HEALTH AGENCIES SEEK TO RESURRECT CRACK-PIPE PROGRAM

It's Too Valuable To Let Go, Says Official With Inner City Group

Health and support agencies that help drug users are gearing up to
start their own crack-pipe program after the city's was scrapped by
council, two agency officials said yesterday.

Wendy Muckle, executive director of Ottawa Inner City Health, said
the program is too valuable to lose and that a way has to be found to
keep it going.

"This is a very hard population to reach, and having them come in to
pick up the kits was a good way of reaching them," said Ms. Muckle,
whose group is the area's primary health provider for the homeless
and addicted.

"We're in a position now where we will have to look at doing it."

Michelle Ball, education and health-promotion co-ordinator at the
Ottawa Aids Committee, dispenses crack pipes and says she will be
working with other agencies to keep the program running.

She said at a total cost of roughly $22,500 per year, getting funding
together will be a challenge for the cash-strapped agencies, but
she's confident it can be done.

"This is something we will absolutely be exploring, and if we all
work together, this is something we can do," Ms. Ball said. "If the
city isn't going to do this, we will. We need people to be as healthy
as they can be."

By a 15-to-seven vote on Wednesday, city council scuttled the
two-year-old program, in which groups hand out crack pipes, mouth
pieces and screens to users at a cost of $7,500 per year to the city.
The provincial government funded the balance of the program.

The program's goal was to stop the spread of HIV and hepatitis C
among area drug users, the majority of whom smoke crack. Ottawa is
currently going through a boom in crack smoking, and users here have
the highest rate of hepatitis C infection in Canada. The rate of HIV
infection among users is also near the top.

The city's chief medical officer of health, Dr. David Salisbury,
repeatedly told council that the program was working, saving lives,
saved millions in future medical expenses and was good for public
health in the city before it was cancelled. He added that scientific
evidence backed up these claims.

His message fell on deaf ears as council, led by College Councillor
Rick Chiarelli, West Carlton-March Councillor Eli El-Chantiry and
Mayor Larry O'Brien, struck down the program.

Mr. O'Brien called the program "foolishness" because it gave users
the tools to do something that is detrimental to their health, and
said the city should concentrate on treatment.

Many others who voted to axe the program also felt the city was
encouraging drug use by handing out the pipes.

Yesterday, Mr. O'Brien's spokesman, Mike Patton, said the mayor
"fundamentally" believes the crack-pipe program wasn't having an
effect on the spread of disease, and that the agencies shouldn't
restart the program.

"He doesn't think outside agencies should pack it up," Mr. Patton
said. "But if they want to do it, it's a free country, and they can
do what they want."

Mr. Patton said the mayor thinks instead the agencies "should put
their lobbying efforts and financial resources toward getting enough
treatment beds in Ottawa." He said doing so would be more help than
continuing the program.

Such thinking makes Ms. Ball angry. She and others who are trying to
help drug addicts stay healthy said the program was working.

"This is not only a short-sighted decision, but it's completely
misinformed on the value of this program," Ms. Ball said. "City
council is supposed to act as a public health board in the interests
of all citizens' health. What they did is completely irresponsible,
and I think it's a breach of the human rights of some of our most
vulnerable people.

"People used this program because they knew they were going to smoke
crack, and they knew they could come in an get a clean pipe," she
said. "They wanted to get a clean pipe because they didn't want to
get infected."

Ms. Ball said her group and other organizations will start a lobbying
campaign aimed at getting continued funding from the province, and
that she hopes Ontario's government will mandate that cities have
crack-pipe programs, like they do with needle-exchange programs.

She said the program helped to not only reduce the spread of disease,
but offered a chance for her and others who give out pipes to make
contact with users they wouldn't otherwise see.

During this contact, she said, she tries to steer them toward
healthier lifestyles and, sometimes, drug treatment.

She added that she can't believe council disregarded clear advice
from Dr. Salisbury on the issue.

"They utterly ignored their own expert," Ms. Ball said.

But Ottawa is not the first city to reconsider its crack-pipe
program. Last month, a similar program was suspended in Nanaimo, B.C.
after health workers faced harassment while handing out the kits.

News that Ottawa's crack-pipe program might return, however, was
greeted with delight by University of Ottawa epidemiologist Lynne
Leonard, who studied the program for a year and concluded that it was
having a positive effect.

Last year, Ms. Leonard presented city council with her findings,
which went on to be presented at international conferences and was
published in a leading medical journal.