Pubdate: Sun, 30 Sep 2012
Source: Province, The (CN BC)
Copyright: 2012 Postmedia Network Inc.
Contact: http://www2.canada.com/theprovince/letters.html
Website: http://www.theprovince.com/
Details: http://www.mapinc.org/media/476
Author: Glenda Luymes
Pages: A10-A12

'THEY'RE PLAYING WITH PEOPLE'S LIVES'

Health experts call for repeal of bylaw against harm reduction but
community is divided

Pastor Ward Draper quotes Scripture and swears in the same
breath.

He wears his clerical collar beneath a military-style black uniform as
he leads a congregation of addicts at a Saturday-night church service
in Abbotsford.

He dispenses communion - and crack pipes.

It's tempting to call him a contradiction. But Draper is adamant:
"We're bringing the church back to where it should be," he says,
meaning the streets and alleys where the community's most vulnerable
reside.

Draper is the pastor of The 5 and 2 Ministries - Canada's only church
outside Toronto that does needle exchange - in Abbotsford, the only
community in the country with a bylaw banning harm reduction.

It took three years for Draper and his church to make the decision to
ignore the bylaw and begin distributing needles.

"When we finally took that stand, we were sure it was right," he
says.

Draper's assurance is not shared by all. In 2005, Abbotsford council
approved a zoning change outlawing harm-reduction services within city
limits, fearing needle exchange would enable and encourage drug use.

The issue was back in the spotlight this spring. A report published by
Fraser Health showing high rates of overdose hospitalizations and
hepatitis C infections in Abbotsford attributed the numbers to the
city's stance on harm reduction. The health authority recently
presented council with a plan for a needle-exchange program.

In response, council has decided to revisit the bylaw and approved a
public consultation process for later this fall.

The Sunday Province set out to explore the community's views on harm
reduction. Along the way, we encountered a few surprises.

While it's clear Abbotsford is divided over the bylaw, we found some
of the harshest criticism coming from outside the city, something
residents resent.

We spoke to politicians - and to recovering addicts. We found people
who favour an abstinence-based drug strategy and others who are
quietly involved in harm reduc-tion, including a drop-in centre cited
as a model for Vancouver to follow.

For many, the issue of harm reduction is as black and white as a page
of Scripture.

Supporters claim harm reduction - needle exchange, methadone therapy
and safeinjection sites - saves lives and prevents disease, in
addition to providing addicts with an avenue to access treatment.

Detractors claim harm reduction makes it easier to use drugs,
providing addicts with less incentive to get clean while diverting
funds away from treatment.

Abbotsford's bylaw was written at a time when InSite, Vancouver's
safe-injection site, was only a few years old and virtually untested.
Council saw Vancouver's drug problems and thought it could prevent a
similar situation in Abbotsford by making the community unfriendly to
drug users.

Abbotsford Coun. Simon Gibson was on council at the time and remains a
supporter of the bylaw.

"I've received virtually no criticism about it from the public," he
tells The Sunday Province.

Gibson says council is reconsidering the bylaw at Fraser Health's
prompting, but that the health authority has a "different mandate"
than the city.

"Their focus is more on the addict, where I believe council is more
concerned with the overall social well-being of the whole community,"
he says, adding he feels harm reduction offers "limited solace" for
drug users as well.

Like Gibson, many harm-reduction opponents favour a return to an
abstinencebased drug strategy.

Abbotsford MLA John van Dongen says harm reduction may have a place,
but he doesn't agree with what he calls the government's "complete
buy-in" of the harmreduction model.

"In Abbotsford, there's a different model at work," van Dongen says,
referring to detox and treatment based on the 12-step program. "The
effort to channel everyone into one model [harm reduction], while
vilifying everything else just isn't helpful. . . . It's almost like
[harm-reduction supporters] are afraid there might be success in an
alternative model."

Vancouver addictions expert Dr. Thomas Kerr disagrees harm reduction
and abstinence are incompatible. He also refutes the idea that
government is funding one over the other.

"There does not need to be a tension between harm-reduction and
abstinencebased models," says the director of the Urban Health
Research Initiative at the B.C. Centre for Excellence in HIV/AIDS.

"Some of the people who promote abstinence-based treatment don't
understand the role of harm reduction in the continuum of treatment.
We all agree - the best outcome is to stop using completely."

Abbotsford Mayor Bruce Banman has been walking a tightrope between the
two sides on one of the first controversial issues he's had to deal
with as the city's newly elected leader.

The mayor was initially supportive of a needle exchange in the
community but has become less outspoken as time goes on.

After a few months of dealing with the issue, he said the city might
be more willing to consider repealing the bylaw if Fraser Health
promised better detox services. The closest medical detox facility to
Abbotsford is in Surrey, although mobile units provide service in
private homes.

"If Fraser Health isn't going to be part of the solution and help us
get detox, what's the point of turning this city upside down and
having all the anger and fear [about harm reduction] come up?" Banman
said at a June council meeting.

The suggestion, which seemed a compromise of sorts, received a
negative response from Fraser Health.

"It is not reasonable to withhold one health service [harm reduction]
that prevents disease, in an effort to lobby for another," says
spokesman Roy Thorpe-Dorward.

"Fraser Health has adopted the harmreduction framework as its
philosophical position to guide the delivery of health services."

The mayor, who is also a chiropractor, recognized the tension between
health-care delivery and city politics in an email interview with The
Sunday Province.

"Although I don't expect that the debate over how to best provide
support for people suffering from addiction will be resolved any time
soon, I do believe that the issue becomes more convoluted when you mix
in political decision-making with health-care best practices," he said.

Council's top priority at this time is to provide a forum for "every
resident" to voice their views and ensure local government policy is
"reflective of the people it serves," he said, then added: "It is also
our responsibility to ensure that our most vulnerable residents get
the best health care possible. This review and advice from experts
will assist us in doing that."

Mark Townsend never set out to be a saviour. But that's essentially
the role his group assumes once a week on the streets of Abbotsford.

"It shouldn't be Vancouver's job to do harm reduction [in
Abbotsford]," says the director of Vancouver's PHS Community Services
Society. "But we can't sit back and watch when we know people need
help."

PHS is one of the most outspoken critics of the Abbotsford bylaw. The
society, which operates Vancouver's InSite facility, began sending a
van filled with harmreduction supplies to the Fraser Valley about a
year ago after learning Abbotsford residents were regularly visiting
the Vancouver needle exchange.

"We all live in this area. It's not right for Abbotsford to think they
can get other people to deal with their problems," says Townsend.

Not surprisingly, there are those in Abbotsford who resent PHS's
presence on the streets - but their problem isn't with harm reduction.
Rather, they dislike the idea that a Vancouver organization feels
compelled to "rescue" Abbotsford.

(According to PHS's latest financial records, the society has assets
of $62 million, annual revenues of $26 million and its top six
executives earn between $120,000 and $200,000 a year.)

But the criticism is lost on Townsend, who vows a lawsuit against the
city if the bylaw isn't repealed soon.

"[Abbotsford] should be ashamed," he says. "[The bylaw] is immoral.
It's un-Christian."

Addictions expert Kerr also has harsh words for city leadership,
calling council's position an "embarrassment."

"It's a purely political game, and they're playing with people's
lives."

Kerr says Abbotsford's position directly contradicts the world's
foremost addictions experts - "scientifically, the debate over harm
reduction is a non-issue."

And it may be science that provides the harshest criticism of the
Abbotsford bylaw.

A Fraser Health report released this spring showed Abbotsford's
hepatitis C infection rate in 2010 was 64.4 per 100,000, compared to a
2009 rate of 54.9 in B.C. and 33.7 nationally. Abbotsford was second
only to New Westminster in the rate of people admitted to hospital
because of illegal drug overdoses.

Spokesman Thorpe-Dorward says the health authority believes
Abbotsford's harm-reduction bylaw is to blame.

"If people did not share needles, we could dramatically reduce hep C
transmission. The No. 1 reason people share syringes is because they
don't have access to clean ones."

She dances on one leg and then the other.

In her mouth is a lit cigarette. In her hands, a baseball. She stops
moving for a second, then suddenly throws the ball - at a police officer.

A loud shout carries across Abbotsford's Jubilee Park, followed by a
splash. It's a sunny Thursday in August and the Warm Zone women's
centre is hosting a barbecue. There's an Abbotsford police officer
perched above a dunk tank. The lineup is long.

Watching the spectacle, Insp. Tom Chesley says police are supportive
of harm reduction in Abbotsford "as long as it truly reduces harm." He
qualifies his statement further by saying police are not supportive of
a "shooting gallery."

The debate over harm reduction in Abbotsford is further complicated by
the terminology. Does repealing the bylaw mean replacing an addict's
dirty needle with a clean one, or the creation of a safe-injection
site such as InSite? So far, Fraser Health has only proposed a
needle-exchange program, beginning with distribution through community
groups and eventually moving to a mobile and then fixed-site service.

At the Warm Zone, needle exchange is nothing new.

Cited in the Missing Women Commission of Inquiry's final report as a
"best-practices" model, the Warm Zone is a drop-in centre where
streetentrenched women can come to shower, take a nap, make a sandwich
or a long-distance phone call, pick out clean clothes, get connected
with a police officer to report a "bad date," or with a doctor, social
services or addiction treatment.

They can also pick up a clean needle or two, something city staff have
turned a blind eye toward since the issue came before council.

Women's Resource Society executive director Dorothy Henneveld says the
Warm Zone is all about harm reduction, but needle exchange is only a
tiny part of what that means.

"We've been distributing harm-reduction supplies for many years
without making a big fuss," Henneveld says.

"More importantly, the Warm Zone is a safe place. It's a place where
clients can take a breath, where they're treated with respect."

Service providers in other communities are often surprised to hear
about the level of support the centre receives from the community, she
adds.

"There are lots of assumptions made about the Fraser Valley. Yes, in
Abbotsford we have a harmreduction bylaw on the books and every so
often there are letters in the local paper [supporting the bylaw]."

Henneveld laughs. "They're almost like caricatures of what outsiders
imagine Abbotsford to be like. I won't say the city's harm-reduction
bylaw is helpful but, on the other hand, we have a community here that
truly and deeply cares."

Abbotsford has been the country's most generous community for nine
years running, according to Statistics Canada. Donors gave a median
donation of $620 to charities in 2010, well ahead of Calgary and
Victoria at $390.

There were 25,650 donors in Abbotsford who claimed a donation on their
tax form, together giving about $74 million to various charitable
organizations.

Hair stylist and Warm Zone volunteer Linda Klippenstine feels
Abbotsford has an unfair reputation for intolerance.

"I think most people who actually visit the Warm Zone realize harm
reduction is the right thing to do," Klippenstine says, watching as
two children take turns at the dunk tank.

They squeal when their ball hits its mark and the police officer goes
down.

Marcy Doyle can't promise she won't relapse again. The recovering
addict admits "loneliness puts me right back there." But the time
between relapses is getting shorter.

"I never expected it to happen to me," the Abbotsford woman says of
addiction.

"I'm a normal person, but something happened and for three years I
lost it."

Doyle supports harm reduction: "Getting clean is a long
journey."

Arnold Mulessa stopped drinking one time, more than a decade
ago.

"Raised by the government," the Abbotsford man says it was only a
matter of time before he became addicted.

Mulessa believes Abbotsford council should stop trying to fight the
inevitable and strike the bylaw from the books, but he's not certain
harm reduction helps beat addiction. "I'm still a firm believer in
abstinence," he says.

Although Doyle and Mulessa are very different, both agree on one
thing: They'd have no chance of success without support.

Mulessa is in the process of beginning a private withdrawal management
company to help people who want to avoid a recovery home.

"The biggest thing that helps is having someone who's been there," he
says.

For Doyle, it's the community of women at the Warm Zone, as well as
her mentor, who keep her moving forward.

"They've seen me through it all," she says. "Sometimes all it takes
for you to take the step [toward recovery] is to know you're supported
- - no matter what."
- ---
MAP posted-by: Matt