DRUG STRATEGY SEEKS SAFER USE

Toronto Public Health

Toronto should provide crack pipes to junkies, consider opening safe
injection sites and support decriminalizing marijuana, according to a
report released yesterday.

The drug strategy prepared by Toronto Public Health contains 66
recommendations aimed at both preventing drug use in Toronto and mitigating
its effect. The goal is to balance "public health and public order
interests," according to Councillor Kyle Rae, who led the strategy's
advisory committee.

Seventeen proposals in the strategy are designated as priorities, including
developing a 24-hour crisis centre for drug users and implementing systems
to monitor hospitals and morgues for indications of new street drugs
infiltrating Toronto.

The report also highlights the need to expand harm reduction programs such
as the distribution of "safe crack" kits. Providing sterile pipes and other
items could help prevent the spread of diseases such as hepatitis C,
according to David McKeown, the Medical Officer of Health.

The kits also provide street outreach workers with a tool to connect with
crack users.

"The kits are a way to reach out and pull in a very marginalized group of
drug users. You can't get people into treatment and you can't reach people
with prevention messages if you can't talk to them directly. So the crack
kits are seen as a good way to do that," Dr. McKeown said.

Providing crack kits and other support to users does not encourage their
addiction, Dr. McKeown argued. He said that while preventing drug use is
the goal, the city must also recognize that addicts exist.

"I think we need to send a strong message about the health and social risks
of drug use, but for those people who continue to use, we shouldn't abandon
them," he said. "If we have the ability to minimize the consequences for
those who are using while we move them towards not using, I think we should
do that."

The strategy does not propose opening safe injection or inhalation sites.
However, it does suggest the city study whether consumption rooms are
needed to provide junkies with a controlled space to indulge.

"We did not focus on that in this report, but we recognized that it is a
methodology used around the world and that we should at least have it on
the table," Mr. Rae said.

He added that the introduction of safe injection sites in other cities,
such as Vancouver and Sydney, Australia, was complicated and lengthy.

"The process that Vancouver went through took many, many months. And it
needs federal, as well as local and provincial, concurrence. So it's not an
overnight process," Mr. Rae said.

Alcohol abuse is addressed in the report. For example, the strategy
suggests limiting the number of bars close to each other to prevent
violence and disorderly conduct.

Public health officials consulted more than 30 community groups and
government agencies while working on the strategy, in addition to holding a
series of town hall meetings. But they admit some of the parties involved
did not agree with the final recommendations. For example, Toronto police
do not support the opening of safe injection sites.

"Based on the experience in Vancouver and other cities, we do not see it as
a viable way, but I'm quite willing to support an investigation into
whether it can be done better," Deputy Chief Tony War said.

Police also object to the report's call to decriminalize possession of
small amounts of marijuana.

"We're concerned about the influx of grow houses. Grow houses are a big
social problem, not just a drug problem. And it's creating a market for the
grow houses," Deputy Chief War said.

The report will be presented to the Board of Health for approval this month.