B.C. DETOX BED SHORTAGE HELPS SPREAD HIV, STUDY SUGGESTS

Addicts Who Try To Get Treatment And Fail Are More Likely To Share Needles

A shortage of addiction treatment and detox beds in Vancouver may be
contributing to the spread of HIV in the city, according to a new study.

The study, by researchers at the B.C. Centre for Excellence in HIV/AIDS,
found that drug addicts who tried to get into treatment programs but failed
were 29-per-cent more likely to share their needles than other addicts,
putting them at greater risk of contracting the human immunodeficiency virus.

The researchers tracked close to a thousand HIV-negative injection drug
users in Vancouver from May 1996 to May 2002 who weren't already in treatment.

In all, a third of those in the study reported attempting to get into a
drug treatment program but being unable to do so.

During the course of the study, 10 HIV-negative addicts in the study who
sought addiction treatment but were unable to get it later became infected.

Evan Wood, the study's lead author, said there are a couple of theories as
to why those turned down for treatment are such a high-risk group.

One is that drug addicts are most likely to seek detox when they hit "rock
bottom" -- feeling at their worst and so desperate for drugs they are more
likely to share needles.

The other theory, the study notes, is that being turned down for detox or
treatment "may promote depression [and] anxiety" in addicts -- making them
more likely to engage in risky behaviour.

The estimated cost of treating a patient with AIDS in hospital is $150,000.

The study, which will be published June 1 in the international journal
AIDS, notes that failing to invest more money into addiction treatment "may
result in a major missed opportunity" to prevent the spread of HIV.

"We have a population out there that has been repeatedly sharing syringes
and they're actually willing to get into addiction treatment and get off
the streets," said Wood. "But we need to make sure we have the capacity to
help these people get off drugs."

There are 52 adult and 10 youth detox beds in Vancouver and Richmond.

Viviana Zanocco, a spokeswoman with the Vancouver Coastal Health Authority,
said the authority has made significant improvements in reducing the
waiting lists for detox beds.

When the health authority took over those programs four years ago from the
provincial government, Zanocco said, the average waiting time for
residential detox was about six weeks.

The average waiting time is now down to just two days, she said, although
the actual wait can be as long as five days or as short as zero.

That reduction is due in large part to the authority keeping better track
of available detox beds, Zanocco said, and establishing a single number,
Access 1, that addicts can call to get a detox spot.

While two days may not seem like very long time to wait, advocates say the
nature of drug addiction requires something close to on-demand detox to
help people when they are willing to seek help.

"When you get to the point when you want to go into detox, you're in a
pretty desperate condition," said Ann Livingston, project coordinator for
the Vancouver Area Network of Drug Users. "There is a window of opportunity."

Zanocco confirmed that about one third of those who put their names on a
waiting list for detox don't show up when a spot finally becomes available.

However, she said the health authority needs to balance the demand for more
addiction services with other health priorities.

"Where do you take [the money] from?" she said. "Is addiction treatment
more important than hip replacements? I don't know how you decide what's
more valuable. ... There are a lot of demands on the public purse and there
always will be."

Zanocco said the health authority has started implementing alternatives to
residential detox to provide more services for addicts.

These include "day-tox" programs in which people attend hospital during the
day and then return home at night, and home detox, where people stay at
home and are visited once a day by a nurse