THE DRUG SCOURGE WILL CONTINUE UNTIL THE MISSING PILLAR IS IN PLACE

Vancouver's supervised injection site is now a year old, and while
it's still too early to draw any substantial conclusions, a survey of
users suggests that the site is fulfilling its goals.

According to an evaluation by the B.C. Centre for Excellence in
HIV/AIDS, a total of 3,036 people (out of an estimated 4,700 addicts
in the Downtown Eastside) accessed the site between March and August
2004. The number of daily visits slowly increased over the six-month
period, with an average of 588 visits a day in August.

The vast majority of clients visited the site to use the injection
room, although some accessed nursing or counselling services. On the
whole, clients were happy with the services, with 95 per cent rating
them as either good or excellent.

These results suggest that many addicts feel comfortable using the
facility, which is fundamentally important if the site is to achieve
its goals. The primary goal, of course, is reduce the harms associated
with injection drug use, such as the transmission of blood-borne
diseases and death by overdose.

It's not possible to tell whether disease transmission has been
reduced, since studies are still ongoing. But there is clearer
evidence about the site's effectiveness in dealing with overdoses.

A total of 107 overdoses among 72 clients occurred between March and
August. All recovered, which isn't uncommon since many people who
overdose recover without intervention. However, the death rate from
overdoses is approximately two to three per cent, which means the
facility likely saved several lives, including the life of one user
who required CPR before an ambulance arrived.

The site was also intended to act as a resource for addicts who are
motivated to seek treatment. Sure enough, professional staff at the
site made a total of 262 referrals to counselling services and a
further 78 referrals to detox programs.

That's a small percentage of the total number of users of the
facility, but treatment won't work unless addicts are highly motivated
to get off drugs. Further, these numbers don't include referrals by
non-professional staff at the site.

Overall, then, the preliminary data suggests that the site has had a
positive effect on the lives of at least some addicts. The harm
reduction pillar of Vancouver's four-pillar approach -- prevention,
treatment, enforcement and harm reduction -- to dealing with drug
addiction seems to be working well.

Vancouver Mayor Larry Campbell deserves congratulations for seeing the
project through. But so does former mayor Philip Owen, who shepherded
the project from the start even in the face of significant opposition,
including the objections of some members of his own Non-Partisan
Association party.

While the signs are positive for the harm reduction pillar, we must
not forget the other three. Some things are coming along: The city
will present its prevention plan in November, and the police have
engaged in a controversial crackdown in the Downtown Eastside.

That leaves treatment as the only pillar we haven't addressed and it's
a pillar that must be in place if we are to substantially reduce the
scourge of drug abuse. After all, there's little point in referring
addicts for treatment if treatment beds aren't available.

At a recent meeting of The Vancouver Sun's editorial board, the mayor
said he didn't know if anyone had been turned away from treatment for
lack of beds, but said it has "probably" happened. He also said he
thinks sufficient beds exist, but believes they haven't been
adequately identified.

As such, identifying treatment services must become a priority for the
municipal and provincial governments. The supervised injection is a
good first step, but it won't take us anywhere unless other steps follow.