DRUG ACTIVISTS CON COUNCIL, SAYS OUTSPOKEN DOCTOR

Vancouver city council and the NDP government don't want to listen to
doctors who treat addiction in the debate about alleviating the
Downtown Eastside's health woes, says one of the most-active and vocal
B.C. medical practitioners in the field.

Dr. Douglas Coleman believes he and his colleagues are rarely heard
because they use the word abstinence and hope to help patients live
without drugs.

"Addiction can be effectively treated and managed," Coleman said.
"It's a chronic problem like obesity or diabetes. It's not unusual.
It's like any other chronic disorder."

Coleman, who treats fellow physicians with drug problems as well as
ordinary folk, said he thinks social workers and civil libertarians
have pulled the wool over the eyes of politicians.

As he put it: How can taxpayers willing embrace Mayor Philip Owen's
so-called harm-reduction program when it boils down to changing the
rules and providing resources so the drug-dependent can chemically
lobotomize themselves in a safe environment?

Coleman said society's message should be that addiction screws up your
life.

"They make it sound like addiction is a public policy mistake," he
said. "It implies that changing the laws will eradicate the hazards
associated with addiction, mental illness and HIV disease. This is
absurd."

He said it's time in the Downtown Eastside to tease apart health
issues from thorny land-use questions of what to do with the area and
the poor people who are threatened by eviction if development occurs.

The behavioural issues of the drug-dependent in the Downtown Eastside,
he continued, can only be solved through long-term,
specifically-tailored programs of intensive health and social services
- -- and coercive treatment laws.

He is particularly scathing in his criticism of those activists who
brandish what he sees as selective information about a few Europe
countries, without discussing the draconian laws and staggering costs
involved.

"The public in B.C. are not given the full story of how Switzerland is
attempting to cope with its drug and HIV problem," he complained.

This is a central point emphasized by Dr. Colin Mangham, director of
Prevention Source BC, a faculty associate at the Institute for Health
Promotion Research at the University of B.C. and adjunct professor at
the School of Human Health and Performance at Dalhousie University.

Mangham prepared a key background paper on the vogue initiatives for
the Special Parliamentary Committee on Illegal Drugs.

"Some harm reduction supporters would have Canada copy selected
European countries in adopting a harm reduction stance, without
sufficiently examining the negative experiences in these nations, or
acknowledging serious side effects and failures in these countries'
harm reduction policies," he concluded.

"These problems include increased illegal drug production and
trafficking; the countries or regions in question becoming havens for
drug criminals; serious problems in border towns with people coming
into the countries to get drugs; uprisings by town councils against
the harm reduction policies; failure of needle parks and coffee houses
to improve the situation; inability of governments to provide adequate
prescription heroin; sale of prescription heroin or other drugs to
users not in the program; and increases in illegal drug trafficking
and in the incidence of cannabis and other so-called 'soft' drug
(e.g., ecstasy) use among youth. We have so many better alternatives
that we are not exploring because harm reduction advocates have seized
the agenda."

Coleman said Switzerland is about the size of Vancouver Island and has
a drug-dependent population estimated at about the same size as
B.C.'s. But, Coleman pointed out, the Swiss operate some 5,000 detox
and roughly 1,300 residential treatment beds, while in B.C. there are
fewer than 100 detox beds and a similarly inadequate number of
treatment beds.

Sweden, too, Coleman said, has about the same number of intravenous
drug addicts as B.C. but a much better record in controlling the
spread of infectious disease among users because the Swedes use
heavy-handed laws along with comprehensive treatment programs.

If we want to deal with epidemic disease such as HIV/AIDS or
hepatitis, use the quarantine and public health laws as you would with
typhoid or any other infectious disease, Coleman suggested.

He thinks anyone selling a solution whose main component is coddling
those who use drugs is doing a disservice to the community and the
user. Which doesn't mean he's against providing clinical injection
rooms or heroin prescriptions to the minuscule number of people who
might require such treatment.

Laws compelling treatment whose aim is abstinence are a better start,
Coleman said.

"Ignoring the lessons of countries that are doing much better than we
are in treating their addictive population and thus controlling their
HIV epidemic is foolhardy," he said.

Coleman also said the health care delivery system should be made more
accountable.

For example, he said, the Vancouver needle exchange program hands out
some 2.8 million needles a year, but there is no evidence it has
helped reduce the spread of contagious disease.

Coleman said the rates of infection skyrocketed in the mid-1990s --
several years after the needle program was established in 1988.

Coleman insisted the New Democrats have shown no more stomach for the
tough measures needed to address the issue than their Social Credit
predecessors.

"There are less detox beds than when I began practising in the 1980s,"
he lamented.

The reason is patently obvious to anyone who has even glanced at the
problem: Addressing provincial addiction issues will cost tens of
millions of dollars. Even then, the deranged, the disaffected and the
despairing are not necessarily going to be deterred from abusing
themselves and others in public.