OPIUM GLUT MEANS MORE DRUG DEATHS, WARNS REPORT

Safe Injection Sites Best Bet To Mitigate Expected Spike In Overdose
Deaths, Study Says

B.C.'s drug-overdose deaths will probably rise as opium production rebounds
in Southeast Asia in the next few years, says an annual report monitoring
B.C. drug trends.

The death rate has dropped by half in the past few years in B.C., from 417
in 1998 to 222 last year.

But the report says that drop is likely due to lower opium production
throughout the world because of drought in Southeast Asia and Afghanistan's
former Taliban government ordering poppy farmers to reduce opium cultivation.

"If opium production in Southeast Asia rebounds, B.C. must prepare to
protect itself against a possible increase in population risk of illicit
drug deaths," says the report by Mark McLean, associate medical health
officer for the Vancouver Coastal Health Authority.

He says safe injection sites, rather than increased enforcement, are likely
to have the most impact on reducing death rates in the future.

The report says it appears that police seizures of drugs have little impact
on the number of deaths. A comparison of the tonnes of drugs seized in B.C.
and overdose deaths shows that, as seizures increase, so do deaths; as they
drop, the deat hs drop correspondingly.

That is because high rates of police seizures and high numbers of deaths
are both linked to high opium production around the world.

That pattern holds true with European statistics, says the report.

McLean writes that "although over shorter periods of time and in smaller
jurisdictions," seizures can have a temporary "protective" effect in
preventing overdoses, the over-all pattern is that they do no more than
indicate what the international production level is.

The report notes it's difficult to say whether the reduced death rate is
due to the health authority's existing efforts in harm reduction, such as
educating addicts how to prevent overdoses. And since police seizures only
capture a small part of the heroin market, authorities need to look at
other measures at the production and consumption ends of the drug market.

At the consumption end, there could be an impact if Vancouver gets a
supervised drug-injection site for addicts, McLean writes.

"Provincially, and locally, it is likely that the best way to protect our
population against heroin deaths is by developing specific harm-reduction
interventions to enable people to protect themselves. Supervised injection
sites are being considered for implementation in Vancouver and a number of
other Canadian sites and may be a part of the solution."

McLean was laid off last month, after cutbacks at the health authority, but
the VCHA's chief medical health officer, Dr. John Blatherwick, released the
report.

Blatherwick said there's "no question" that international drug production
has an impact on seizures and overdose deaths, but he said no one has hard
scientific evidence about the link.

But he concurred with McLean's conclusion that safe-injection sites could
help reduce overdose deaths.

His report indicates that, in the past two years, there were fewer overdose
deaths in the city of Vancouver than in the rest of the entire Lower
Mainland, for the first time since 1992.

McLean's report is part of a national effort to monitor drug trends. Called
the Canadian Community Epidemiology Network on Drug Use, it has been going
on for about five years.

While the report drew on input from people in different Vancouver agencies,
not all of them agree on everything in the report.

RCMP Staff Sergeant Chuck Doucette said he generally supports what the
network is doing, because it's important for everyone involved in drug
addiction issues in Canada to know what's working and what's not.

But he disagrees with McLean's conclusions that safe-injection sites may
reduce overdose deaths and he believes they could increase harm to the
community as a whole.

"I'd like to see people off drugs. The problem with safe-injection sites is
they take money from prevention and treatment."

He said people often cite Frankfurt's safe-injection sites as proof that
deaths drop when injection sites are introduced, but don't mention that
Frankfurt experienced its biggest drop in drug-overdose death rates after a
methadone program was introduced there.

However, provincial medical health officer Dr. Perry Kendall said there is
a lot of evidence to show that injection sites bring the death rate down
even further.

"There have been hundreds of thousands of injections in European sites,
without one death. They're also important because they prevent the
transmission of HIV and hepatitis C and people say they're important to
getting public drug use off the streets."

Only Australia, which opened its first injection site last year, is doing a
scientific evaluation of the effects.

There is a growing movement among Canadian cities to try pilot
safe-injection sites.

At the suggestion of Vancouver Mayor Philip Owen, the mayors of 20 major
cities, including Regina, Edmonton, Victoria, Montreal, Quebec, and Toronto
have endorsed the concept of trying a scientifically monitored pilot.

Health and police officials are gathering in Ottawa this week to discuss
the issues involved in that kind of pilot.