NEEDLE EXCHANGE ENTERS UNTESTED WATERS

We're about to become the first major city in Canada to pull the plug
on its needle exchange, without a clue about what will happen as a result.

At the end of May, the region's largest needle exchange will close
its doors on Cormorant Street and begin a mobile service. The
business of exchanging as many as 2,000 needles a day will be done on
the street.

What's the rationale? There isn't one. It's just what happens when
the chips are left to fall where they may. The needle exchange isn't
going mobile because it's an effective strategy on any front, but
simply because no place can be found for it.

Greater Victoria has had a needle exchange for almost 20 years,
operated by AIDS Vancouver Island. You'd never know it from the
hand-wringing and hysteria that has accompanied any mention of the
exchange this past year or two, but once upon a time the exchange had
neighbours who actually wrote letters supporting it, and a day-care
centre right across the street. Those days are long gone, and for
reasons that have little to do with the needle exchange itself.

Most notably, the number of people using the needle exchange has
increased dramatically -- from 500 clients in 1996 to more than 1,500
today, with no concurrent increase in funding. Up until a small lift
last fall in the midst of a community uproar over Cormorant Street,
the exchange had been juggling triple the number of clients with the
same staffing levels as a decade ago.

The drugs have changed as well, says AVI communications co-ordinator
Andrea Langlois. Mellower drugs like heroin have given way to intense
ones like cocaine and crystal meth, which can crank up negative
behaviours in users due to the way they affect brain chemicals.

Both of those drugs are also injected far more frequently by addicted
users -- sometimes 20 or more times a day. That has increased traffic
at the exchange.

Then there's the sheer volume of people out there. The number of
people living on the streets has grown fivefold since the exchange
moved into its current Cormorant Street location in 2001. With most
other services closed at night, the exchange evolved into a place
where the street community could hang out.

No surprise, then, that the neighbours gradually worked themselves
into a fury over the discarded needles, garbage and steady stream of
sick, scabby people they were seeing outside their doors. The owner
of the building that housed the exchange gave AVI notice last fall
that the service had to go.

Months of fruitless searching for another location followed. There
was a plan to move the exchange into a Pandora Avenue building next
to the Our Place drop-in, but that fell through after alarmed parents
from a private school a couple of blocks away nixed the move. With
the May 31 eviction date looming, AVI has no choice but to go mobile.

It's a most peculiar development for a region that really can't
afford any more evidence of the social decay in its core. Up until
now, we've had one needle exchange; in the near future, we'll have
one wherever AVI's van stops. What's our plan when those
neighbourhoods inevitably start to complain?

Langlois is especially worried about the clients who like to maintain
a low profile -- the ones who stop by every night after work to pick
up a needle or two.

They're not going to want to risk being identified by having to make
their exchange in a public place, especially if TV crews decide to
make a big deal out of following the van on its route. The
opportunity to connect clients with other services -- including detox
and treatment -- will also be lost when the exchange goes mobile.

"We really don't know how successful we'll be in maintaining the
number of needles exchanged once we're mobile," says Langlois, adding
that if the number of exchanges drops off, "there's potential for an
epidemic of hepatitis C in this city."

The needles might be what bring people through the door, says Steve
Bradley, a Christian outreach worker and recovering addict who used
to run a support group at the exchange. But it's the support and
sense of connection that people get while there that can change their
lives, he notes. Without it, there's no way out.

"You close the needle exchange, you're going to see crime downtown
increasing," predicts Bradley. "We can't afford to lose that place."