EXPAND SAFE-INJECTION SITE, ADDICTION STUDY URGES

B.C.'s Insite Praised but Project's Fate Remains Uncertain

VANCOUVER -- The first study to gauge drug addicts' experiences at a
safe-injection site suggests North America's only such facility needs
to be expanded to reduce public drug use and the unsafe disposal of
needles.

But as the clock ticks toward the site's licence expiring on Sept. 12,
the federal government remains tight-lipped about whether the site
will be allowed to continue operating under an exemption of Canada's
drug laws.

The study, published in the current issue of the international
scientific journal Addiction Behaviors, surveyed 1,082 injection drug
users, 75 per cent of whom said the facility positively changed their
injecting behaviour.

Seventy-one per cent of respondents said using the facility meant they
weren't shooting up outside, while 56 per cent reported less unsafe
disposal of dirty needles.

Addicts who use the centre, known as Insite, inject their own heroin
or cocaine under the watchful eye of a nurse as part of a pilot
project that began three years ago.

Evan Wood, a senior author of the study, said yesterday that HIV rates
have also come down in the drug-riddled Downtown Eastside since Insite
opened. That means health-care costs have been reduced, because it
costs taxpayers $250,000 to treat each person infected with the virus,
he said.

Dr. Wood is concerned that the federal Conservative government
received a request to continue the exemption six months ago and still
has not made any kind of announcement so close to the licence expiring.

"I'm worried, from a public health perspective, about what will happen
if the site closes," said Dr. Wood, an epidemiologist at the B.C.
Centre for Excellence in HIV/AIDS and an assistant professor in the
department of medicine at the University of British Columbia.

"I think there will be such a backlash in Vancouver when we go back to
the same patterns of needles in storefronts and people injecting in
public in the tourist areas of Gastown, that British Columbia will
probably not tolerate it for long."

Federal Health Minister Tony Clement was not available for comment.
Robin Walsh, a ministry spokesman, said no decision has yet been made
on the fate of the site.

"The minister is undertaking assessment of the pilot project and the
results to date," Mr. Walsh said from Ottawa.

The success of Insite -- modelled after safe-injection sites in
Germany, Switzerland and the Netherlands -- has been hailed by police,
community leaders in the Downtown Eastside, Vancouver Mayor Sam
Sullivan and four of the city's former mayors, including Liberal
Premier Gordon Campbell.

"I would say that the international scientific community working in
addiction is essentially holding its breath and watching to see what
happens here," Dr. Wood said.

Insite's positive impact has been written about in studies published
in top international journals such as The Lancet, the British Medical
Journal and The New England Journal of Medicine.

The facility represents the harm-reduction component of Vancouver's
four-pronged approach to the drug problem in the Downtown Eastside,
where about 5,000 addicts live in a 10-block area often referred to as
Canada's poorest postal code.

Prevention, treatment and enforcement are the other aspects of dealing
with the issue, which keeps tourists away from the area and its open
drug trade.

"I'm a little bit concerned that some of the key players with the
federal government aren't aware, not appropriately informed, about the
evidence in terms of the public health issues and how to address
them," Dr. Wood said.

"For [Prime Minister] Stephen Harper to have said recently that 'our
government will support prevention, enforcement and treatment,' and
not mention harm reduction is very disturbing to people who are
familiar with addiction."

Harm reduction has the greatest scientific support behind it, while
there's not a lot of evidence to suggest strategies to prevent drug
use work, Dr. Wood said.

As for enforcement, 30 per cent of HIV-infected drug users likely
acquired the virus while in prison, he said. And while people support
treatment, only a fraction of drug addicts are attracted to that
option, Dr. Wood added.

Ernie Crey, a first-nations advocate, noted that aboriginals are
overrepresented in the Downtown Eastside and said he's worried about
his community's fate.

"I'm trying to encourage more prominent aboriginal leaders in British
Columbia to make their position known on the site to the federal
government," he said.