STUDIES LAUD SAFE-INJECTION SITES

Vancouver - It is time for Canada to embrace a policy of safe injection
sites for drug addicts, the authors of two new medical studies on the grim
impact of injection drug use in Vancouver say.

The studies, published in Tuesday's edition of the Canadian Medical
Association Journal, found that injection-drug users clog hospital beds and
emergency wards at huge expense to the health-care system, suffer an
appalling number of fatal drug overdoses and continue the risky practice of
sharing needles, despite comprehensive needle-exchange programs.

"Safe injection sites are an investment to prevent medical problems that we
would otherwise end up paying for downstream," said Anita Palepu, an
internal medicine specialist at St. Paul's Hospital in downtown
Vancouver. "They make sense from both a moral and fiscal point of view."

She said drug overdoses are the leading cause of death among British
Columbia men 30 to 49 years of age. "There is a segment of society that
will always misuse drugs. But these are not necessarily horrible people.
It's important to treat them as human beings."

Safe injection sites for intravenous drug users, staffed by qualified
clinicians and counsellors, exist in many European cities. A similar
facility recently opened in Australia. A policy of appearing to condone
illicit drug use, however, remains controversial in Canada.

Vancouver, considered to have the country's worst drug problem, has
endorsed the idea but has yet to approve a safe injection site.

Martin Schechter, head of the University of B.C.'s department of health
care and epidemiology, said Canadian attitudes are changing.

"What we have tried for the past several decades is not working," Dr.
Schechter said. "The public is getting fed up with the problem. People in
Vancouver are embarrassed by what they see in the Downtown Eastside," which
has the city's major concentration of drug addicts. "They are ready to
explore alternatives, to try new things."

The medical journal, Canada's most respected, gave strong backing to the
authors' call for serious consideration of safe injection sites.

An editorial accompanying the studies pointed out there is no quick fix for
the severe drug problems in many Canadian communities.

"But we can make the lives of people with drug addictions a little better
and neighbourhoods a little safer," the editors wrote. "Supervised
injection rooms are a logical next step, one that combines the merits of
realism and compassion."

The study co-authored by Dr. Palepu looked at the medical records of 598
injection-drug users over a period of three years. They accounted for a
total of 2,763 visits to St. Paul's emergency wards and 495 actual
admissions to the hospital.

"Those numbers are very high, especially when you consider most of these
people are in their early to mid-30s," Dr. Palepu said.

Nearly all hospital visits were prompted by medical problems caused by
unsafe injection practices, such as sharing needles, using a discarded
needle or injecting alone. The most common reasons for admission were
serious skin abcesses and pneumonia caused by bacteria-bearing needles.

Patients identified as using risky needle behaviour ran up medical bills
$1,752 a year higher than drug users who appeared to practice safe needle
use, the study estimated.

"This money should be invested in treatment and prevention," said Dr.
Palepu, who added she had no idea of the scope of Vancouver's drug problem
until she came to St. Paul's five years ago. "The hospital is the wrong
place for these people."

Dr. Schechter's study found that nearly 28 per cent of 776 drug users
surveyed reported they had shared needles with another user at least once
over a six-month period, exposing them to the danger of infection with HIV
or other diseases transmitted by blood.

He said that was very discouraging in light of Vancouver's pioneering,
high-profile program of providing sterilized needles to drug users on
demand. "This shows that needle-exchange programs alone are not sufficient
to do the whole job."