SAFE INJECTION SITE A PUBLIC HEALTH MEASURE: EXPERTS

'It Is A Treatment To Try To Reduce The Injury ... When Everything Else Has
Failed'

Providing a safe place for addicts to inject drugs and drink alcohol isn't
capitulating to addiction. Rather, it is a public health measure that
allows addicts to win some control over their lives and, occasionally, take
the first step to recovery, addictions experts say.

News that a possible safe-injection site for drug users is to be studied
for Ottawa has generated some negative reaction from people who feel
government should not be enabling illegal drug use. Ottawa police Chief
Vince Bevan said he wishes authorities would put more effort and money into
drug treatment.

But programs that allow hardened addicts to drink or take drugs in a safe
place are considered by some addictions specialists to be just that.

"It is a treatment to try to reduce the injury and disarray.... when
everything else has failed," said Dr. Philip Berger, a professor of family
and community medicine at the University of Toronto. "One always has to
have a wide door open to any type of patient.

"On a quick, perfunctory glance, it looks as if this is reckless," said Dr.
Berger. "People feel it's bizarre. It's like giving diabetics sugar, but I
suppose that's better if it's done in a supervised fashion."

"This will bring it under control. It will be on the side of more control,
not less. There are some people who have failed every drug treatment plan,
model, philosophy. It's better that their injection drug use take place in
a supervised environment where at least they're still part of the treatment
system, are welcomed into it rather than being tossed out of it and left on
the streets," said Dr. Berger.

By having drinkers and drug addicts in a clean environment, close to
medical professionals, the health of addicts -- who might otherwise be
bingeing or overdosing on the street -- is improved.

Vancouver, with a notorious intravenous drug problem on its streets, has a
pilot project under way that sees addicts able to shoot drugs 18 hours a
day, seven days a week, at a supervised government-funded building at 139
East Hastings. Vancouver's addicts often shoot drugs with dirty puddle
water and in alleyways. Health officials in Vancouver refuse to allow
journalists to tour the site or interview staff. But in the first year of
the three-year pilot project, officials reported that about 3,000 people
were using the site and, in a six-month period, there were 262 referrals to
addiction counsellors and 78 detoxification cases.

The University of Ottawa professor who is studying intravenous drug use in
Ottawa, Lynne Leonard, believes there are between 3,300 and 5,300 injection
drug users in Ottawa. Drug users and city officials will be surveyed over
the next six months about whether a safe-injection site would be accepted
and used in Ottawa.

Benedikt Fischer, a professor at the University of Toronto, said a
safe-injection site won't fit every community and the results are difficult
to measure. In some ways, it's a "a timid step" because the drugs that
addicts shoot are often contaminated, purchased in the black market at
outrageous prices. For these hard-core addicts, it would make more sense to
prescribe a clean supply of the drug, in addition to clean needles, said
Mr. Fischer.

What a safe-injection site will provide is reduction in overdoses, HIV and
hepatitis transmission through shared needles. As well, there are major
savings to the health system, because there are fewer cases of addicts
winding up in emergency departments, said Mr. Fischer. Addicts can also get
access to food, shelter and addiction treatment through such centres.
Addiction researchers believe there are about 125,000 injection drug users
in Canada.

A safe drinking site for the most severe alcoholics, one of only two such
sites in Canada, has been quietly operating in Ottawa for the last couple
of years at the Shepherds of Good Hope.

For the Shepherds, it was a case of responding to the needs of chronic
alcoholics, including one man who was routinely hit by cars when drunk on
the street. The Shepherds brews its own wine and dispenses it hourly,
almost like doses of medication, to 20 men and women in the program. The
health, cleanliness and behaviour of those in the Hope Recovery Stage 2
program has improved significantly, said Shepherds spokesman Rob Eady.

The goals of people in the program vary, said Mr. Eady. Some are near the
end of their lives and just want to die with dignity. One man wanted to,
and did, die sober. Some people have been drinking so long that they cannot
stop drinking without risking death. A few, who initially drank on the
program, have gotten treatment and are now off alcohol.

A controlled beer-drinking program at Seaton House, a shelter for homeless
men in Toronto, has been similarly successful, with chronic alcoholics
getting treatment for a host of health problems, including tuberculosis,
according an article in the Canadian Medical Association Journal.

There's a waiting list of people wishing to get into the Hope Recovery
Stage 2 program at the Shepherds.

But it's not the only waiting list for addictions help in Ottawa.

Ottawa needs to help people well before they become serious drug addicts
and need extraordinary help such as safe-injection sites, but the lineups
for help are growing, says Lyn Atterbury, a program director at Rideauwood
Addiction and Family Services. She hopes publicity over the possible
creation of a safe-injection site will focus people's attention on the
increase in addictions problems.

This includes 12- and 13-year-old children who are using drugs. "These are
kids who, by the time they are 15, are going to be injecting heroine and
cocaine," she said. "Things are getting worse. There are more things to get
addicted to."

There's a been a "skyrocketing demand" for help with everything from
gambling to alcohol and drug problems in the last year, she said. At
Rideauwood, it's led to people being placed on waiting lists and parents
becoming frightened about whether their children will become mired in
severe drug addiction.

Even a modest boost to provincial funding for addictions agencies would
mean many more people would get help, she said.

"It's taking a long time to get into programs," she said. "Nobody likes
addicts. Nobody likes to treat addicts."

Ottawa city council passed a motion in the spring calling for more
treatment efforts for addictions through an "integrated drug strategy." But
the matter has been "farmed off to staff," and there's been no action,
according to Councillor Alex Cullen, vice-chair of the city's health committee.

At the Dave Smith Youth Treatment Centre in Ottawa, assessments of
teenagers are reasonably prompt. But the chairman of the centre's board of
directors, Howard Williamson, agrees that addiction problems have been
underfunded for years and his board spends most of its time raising money.

Unlike diseases such as cancer, addiction is an intangible problem. But
left untreated, Mr. Williamson noted, addictions spell a lifetime of trouble.