HARM-REDUCTION IS TO REDUCE HARM, NOT ADDICTION

The twilight of AIDS 2006 in Toronto would seem to be rather odd timing for
Councilor Kyle Rae to retreat from his former position favouring safer drug
use facilities in Toronto (based on the Vancouver and Hamburg models). Rae
now says that such a program is unlikely to work here because our major
illicit drug problem is crack cocaine, and that since, alas, there is no
medical substitute for crack (as there is methadone for heroin) it would
seem that, oh well, it just won't work here after all. Tellingly, he has
peddled this spurious methadone excuse several times of lately, perhaps to
avoid going to battle on these issues in the upcoming November election.

But the much-vaunted successes of the Vancouver safe injection site model
are not about getting heroin users into methadone maintenance. Vancouver's
harm-reduction initiative is not reducing drug use, or weaning people off
their addiction. A Simon Fraser University policy analysis by Bruce K.
Alexander says that "there is no reason to think that the prevalence of
addiction to drugs, alcohol or anything else has decreased" and that "there
are continuing difficulties in attracting more than a minority of injection
drugs users to methadone maintenance programs."

What it has done, Alexander confirms, is reduce overdose deaths, new AIDS
infections, street crime and discarded needles. This has won the support of
some unlikely allies in Vancouver who have seen the reduction in the
wide-open drug scene. So even if not curbing addiction, it is making it
decidedly less of a public disorder and a health menace, a virtual textbook
definition of harm reduction. The councilor may have his own reasons for
the softening his earlier enthusiasm, and there are doubtless arguments to
be made about why Vancouver's supervised injection site model won't work
for crack in Toronto. The lack of a medical substitute isn't and shouldn't
be claimed to be one of them.

Alex MacLean