Pubdate: Fri, 11 Feb 2011
Source: Coquitlam Now, The (CN BC)
Copyright: 2011Lower Mainland Publishing Group, Inc.
Contact:  http://www.thenownews.com/
Details: http://www.mapinc.org/media/1340
Author: Jennifer McFee
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)
Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction)

IDEA OF NEEDLE EXCHANGE EXPLORED

The Fraser Health region has one of the largest populations of 
injection drug users in the province, yet distributes the 
second-lowest number of clean needles in B.C.

According to data provided by Ann Livingston, a volunteer with the 
Vancouver Area Network of Drug Users, about 14,000 to 16,000 people 
in the Fraser Health region inject drugs -- the same number as in 
Vancouver Coastal. However, she said Fraser Health distributes few 
clean needles compared to other health authorities.

Vancouver Coastal gives out three million needles per year, compared 
to only about 400,000 on the part of Fraser Health, according to a 
report by Livingston.

"Fraser Health has the lowest number of syringes given to injection 
drug users and the very highest rate of hepatitis C ... They're just 
not moving forward," Livingston said. "There isn't even a needle 
exchange in the Tri-Cities at all."

Livingston said a Lower Mainland strategy is needed, which could 
include harm reduction techniques like needle exchanges or injection sites.

"If you do an injection site, you don't even need a needle exchange 
because a lot of people don't like them. And further to that, you 
could get really smart and give prescription drugs to people who are 
addicted to drugs," she said.

"Then you don't have a black market. You don't have gangs shooting 
each other. You don't have jails full of people that cost huge amounts.

"You can prevent HIV and hepatitis C among drug users. It's been done 
elsewhere. All the science is in. We don't need any more studies. We 
can implement the harm reduction strategies and save ourselves 
millions of dollars and, of course, save all those people all that misery."

For Dave Portesi, public health director for Fraser Health, 
improvements need to be made.

"We distribute the second-smallest number of clean needles in the 
province and yet have the largest population overall. So I can tell 
you from a Fraser Health leadership perspective in public health, we 
absolutely recognize that we need to increase the number of needle 
distribution partners. We need to get more needles out into the 
community to have a more effective harm reduction system," Portesi said.

"But we also recognize that we must engage other partners in this 
effort. We don't want it to be just Fraser Health because we know 
other providers --  such as peer-to-peer providers, pharmacy based 
providers in needle distribution -- they create border access to a 
community that's often hard to reach."

Portesi said it's difficult to measure the number of active drug 
users in a small geographic area like the Tri-Cities.

"For Fraser Health, we have some pockets of high use such as the 
Whalley area, and certainly in Burnaby and New West and out in 
Chilliwack. For that reason, the needle exchange services we do have 
or needle distribution services we do have are based out of those 
areas," he said.

"But we certainly realize in an area such as the Tri-Cities, it's 
very likely that they have active users. But folks who live in the 
Tri-Cities would have to travel to other communities to get needles. 
That's where we need to bring in alternate providers to help us with 
this mission."

The best practice is to strive for a seven-day-a-week needle 
distribution service that's available through multiple sites, Portesi added.

"I think we're certainly in the planning stages to try to increase 
access. We've certainly recognized that there's a problem. With the 
resources we have, we are getting needles out there, but we know we 
need to expand that access beyond what we have now.

"We're very interested in partnering with other organizations to 
distribute needles in the community, and we encourage any 
community-based organization that wants to promote health through 
effective harm reduction to contact [Fraser Health] to partner with 
us on this issue."

Fraser Health is trying to build support and start a dialogue at the 
community level about supporting harm reduction in a non-judgmental 
way, Portesi said.

"The fact is, handing out needles to people who are addicted to drugs 
and using drugs is also an effective way to engage them in a 
discussion around quitting and making healthier choices. It's a 
critical discussion. If a community's shut off to the idea, they're 
also saying that we're open to the idea of disease transmission and 
allowing that to happen in our community.

"I certainly am a believer in that where there's the highest need, 
that's where you locate services. I think the services need to be 
accessible -- if not in their town, it's in the next town over. 
Ultimately any health service needs to be accessible to be effective. 
So if that means it should be in every town, then yes, it should be 
in every town."

But Hope for Freedom Society director Rob Thiessen does not want to 
see needle exchange services in the Tri-Cities -- or anywhere else.

"We, frankly, are philosophically opposed to any sort of needle 
exchange. Evidence suggests that it just simply increases needle use, 
and there are dirty needles on the streets and alleys and so on. You 
just have to check out the Downtown Eastside to see that," Thiessen said.

"What's happened since the needle exchange was introduced in the 
Downtown Eastside, contrary to claims that it was going to reduce 
dirty needles in the Downtown Eastside, their dirty needles have 
actually gone up exponentially in that region."

Similar to other regions, heroin is the second most-used drug in the 
Tri-Cities, Thiessen said.

"By far, the majority of drug of choice in the Tri-Cities region is 
crack. Heroin users aren't nearly as many as people who use crack. 
It's a small second compared to crack. Crack's No. 1 pretty much everywhere."

Thiessen said the Hope for Freedom Society, which provides addiction 
recovery services, would not promote or partner in a needle-exchange 
initiative.

"I'd like to see it stopped everywhere. We would do absolutely the 
opposite of promoting it. And anybody in the health department that 
thinks it's a good idea is wrong," he said. "The health departments 
in the province have gone for this ... harm reduction model with 
respect to dealing with addictions. We just believe people can stop. 
We don't believe that you need to give them new and different ways of 
continuing their addiction.

"So our philosophy is way cheaper because we don't have to spend 
money on legalizing drugs or giving out drugs, which is being 
proposed in the Downtown Eastside ... In a time of restraint and 
everything else, we can't really afford it."

The Hope for Freedom Society offers a long-term recovery program that 
takes seven months to a year to complete, Thiessen said.

"Why not just teach people to stop? We've successfully been doing it 
for almost 15 years. We've helped thousands and thousands of men and 
women stop, so it's possible. It's not easy.

"We believe that most people are medicating something. There's not 
very many drug addicts out there who became drug addicts simply 
because they partied too much as young people. Most of them are 
medicating a hurt of some sort. So we help them dig that out, figure 
out what that is and then help them deal with it in a healthy 
fashion, rather than an unhealthy fashion."
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MAP posted-by: Jay Bergstrom