REACHING OUT; NEEDLE EXCHANGE FOSTERS HEALTH

Deadly diseases are spread through the sharing of needles and unsafe sex.

Acquired Immune Deficiency Syndrome (AIDS), Human Immunodeficiency Virus
(HIV), and Hepatitis C are potentially fatal diseases that can alter lives
and families irrevocably. In the absence of responsibility and caution,
they can quickly be spread through the general community. Youth represent
the fastest-growing population of HIV/AIDS infections worldwide. National
AIDS Awareness Week runs from November 22 to 29.

The Needle Exchange Program was started four years ago in Powell River to
address issues of safety associated with intravenous (IV) drug use.

According to Margaret Antolovich, director of public health for Coast
Garibaldi Community Health Services Society, the Coast Garibaldi region has
the highest rate of AIDS in BC outside the Lower Mainland.

"It was enough of an issue in our community to warrant a needle exchange,"
she said.

After four years in action, the program has proven extremely successful.
Coordinator Lisa Rogers said that out of an estimated 200 IV drug users in
Powell River, about 100 people utilize the service. Sixty-eight people
ranging in age from 18 to 52 use the program regularly. Seventy-five per
cent of the clients are men.

"They come because they're comfortable: it's a safe place to come," said
Rogers. But it has taken time to get to this stage. "There were only a few
in the beginning...The scare has people coming in. They don't want to
spread or catch anything. They're being responsible."

There is a lot of support for the program within the community. Sergeant
Andy Brinton said that the RCMP support it from a health perspective. The
police don't participate in the program, except to point individual known
users to the program.

"We're not advocating drug use," he said. "But this is the lesser of two
evils. [RCMP records] don't have anything to suggest that drug use has gone
up since the program started up. It just decreases the risk of [spreading
disease]."

Coroner Stewart Alsgard said from his perspective, any steps taken to
prevent death are positive ones.

"The goal [of the program] is a benefit to the whole community," he said.

It is extremely important that the service be completely confidential. The
exchange is located at the health unit, but clients can enter the room
through a separate door, directly from outside.

One client, Brian [not his real name, by request], started using the
service about six months ago. He agreed that confidentiality is of utmost
importance to him and other users he knows.

Brian has been using drugs for a number of years. He recently turned to the
needle exchange because of the hassle he got every time he tried to buy
needles at the pharmacy.

"People at the pharmacy and hospitals don't think I have the right to
choose [whether or not to use drugs]," he said. "But the whole [lecture] is
moot once you've heard it once." He heard the warnings once at the needle
exchange, and knows that help is there for him if he wants it. But he also
knows that he can go, exchange his needles, have a chat with Rogers: who
has become a close friend: and leave, without being judged.

Going to the needle exchange gives Brian peace of mind. "I don't have to
worry about using the same [needle] all the time, or about other people
stealing my needles...I hand them out to other people who need them."

Antolovich explained that the exchange offers a harm-reduction strategy.

"From the public-health perspective, we would hope that people would not
choose to use drugs...but the needle exchange is a continuum. We encourage
people to be as healthy as possible. We can't deny services to the target
population: our concern is to prevent the spread of disease in the community."

It is not only the drug-using population that is at risk, she added. When
IV drug users interact with the non-drug-using population, the spread of
disease becomes a danger.

Dirty needles left around the community were a much larger safety issue
before the exchange started.

"There is a great danger in needles found just anywhere," said Alsgard.
"Accidental contact puts people at risk." The Needle Exchange Program
allows a certain control over where the needles go.

Brian said the problem seems to have vastly improved recently.

"Six months ago, I could go downtown and find 10 empty needles around in a
week. But I haven't seen one on the street in a couple of months now."

When clients come into the exchange, Rogers said, she talks to them about
how to take care of themselves and to stop the spread of disease. She
distributes condoms and exchanges dirty needles for clean ones.

"I give them information and places they can go for help if they want it.
Sometimes they just want someone to talk to."

Even though the needle exchange is not necessarily trying to stop people
from using drugs, Rogers said sometimes all it takes is having someone
around who cares.

"Everyone has it in them to quit if they can be honest with themselves...a
lot of it has to do with trust and getting people to feel like they can.
Everybody's different: some are in and out, and some grasp onto [recovery]
right away."

Brian said that four or five people he knows have gone to the exchange to
get advice on quitting.

"A couple of them have stopped...but [Powell River] could use more help for
people who want to stop."

Rogers said the personal relationships she has developed with many of her
clients makes her work very rewarding.

"People want to deal with me personally: they care about me." Seeing people
clean up is a great feeling, she said. "It's being a part of the solution:
helping people to at least maintain their health."

Having the needle exchange located in the health unit is a real benefit,
she added, because if there's something she doesn't know, the public health
nurses are close at hand.

"That's why it works so well."

When the needle exchange first started, the health unit received $5,000 a
year from the ministry of health to operate the small, fixed site. On
October 13 of this year, an increase requested by the health unit was
announced. The annual funding for the program has been increased to $27,568.

With the extra money, the program will be expanded. The original site will
be open two times a week, instead of only once. Antolovich said that,
within the next month, they are also planning a community meeting on Texada
Island to look at the possibility of expanding needle-exchange services to
the island.

"We will continue to provide HIV and AIDS prevention education to community
groups and agencies...but we now have funding to do more of this."

Brian expects the expansion to be an improvement because it has been hard
for some users to get to the health unit when the program is only open once
a week.

The bottom line, Rogers said, is that it's an important community service.

"Everybody deserves a chance in life," said Rogers. "[Drug users] are
people and they have problems. Problems can be fixed: you don't just write
people off."