ADDICTS' USE OF FREE NEEDLES SOARING

Hamilton drug addicts scooped up 52,000 free needles last year, a nearly
fourfold jump from 1997 when a surge of overdose deaths sparked a police
warning about increased heroin use in the city. The latest figures show the
city's taxpayer-funded needle exchange program has seen a dramatic increase
in demand for the disposable needles, from the 12,182 doled out in 1996 and
14,231 given out in 1997.

Documents obtained by The Spectator under Freedom of Information
legislation helped to reveal that volunteers and staff handed out nearly
30,000 in 1999.

The needles are used by intravenous drug users to inject heroin, cocaine,
the prescription drug dilaudid and, more rarely, speed (methamphetamine).

Free syringes help reduce needle sharing and are viewed as a key weapon in
the battle to reduce HIV and hepatitis C infection rates.

But neither police nor public health officials can say definitively whether
the increase is due to greater awareness and trust in the program among the
city's tight-knit circles of junkies, or if it's due to a true jump in the
number of addicts. That's because the program counts needles handed out and
brought back and each "contact" with a client, but doesn't track specific
individuals.

Suzanne Newark, co-ordinator of The Van, the needle exchange and street
health care centre, doesn't know how many individuals are using the program
because "I don't see ... a need (to know)." There is no limit to how many
needles any one person can ask for at one time.

The needle exchange program once gave 500 to one person.

Newark admitted she doesn't know how many addicts are in the city, but she
believes the jump in needle use reflects "an increased awareness of the
program."

In 1997, nine heroin overdose deaths in quick succession led local police
andthe coroner to warn about an increased availability of the drug and a
surge in its potency.

A local clinic reported five teenagers seeking help for addiction in a
two-month span, an unprecedented event.

Police said heroin traffickers were dropping their prices and increasing
the drug's purity in an effort to win back drug users who had switched to
crack cocaine.

Hamilton recorded 14 overdose deaths in 1996 and 17 in 1997.

More recent figures are not available.

Staff Sergeant Rick Wills, current head of the Hamilton police vice and
drug squad, is often asked how many addicts the city has, but he has no way
of knowing.

"It's so close-knit, it's hard to identify heroin addicts. The addiction
runs through every level of society, including the affluent. A functioning
heroin addict can go for years" without coming to police attention, Wills said.

He said heroin was turning up in crackhouse raids and his officers were
finding dealers "cutting" crack with heroin as a marketing tool.

But heroin arrests and seizures were a minor part of their work.

Studies by researchers with the province's Centre for Addiction and Mental
Health in Toronto identified 450 Hamilton heroin addicts who were using
methadone treatment services, or would if they could get them.

A 1990 study identified 176 junkies in Hamilton who had sought treatment,
but estimated they represented a mere 7 per cent of the total addict
population.

Regardless of the true number of intravenous drug users in the city,
officials agree the dramatic increase in needle demand means injection drug
users -- the homeless, prostitutes and other marginalized residents -- are
beginning to trust health officials.

"Hamilton is a very small town in a way, with a closed environment,''
Newark said.

"People are still pretty private and it takes a long time to build trust."

The needle exchange is driven by public health goals and Newark is
convinced that without the exchange -- and the 49,000 free condoms also
distributed last year -- Hamilton would have high rates of HIV and hepatitis C.

There were 11 new HIV infections, contracted mainly through sex, reported
in Hamilton in 1999, compared to 12 in 1998 and 23 in 1997.

The needles and condoms are given out from a mobile van that operates
Monday to Friday nights from 8 p.m. to midnight, driving to anywhere in the
city that drug users need clean needles.

A user only has to call 317-9966 and make arrangements.

There are also seven locations in the city where drug users can exchange
needles, including the Hamilton AIDS Network on James Street South, the
Elizabeth Fry Society on Main Street East, and two pharmacies.

Last year, 94 per cent of used needles were turned back in.

The van program also includes a street health clinic for the homeless,
hookers and the down-and-out at the Wesley Centre on Ferguson Avenue North.

The program is budgeted at a little over $50,000 a year.

A 1997 McMaster University study found the program delivered good value.

The study estimated Hamilton's program from 1992 to 1997 had saved
taxpayers $1.3 million in health-care costs.

Still, the programs are not without controversy.

In Vancouver last August, an alliance of business and resident groups
demanded an end to government-funded needle exchange programs because, they
said, they facilitated drug use.

Newark said Hamilton taxpayers are getting their money's worth.

"In keeping the infection rate (of HIV and hepatitis C) low, we keep the
costs of medication and health care low.

"Since 1992 (when the program started), HIV hasn't become epidemic, so we
must be doing something right."

Ted Myers, a University of Toronto HIV studies professor, like others in
the health field, is also convinced outreach programs catch larger numbers
of people who need help.

But he admitted, "I don't know if we have good evaluations" of their
cost-benefit ratio.

Hamilton's needle exchange is now a ministry of health-mandated program for
communities where drug use is recognized as a problem.

Halton has approved a $40,000 pilot van program for this year, although it
doesn't know how many people will use it.

Hamilton's van program also offers anonymous HIV testing, methadone
treatment referrals to help drug users get off heroin, addiction
counselling and pregnancy testing.

Needle exchange facts

Hamilton public health department documents obtained from the province
under Freedom of Information laws show a dramatic jump in the use of the
city's needle exchange program. Here's some of what the documents showed:

- - In 1995 the program handed out 14,207 needles, which dropped to 12,182
the next year and back up to 14,231 in 1997, a year that also saw a jump in
heroin overdose deaths in Hamilton.

- - In 1998 the needle exchange program saw a huge jump in demand, handing
out 25,068 needles that year and 29,872 in 1999.

- - Last year the demand surged yet again, with volunteers and staff giving
addicts more than 52,000 needles.

- - The "return" rate, an important indicator of -- among other things -- the
actual use of the needles, has climbed fairly steadily from a low of less
than 50 per cent in 1995 to 94 percent of the needles exchanged in 2000.

- - Usually more women than men access the program's services and in 1999 the
average age of the clients was about 30.

- - The program cost about $50,000 last year to operate.