Pubdate: Mon, 30 Jun 2008
Source: Victoria Times-Colonist (CN BC)
Copyright: 2008 Times Colonist
Contact: http://www.canada.com/victoriatimescolonist/letters.html
Website: http://www.canada.com/victoriatimescolonist/
Details: http://www.mapinc.org/media/481
Author: Cindy E. Harnett
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)

WORKERS SLAM LACK OF FIXED NEEDLE EXCHANGE

Mobile Service Lets Too Many Addicts Through The Cracks, Outreach Staff Say

Outreach workers handing out syringes to injection drug users say 
since going mobile at the end of May they are reaching fewer clients 
- -- from those discreet users who pick up needles after work to 
hard-core addicts living on the street.

"It's a lose-lose situation," said Erin Gibson, her mountain bike 
laden with syringes, alcohol swabs, sterilized water, condoms and 
other drug paraphernalia. "Every Canadian under our Constitution is 
deserving -- no matter where they've come from, or what they've done, 
or where they've been -- of a basic level of service and human rights 
and health rights. This is negligence."

Health and city officials strongly support the needle exchange 
because it's proven to help prevent the spread of HIV/AIDS and 
hepatitis C contracted through the sharing of dirty needles. It's 
also proven to reduce health care costs. The B.C. Ministry of Health 
reports each new HIV infection costs $188,000 to $225,000 in direct expenses.

On this particular day, the outreach workers, Gibson and Heather 
Hobbs, walk Victoria's downtown streets furtively scanning alleys, 
doorways and squares for people in need. As this is a trial period 
for the mobile exchange, they fine-tune their hours of operation and 
routes so as to be more effective and reach more users as time goes on.

In one instance, they pull up their bikes to Store and Swift streets. 
Within moments, like magnets, they draw a variety of people to their 
side -- young and old, obvious users and not.

One young man's arms are ripped with muscles, his chest puffed. Only 
the needle marks up down his arms give him away as an injection drug 
user. Another well-groomed man in his late 50s, in his bike helmet 
and white breathable marathon running shirt, looks no different from 
the other cyclists in the area.

Some people drift over from the other side of the street where they 
are sitting idly near an upscale furniture store. Others stray over 
from nearby Streetlink.

They are looking for needles, water, cookers, "soda" (baking soda and 
ascorbic acid to prepare drugs), condoms, "vitamin S" (slang for 
strawberry flavoured condoms) and more. The outreach workers hand out 
push sticks and various types of filters for crack pipes, whatever 
they are permitted to distribute, knowing more is needed.

Some clients are clearly uncomfortable with the spectacle they are 
creating, while outreach workers, surrounded by clients on all sides, 
looked harried as they try to fill a variety of requests.

"It's very different, it's more impersonal, it's more crisis-based 
and we don't have as much to offer them," Gibson said. "I just had a 
guy say to me that this is crazy it's so public, out in the open, and 
that he was not comfortable at all. We're getting those comments."

At the fixed site, AIDS Vancouver Island staff could talk with 
clients privately to identify any physical or mental health concerns 
and refer them to needed services. Clients would confide in them.

"It's not discreet now. And people are in a rush so they're not 
likely to stand there and talk to us because they don't want to be 
seen," Gibson said. "It's the same with people coming after work, 
they don't want to be seen."

Hobbs rejects the suggestion that users may possibly stop using drugs 
if the mobile needle exchange service doesn't meet their needs.

"Absolutely not," said Hobbs. "It won't make anyone quit. If it was 
that easy to quit people would be quitting. It's not like you can 
wave a magic wand and say because you're not comfortable shooting up 
here, today you'll quit.

"Addiction is a serious health issue and I don't think the public has 
enough understanding of that. This is not a choice in that sense of 
the word," Hobbs said.

She is worried that the needle exchange fixed site that provided a 
safe refuge for clients -- some who often fall through the cracks -- 
will be lost.

The needle exchange, run by AIDS Vancouver Island and funded by the 
Vancouver Island Health Authority, has 1,500 registered clients. It 
served about 400 of those clients a month out of its Cormorant Street 
location where it had been since 2002.

However, over the last year, the operation became increasingly 
controversial because users loitered outside the building, leaving 
behind dirty syringes, blood and human waste. Some neighbours took 
legal action forcing the landlords to evict the service -- effective May 31.

Until a new location is found, VIHA and AVI have established a mobile 
service. Staff drive and park a van or walk their mountain bikes 
around the downtown core to seek out those who need clean supplies. 
They expect the service will only improve, but for right now it's a 
going concern.

Drug researcher Benedikt Fischer, at the University of Victoria's 
Centre for Addiction Research B.C., had predicted that rather than 
drug users concentrating in one area, with a mobile exchange they 
would only scatter in small groups throughout the city and that their 
health would deteriorate as they'd be harder to contact.

Hobbs said that's exactly what's happening: "What we've experienced 
so far and what we hear from people who were using the fixed site is 
people are spreading out in smaller groups. As well there's rigs 
being found in areas there weren't before."

The outreach workers hand out old Nalgene sport water bottles -- that 
have been turned in for recycling after a recent scare about 
Bisphenol A in hard plastics -- for addicts to deposit their dirty 
needles. There are also drop boxes placed on poles throughout town.

Using a password, involving some mix of the client's name and 
numbers, the number of syringes given out and retrieved are recorded 
"so we can encourage people to have a good exchange rate and so we 
can see how many different clients are coming in a month," Hobbs said.

VIHA and University of Victoria researchers will evaluate the service 
from June until September to determine if it works.

Equipped with cellphones, outreach workers will also respond to calls 
at 896-2849 for information on where to get clean needles.

Nearing the end of their shift, as the workers head up Pandora 
Avenue, a man, with the deep lines of a hard life etched in his face, 
stands up from where he's sitting with a few friends.

He gives Gibson a hug and shares a huge smile. They talk.

Afterwards he backs away, signals "hang loose," with his hand and 
says "I love you."

As she walks away she explains how hard it is for her to see people 
living on the street, or addicted to drugs, as others see them -- "a 
transvestite, crackhead, junkie or prostitute."

"I am in this so much I forget that other people see people like 
that. They reduce them to those entities," Gibson said. "It 
legitimizes people's fear. People are so much more than those words.

" I feel more safe here than anywhere else," she says, as she and 
Hobbs get back on their bikes, determined to save more people from themselves.
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MAP posted-by: Jay Bergstrom