Pubdate: Mon, 24 Jun 2013
Source: Vancouver Sun (CN BC)
Copyright: 2013 The Vancouver Sun
Contact: http://www.canada.com/vancouversun/letters.html
Website: http://www.canada.com/vancouversun/
Details: http://www.mapinc.org/media/477
Author: Ian Mulgrew

DRUG HARM-REDUCTION STRATEGY CUTS NUMBER OF INJECTION USERS

Much to the chagrin of the federal Conservatives, Vancouver's 
approach has been highly effective, study finds

Vancouver's progressive approach to drug addiction over the past 15 
years is working, says a major report obtained exclusively by The Sun 
and based on comprehensive health and safety data.

Produced by scientists from the Urban Health Research Initiative of 
the B.C. Centre for Excellence in HIV/AIDS and the UBC Division of 
AIDS, the 2013 Drug Situation in Vancouver report to be released 
Monday shows liberal harm-reduction policies are effective at 
reducing illicit drug use and improving public safety.

In addition, the researchers have a study coming out in a top U.S. 
addiction journal that suggests the dramatic expansion of the 
needle-safety program in the Downtown Eastside led to a greater 
proportion of drug users turning away from injecting - from 0.4 per 
cent in 1996 to almost 50 per cent in recent years.

"The objective of this report is to make data accessible to a wide 
variety of stakeholders and to directly inform the City of 
Vancouver's Four Pillars Drug Strategy, the Province of British 
Columbia's response to illicit drug use, and the Canadian federal 
government's National Anti-Drug Strategy," the authors say.

Together, the report and the article establish the success of 
harm-reduction programs at connecting addicts to treatment and 
reducing the health risks, such as HIV transmission, associated with 
illicit drug use.

Overall, they imply investing in health care workers is far more 
effective than spending money on police and jail guards when it comes 
to combating and reducing the damage done by illegal drug use.

"In recent years, there seems to have been an overall decline in 
illicit drug use," as a result of the harm-reduction approach, the 
report says, although that conclusion is difficult to ascertain with certainty.

"Overall, the prevalence of daily cocaine injection among persons who 
use drugs has dramatically decreased-from 38.1% in 1996 to 6.9% in 
2011. As well, the proportion of (persons who use drugs) reporting 
daily heroin injection has declined over the years."

In the teeth of federal opposition to harm-reduction programs and an 
escalating law-enforcement war on drugs, the research indicates that 
providing access to treatment and supervised injection sites is a 
better way of dealing with addiction.

Increased spending on law enforcement together with longer prison 
sentences has not made a difference in either the availability of 
illicit drugs or their price.

Although a large proportion of users in the city said they had been 
jailed because of the federal tough-on-crime approach, the laws 
haven't affected the supply - heroin still sells at $20 per 0.1 gram 
and cocaine, crack cocaine and crystal methamphetamine at $10 per 0.1 gram.

"The availability of these so-called 'hard drugs' is comparable to, 
and in some cases even greater than, the reported availability of 
marijuana," the authors state.

"These data suggest that while programs and policies targeting 
infectious disease and overdose have been effective, few gains have 
been made in terms of reducing the supply of drugs. In addition, drug 
trends are shifting, with fewer (persons who use drugs) injecting 
illicit drugs and a larger proportion smoking crack cocaine."

Aside from the vast amount of data available in the report, The Drug 
and Addiction journal article provides evidence that the expansion of 
needle-exchange and distribution programs have not led to increased 
drug use, as the government and its supporters argued.

"In summary," its authors added, "the present study suggests that 
increasing needle and syringe program availability does not appear to 
contribute to delayed cessation of injection drug use."

In other words, the fear that having a safer place to inject keeps 
people on the needle longer is unfounded.

All of the data support the city's decision under Mayor Philip Owen 
in the late 1990s to adopt the four pillars approach - treatment, 
prevention, harm reduction and enforcement,

The BC Centre for Excellence in HIV/AIDS started an investigation of 
the HIV outbreak in the Downtown Eastside and began compiling this 
important database in 1996.

An examination of intravenous drug users - the Vancouver Injection 
Drug Users Study - was also established and later received funding 
from the U.S. National Institutes of Health.

That ongoing research involves semi-annual followup of 1,200 
participants, who visit an office to be tested for HIV and hepatitus 
C and to answer a detailed questionnaire.

Since the launch of the injection drug users study, the centre has 
done a number of other studies funded by peer-reviewed grants from 
various agencies.

In 2006, it received money from the Canadian Institutes of Health 
Research to create a research program that combined all of these data 
sources and allow for a comprehensive analysis.

To meet that end, the Urban Health Research Initiative was 
established in 2007 at St. Paul's Hospital led by Dr. Evan Wood and 
Dr. Thomas Kerr. Part of its mandate "is to help inform policy 
decisions using the best available scientific evidence regarding the 
illicit drug problems in the City of Vancouver."

The group released a similar report summarizing 10 years of data in 
Nov. 2009 that found the city's hard-drug trade thriving, with steep 
increases in the use of crack cocaine and a significant increase in 
the use of crystal meth by street youth.
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MAP posted-by: Jay Bergstrom