INSITE - National Post article by Mason Wright

Drug measures merit support
Vancouver's Insite, Toronto's safer crack use kits success stories

Mason Wright
National Post

Thursday, August 17, 2006

Whether drug addiction is a criminal or health issue would seem to be a fairly polarizing question. But in Vancouver there has been a surprising amount of agreement among governments, community activists, police and business groups, thanks to the Downtown Eastside's safe injection site for drug (especially heroin) users, Insite.

Yesterday at the intersection of Yonge and Bloor, local activists and delegates from the International AIDS Conference staged a brief demonstration by blocking traffic to raise awareness of Insite, which is threatened with closure next month after a three-year trial period unless Health Canada extends its exemption from drug-use laws.

The facility's success is undeniable. It offers a clean, health-focused location for addicts to inject safely and get information about addiction treatment services.

With the availability of clean needles and medical staff on-site, Downtown Eastside rates of blood-borne infections such as HIV and hepatitis C have reportedly been reduced, and there are fewer instances of people shooting up in public -- a plus for nearby Chinatown businesses that originally opposed Insite.

Add to that a record of zero deaths despite 453 overdoses at the facility between its September, 2003, opening and March, 2006, and it's easy to see why Insite has the support of Vancouver Mayor Sam Sullivan, the B.C. government and former mayors Phillip Owen and Larry Campbell.

"My staff has been working on the front line with the VCHA [Vancouver Coastal Health Authority] to ensure that both enforcement and health related goals are addressed in this project," Vancouver Police Chief Jamie Graham wrote in a letter to Health Canada supporting Insite.

Vancouver's Insite experience has also provided an example for Toronto. While heroin use is not as big a problem as crack cocaine addiction, the principles of harm reduction are the same. In Vancouver, they call the plan for fighting drug addiction the "four-pillar" strategy, with harm reduction, treatment, enforcement and prevention playing equal roles in the battle.

City Hall adopted its Toronto Drug Strategy in December, 2005, with harm reduction strategies that include a needle exchange and the distribution of safer crack use kits.

Crack cocaine use is risky: the rock form of the drug can be injected after being diluted with lemon juice or vinegar, which carries the usual problems of needle-sharing and overdoses, but is commonly smoked, which provides an intense and immediate high.

Because the majority of crack users live in poverty or on the streets, there are many risk factors associated with the addiction. The spread of HIV is one, since some smokers engage in unprotected sex in exchange for money or drugs or risky sexual behaviours with unfamiliar partners. The use of makeshift smoking pipes and the sharing of pipes can also spread HIV and hepatitis C because burns and sores on the mouth can allow for the exchange of blood.

The safer crack use kits distributed by Toronto Public Health's needle exchange program include clean glass stems, mouthpieces and metal screens, as well as information on how to prevent the spread of diseases. They also give outreach workers the opportunity to make contact with some of Toronto's most isolated people, building trust and connecting them with support services in the community.

With Vancouver's Insite and Toronto's safer crack use kits showing the benefits of harm reduction, Canada can continue to be a world leader in reducing the ills of drug addiction. This, however, will require a show of support from all segments of society to win the Health Canada exemption from Ottawa.

The Conservative party's tendency to view drug addicts as criminals instead of treating the problem as a community-wide health issue means Health Minister Tony Clement and Prime Minister Stephen Harper may need some persuading.