NURSES HELP ADDICTS INJECT HEROIN

Supervision Reduces Disease, Dr. Peter Clinic Director Says

As nurses watch, iIlegal drug users are injecting heroin and cocaine at a
Vancouver clinic for people with HIV and AIDS.

Maxine Davis, executive director of the Dr. Peter Centre, says nurses have
observed about 10 clients inject drugs, some several times, in the centre
since December, to ensure patients are using safe injection methods. Davis
made the disclosure at a news conference Thursday, where she and
representatives of AIDS Vancouver and a drug users group endorsed a report
calling for trials of federally funded "safe injection facilities" in
Vancouver and other Canadian cities to help prevent overdoses and the
spread of blood-borne diseases like AIDS and hepatitis C.

Davis said the Dr. Peter Centre has not become a government-designated safe
injection site, but nurses are trying to reduce the risk of infection and
blood-borne illness, just as they already teach diabetics how to use a
syringe for injecting insulin.

"Safe injecting is part of an array of other clinical services we deliver
here," Davis said in an interview.

"The Dr. Peter Foundation is committed to providing the best health
possible to all its clients, many of whom are drug users," Davis told the
news conference. "We are providing a range of harm-reducing clinical
interventions."

Bonnie Lantz, president of the Registered Nurses Association of B.C., said
the service falls within the scope of the things that registered nurses are
allowed to do, because they can educate patients to prevent disease. Alan
Wood, the Dr. Peter Centre's director of nursing, said even long-term drug
addicts may not know how to inject drugs safely. He pointed to one
injection drug user at the centre -- a heroin addict for more than 20 years
- -- who had a history of skin abscesses, infections, hospital admissions and
antibiotic treatments.

Wood said a nurse noticed that man was putting in the needle the wrong way.
Nurses know a needle has an "up" side and a "down" side because of its
bevelled edge, Wood said, but the heroin user did not. "If you insert it
the wrong way, you're actually ripping through tissue," he said. "If you
put it in the correct way, you're actually doing it much safer. You're
significantly decreasing the risk of infection and tissue damage. You're
maintaining your veins, not breaking them down over time." Thomas Kerr, a
Vancouver researcher and a board member of the Canadian HIV-AIDS Legal
Network, who presented the report at the news conference, said: "Logic,
compassion and basic decency require us to act. "We cannot continue to
close our eyes to the staggering amount of disease and death in British
Columbia, resulting not just from injection drug use, but also from
government failure to put a comprehensive prevention and treatment strategy
in place."

The report reviewed safe-injection facilities elsewhere in the world and
recommends ways to legalize government-sanctioned drug injection buildings
in Canada. It notes: ? In 1999, 34 per cent of the estimated 4,190 new HIV
or human immunodeficiency virus infections in Canada were among injection
drug users. ? More than 60 per cent of the approximately 4,000 new
hepatitis C cases each year are related to injection drug use.

In B.C. alone, more than 2,000 illicit drug overdose deaths have occurred
since 1992.

Kerr said the facilities in other countries cost $300,000 to $1 million,
which he said is low compared to the billion-dollar price of drug law
enforcement and health care for drug-related disease. Kerr said drug
injection facilities would provide sterile injection equipment and a safer
place than the streets. Staff wouldn't provide the drugs or help administer
them, he said, but would intervene if there was a medical emergency and
encourage users to seek counselling and other help for their addictions.

"Safe injection facilities aren't to be confused with unsanctioned shooting
galleries where illicit drugs are bought, sold and consumed, often in
unsafe and unhygienic conditions," he said.

Dean Wilson, president of the Vancouver Area Network of Drug Users, said
drug users are dying daily of drug overdoses. A safe injection facility
would be the first point of contact for street people, so they can start to
get the continuum of treatment that drug abuse experts advocate, including
counselling and detoxification treatment.

"The buck has got to be stopped being passed around," Wilson said. "Dead
people don't detox. We've got to open one up. If they don't, I will."
Wilson made the same threat last year, but the Dr. Peter Centre acted
first. The Dr. Peter Foundation and its Comox Street clinic is named after
Dr. Peter Jepson-Young, who died of AIDS in 1992. During the last two years
of his life, "Dr. Peter" went on CBC Television to describe his struggle
with AIDS or acquired immune deficiency syndrome.

Bonnie Lantz of the Registered Nurses Association said the association
doesn't have a position on safe injection facilities for illegal drug
users. But she said she personally supports programs -- including
needle-exchange programs in several Lower Mainland communities -- where
nurses support harm-reduction initiatives.