NEEDLE EXCHANGE PROGRAM DESERVES A CHANCE

More than a year ago, AIDS Vancouver Island, the organization that
runs the needle exchange on Cormorant Street, announced that it could
no longer operate at the site and with a budget that had not increased
for more than 10 years. We were bursting at the seams.

Population growth, a small site with few staff and a shift to street
drugs that required more injections meant that people were
congregating outside the needle exchange, one of the only services
open after hours.

Cutbacks to many provincial and federal programs, such as drug and
alcohol treatment, housing and welfare, as well as
deinstitutionalization, compounded the grief of those who use the exchange.

The needle exchange bore the brunt of these failed
policies.

During the past year we set out to explore different models for needle
exchange services and to find a more suitable location. Recently, with
the help of the Vancouver Island Health Authority, we were able to
hire additional staff and begin to implement changes in the way needle
exchange services are delivered.

Any needle exchange system must do just that: Exchange clean needles
for used ones. On that score the fixed site exchange on Cormorant
Street and the mobile exchanges are doing well.

Not surprisingly, fixed sites do better on exchange because staff can
work more closely with individuals and those using injection drugs
often respond better to a permanent location with regular hours.
However, mobiles are key to providing services in appropriate
locations and can shift quickly as those locations change.

Secondary sites, usually organizations that provide health services to
vulnerable populations, are also essential. At present there are a few
such sites, and we are seeking more. Drop boxes in a few places in the
city assist greatly with collection. Again, more are required.

Another central part of any needle exchange program is to offer basic
health services for those whose addictions and street life take a
heavy toll. Street nurses operate from the fixed site providing basic
health services to combat the other diseases that afflict many of
those using IV drugs and help them maintain prescription drug regimes,
often for mental illness.

Street nurses also join outreach workers from the fixed site on alley
patrols, going to locations where intravenous drug users congregate to
exchange needles and offer nursing services.

Another function of a needle exchange is to connect people to services
to help them get by and make changes. Most of us have been affected by
addictions in one way or another, through family members or our own
experience.

We know that standing by, providing support and acceptance and
connecting people to help when they are ready to receive it is crucial.

A needle exchange co-located with appropriate health and addiction
services can help people take these steps.

The time has long passed when we can have a stand-alone needle
exchange, a model that most Canadian cities have left behind.

Instead, we are changing the way needle exchange services are
delivered, combining a central site and decentralized services, all
closely connected to other health and law enforcement services.
Already improvements have been noticed.

A move to a new location on Pandora Avenue was a central part of this
plan. The site offered space with other related health organizations,
a central location and a supportive neighbour, Our Place, next door.

The alternatives are bleak. We have no space and must relocate the
exchange by May 31. The prospect of moving to an isolated industrial
area and continuing the stand-alone model is unacceptable and would
likely bring the same problems as before. VIHA, the City of Victoria,
the acting chief of police and many others were in favour of the move
to Pandora Avenue.

We support the idea of community consultations so that the move to
Pandora Avenue can be done over time and with proper safeguards in
place. However, a few organizations and individuals should not be able
to veto the move before these consultations take place and without
giving us the chance to demonstrate how comprehensive needle exchange
services can be delivered.

Marilyn Callahan is the chairwoman of AIDS Vancouver Island.