ALL FOUR PILLARS NEEDED TO COMBAT DRUG SCOURGE

Police crackdown merely moves the problem around

The Canadian Medical Association Journal report on the police crackdown in
the Downtown Eastside confirms precisely what many critics, including The
Vancouver Sun, predicted -- that the crackdown wouldn't solve the problem of
illegal drug use, it would merely spread the problem to other areas of the
city.

Nevertheless, the report is useful in that it is the first scientific study
that confirms the prediction, and, more importantly, provides evidence for
why a four-pillar approach is needed to combat drug abuse.

The study, which gathered evidence from interviews with drug users both
before and after the crackdown began, and also looked at data from the
needle exchange, found that the crackdown had little effect on the number of
people using heroin and cocaine.

The study also revealed that the price and availability of drugs changed
little, as did the percentage of addicts receiving methadone treatment. And
in a troubling development, fewer addicts said they would be willing to use
the safe-injection site after the crackdown began.

Not surprisingly, the Vancouver Police Department was unimpressed with the
study, calling it "flawed" and saying the purpose of the measure (police
bridle at the use of the word "crackdown") was to suppress the open air drug
market and restore some order to the Downtown Eastside.

To be sure, the police effort has achieved some success in that respect.
Many residents and business owners say they feel much more comfortable now
that the scourge of open drug dealing has been reduced.

However, the problem hasn't disappeared. The study notes that the crackdown
merely spread the drug trade from Main and Hastings to the rest of the
Downtown Eastside, and to other areas including Granville Street, the West
End and Commercial Drive.

If police had the money and personnel, they could start cracking down in
these areas, but that would simply prompt addicts to find yet another place
to shoot up. Since there's no way to win this game, it's better if we choose
not to play it at all.

That's not to say that police enforcement is unimportant. Indeed, it's one
the four pillars -- along with treatment, prevention and harm reduction --
but it's the only pillar that's operating at full force. The safe-injection
site, part of the harm reduction pillar, is the only other measure in place.

This two-pillar approach -- really, one-and-a-half, since more harm
reduction measures could be implemented -- is doomed to failure. The authors
of the study acknowledge as much, saying "if there are no channels for
[addicts] to move to better care and support, then the enforcement will have
a transient and geographically limited effect."

Exactly. If we're ever to help residents of areas plagued by drug abuse, and
to help drug addicts themselves, the enforcement and harm reduction efforts
must be combined with adequate treatment. And we must devote resources to
education programs to prevent a new generation of addicts from taking over
from the current generation.

Further, the four pillars must not operate separately, but must be
intertwined. For example, if sufficient treatment facilities were
identified, police officers could direct motivated addicts to them, rather
than scaring them away. But as long as we're missing the treatment pillar,
there's little police can do other than to proceed with enforcement.

Fortunately, health authorities and city officials are developing a
coordinated plan of enforcement, treatment, health care and prevention.

Now that the Canadian Medical Association Journal study has confirmed that
it is futile to operate with fewer than four pillars in place, we urge
officials to complete and implement the plan without delay.