November 2018 (UTC)

Wiki Education Foundation-supported course assignment
This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Quynhkieu, Erchan19, Lagunasunset, Tht001.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 23:05, 16 January 2022 (UTC)

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 18 January 2021 and 14 May 2021. Further details are available on the course page. Student editor(s): Manorhe18. Peer reviewers: Daniellesori, Cheynehoke.

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Wiki Education assignment: Poverty, Justice, and Human Capabilities
— Assignment last updated by Asmaley (talk) 19:29, 7 February 2023 (UTC)

New page on harm reduction in the U.S.
Hello all! I am considering creating a new child page on harm reduction specifically in the U.S. There is currently one on the Atlanta Harm Reduction Coalition, and I think creating a page looking at harm reduction on the national level would be a good idea. --Skyef25 (talk)

Update: I will be creating a new article on harm reduction in the U.S. If any former or current contributors to this page have any tips for where to get started, please let me know! --Skyef25 (talk) 23:43, 21 February 2023 (UTC)