POLICE CRACKDOWN HAS CUT DRUG USE, EXPERT DOCTOR SAYS

Shortage of heroin increases methadone requests

The police crackdown on drug dealing in the Downtown Eastside has helped
some addicts reduce their drug use and seek methadone treatment, says the
head of addiction medicine at St. Paul's Hospital.

Dr. Stanley deVlaming said he has seen positive benefits to the police
operation, which has been criticized by some physicians and activists who
say enforcement has pushed dealers underground, increasing violence and
causing addicts to inject their drugs less safely.

One of America's leading proponents for drug reform was in Vancouver Monday
to support Canada's efforts to introduce safe injection sites and
decriminalize possession of small amounts of marijuana.

Dr. Ethan Nadelmann's visit came less than a week after a representative of
the U.S. drug office issued a dire warning that Canada could have strained
relations with the U.S. over the new drug policies.

The police crackdown on the drug market in the Downtown Eastside is a
three-month trial that involves putting extra officers into the area as part
of the city's drug strategy, which recommended strengthening four "pillars"
- -- enforcement, treatment, harm reduction, and prevention -- to tackle the
city's huge drug problem.

DeVlaming said the action has resulted in four or five heroin users a week
asking to go on methadone, compared to one or two previously at the Pender
Community Health Clinic where he also works. Cocaine use is common with
people on methadone, but deVlaming said some of his patients are reporting
using less of that drug too because of low supply.

"In the last two weeks I've seen an increase in the number of patients
asking to go on methadone treatment. And they are telling me one of the
reasons bringing them in is they are finding it more difficult to get
heroin," said deVlaming, who has worked in addictions medicine for 10 years.

"And our patients are saying they are using less cocaine."

He said the enforcement side of the four-pillar approach should never be
taken too far, but argues it is necessary to curb the supply, especially for
cocaine users. He said heroin addicts wake up needing their next fix, while
those who use cocaine tend to binge on the drug when its readily available
- -- and can therefore reduce their binges, which can last as long as a week,
when supply is low.

DeVlaming acknowledged some people will react negatively to the police
crackdown, and said that will also have to be monitored to assess the
long-term success of the enforcement.

"There are pros and cons. Some people are going to see some negative impact,
some people are going to see a positive impact. We need to weigh them all
together before we make any decisions," he said.

Dr. Mark Tyndall, who works in two downtown AIDS clinics and is also a
researcher with the Centre for Excellence in HIV/AIDS Research at St.
Paul's, said it is possible that some addicts are trying to get clean
because it is now harder to find drugs in the Downtown Eastside.

"But that doesn't account for the majority of people who I think are likely
putting themselves at more risk with the increased police presence," said
Tyndall. "The experiment's already been done, especially in the U.S., and
enforcement doesn't stop people from using drugs."

He has noticed a decrease in the number of people coming into his clinics to
get their AIDS drugs because they are afraid of being hassled or arrested by
police while on the street.

Tyndall does not think Vancouver police should have started the enforcement
until the other three pillars in the plan were underway. "By the police
getting off to a head start, basically, it can be very disruptive to the
other pillars because they can't keep up."

Inspector Doug LePard, the Vancouver police officer responsible for
overseeing the crackdown, said Monday that addicts should not be afraid to
be on the streets because officers are targeting dealers, not users.

"There's a lot of inflammatory rhetoric out there," he said. "No addict has
to be concerned about going to a clinic or anything like that, because we
simply are not making arrests on simple possession."

Whether reducing the drug supply means fewer people getting high is a matter
of debate.

A University of B.C. study released in January concluded a record seizure of
heroin on the Downtown Eastside had no measurable effect on the supply of,
or demand for, the drug. In fact, the price of heroin went down and
overdoses went up slightly in the month after the seizure of 100 kilograms
of heroin in the fall of 2000.

But LePard said officers have made it more difficult for dealers to have
"free rein" in the area, and are seeing fewer users -- especially those in
frightening states of cocaine psychosis.

"If you drove down here before, what you would see is many, many people
picking at their skin and crawling around looking in the crevices in the
sidewalk," he said. "Now that has been significantly reduced.

"Some of them are saying you guys have made it difficult for me to get drugs
. and this has provided the incentive for me to seek treatment," LePard
added.

Nadelmann, executive director of the Drug Policy Alliance, the top U.S.
organization that promotes alternatives to the war on drugs, said police
crackdowns can be effective if they target violent dealers and those who
sell tainted or bad drugs.

He said addicts will respond differently to a drop in supply, some
positively and some negatively.

"Overdoses are more likely when police disrupt markets. That's when people
go to unfamiliar sources, it's when they buy unfamiliar drugs," said
Nadelmann, an academic who has written a book about U.S. criminal law
enforcement. "This is not to say that police should never crack down. The
key is to target those people in the markets who are really the most
disruptive."

Nadelmann's visit follows warnings last week by David Murray, special
assistant in the U.S. Office of National Drug Control Policy, and U.S.
Ambassador Paul Cellucci, that Canada-U.S. relations could be strained by
Ottawa's plan to decriminalize possession of small amounts of marijuana and
Vancouver's move to open North America's first injection site for drug
users.

"I'm giving a note of encouragement to people in Vancouver, who are taking
flak from the drug czar's office in the United States and from the U.S.
ambassador to reassure them that what they are doing is the right thing,"
said Nadelmann.

He praised Canada for its harm-reduction initiatives which he said, like
other countries such as Switzerland and Australia, aim to reduce death,
disease and crime associated with drug use.