SEARCHING FOR COMMON GROUND

Ottawa Researcher Says 'Politicization Of Science' Is Harming
Effective Needle Exchanges, Crack-Pipe Programs

No one in Ottawa has tracked the collective behaviour of the city's
drug addicts more closely than a team headed by Dr. Lynne Leonard, an
epidemiologist at the University of Ottawa.

During the past 13 years, she has analysed responses from hundreds of
addicts about their dangerous habit, often with an eye on an
overriding question: Do harm-reduction programs -- needle exchanges,
free crack pipes -- actually work?

Yes, she says emphatically, though she wonders whether some
decision-makers are really listening.

"A lot of the rhetoric that's happening right now, I don't see where
this evidence is coming from. So, as a scientist, I find it extremely
distressing."

She goes even further than supporting free crack-pipe distribution,
an issue that has sharply divided citizens across the city.

Dr. Leonard is now having a study peer-reviewed that suggests Ottawa
should have a safe-injection site, similar to the one in Vancouver.

It promises to be an explosive topic. Though it is a federal matter,
she is not confident the current city council is in any mood to
embrace a publicly-operated site where addicts can shoot up under supervision.

Public health agencies across Ontario have operated needle exchange
programs for roughly 15 years in an effort to cut the spread of
infectious diseases such as hepatitis C and HIV.

The two conditions can result in huge expense to the health system,
not to mention the toll on human lives. Ottawa has some of the
highest infection rates in Canada.

The City of Ottawa expanded beyond needles in 2005 with the
distribution of free crack-pipe kits.

It was immediately controversial, to the point that Mayor Larry
O'Brien made it a lightning rod in his electoral campaign.

Council withdrew its funding in 2007, but alternate money has since been found.

There is evidence, Dr. Leonard says -- evidence peer-reviewed and
published in respected journals -- to show that the crack-pipe
program was working.

"Then, for us to hear it was turned down because there is no evidence
that it's working, to my mind, speaks to the politicization of
science. The science was very clearly there."

The concept of harm reduction is easily misunderstood, Dr. Leonard says.

"Some people's perspective is that, you provide the needle and people
will start injecting the drug. It's only counter-intuitive if you
think the needles are causing the drug problem."

Fundamentally, she says, people approach the problem of drug
addiction from an ideological point of view.

One being that addicts have made their own poor choices and don't
deserve to be an ongoing drain on strained public health resources,
not with cancer waits and chronic bed shortages.

Another being that addiction is a disease, as worthy of treatment and
care as any other.

"I think our biggest challenge is to find a common language and we
don't have a common language to address the problem."

By "common language," she means that recent stories about harm
reduction, for instance, fail to mention the success stories of
addicts -- and front-line workers -- who know the benefits of needle
or pipe programs.

"What I'm not seeing reported in the media is success stories, from
users who will tell you that the needle exchange program saved my
life. You're not seeing front-line workers describing situations they
find on a daily basis."

Dr. Leonard pulls out another example, a story from this week's
Citizen about a meeting held in Lowertown by residents concerned with
the proliferation of used needles discarded in public places.

The mayor said giving free crack pipes to addicts is like adding gas to a fire.

"It's very much like giving bullets to someone with an empty gun who
wants to commit suicide," Mr. O'Brien said.

Actually, says Dr. Leonard, it isn't.

It is a measure to reduce dangerous behaviour.

It is an opportunity for a crack addict, possibly mentally ill,
probably homeless, to connect, however briefly, with a health care worker.

It is not, she says, creating more crack addicts.

"It is neither the cause of crack-smoking in Ottawa, neither is it
the solution."

Her studies have shown that intravenous drug users will begin using
crack pipes -- a much safer method -- in great numbers as soon as
they are made available.

The research also found that sharing of equipment declined as the
program matured.

There were, in the study period, more than 4,400 contacts between
users and public health workers.

"That, to us, was huge, if you were actually able, in some way, to
engage with this very, very marginalized group of people."

Her unpublished study found that roughly 75 per cent of users would
be fully or somewhat willing to use a safe injection site.

This would get addicts out of public places, reduce needle litter and
act as a check on overdoses.

She agrees that more treatment options for addicts would be a great
help. Addicts are often surveyed on this point.

"We get the same answers. I tried. I'm on a waiting list. When I'm
ready to go, there are no beds. I tried. I tried. I tried."

As a researcher, she is reluctant to get into a public war of words
with the mayor or the police chief, who is known to oppose safe
injection sites.

"We have to work together here. It's not a problem that is going to go away."