EX-ADDICTS OFFER EXPERTISE

Edmonton's downtown Streetworks program has enlisted the help of inner-city
residents - some of them recovering drug addicts - to write a manual
offering instruction on the safe use of hypodermic needles and IV drugs.

Called the Vein Care Manual, the 32-page booklet will use plain language
and drawings to help people who use street drugs to do so safely. Diseases
such as hepatitis C and HIV, the virus believed to cause AIDS, can be
transmitted through shared needles. And that's just the top of a long list
of health risks IV drug users face every day.

The idea isn't entirely new - inner-city agencies in Toronto have produced
similar booklets. And Marliss Taylor, team leader for Streetworks (which
runs under the direction of the Boyle Street Co-op and the Boyle McCauley
Health Centre), says residents of the inner city take care of one another
to a degree that would surprise anyone with middle-class sensibilities.

"They don't access health care easily so they tend to take care of each
other - probably, more than the mainstream does," Taylor said.

"The problem is it's tough to do that without the resources and skills."

Some of the people involved in writing the manual "have been (taking IV
drugs) for a long time and some of it works really well. Having their input
. . . gives it some street viability."

Each of the group members, called natural helpers because of their
inclination to help community members by exchanging needles and offering
information on health issues, has a unique experience with IV drugs. Bob,
44, became a heroin addict during the late 1960s, when there was plenty of
information about drugs available. Mainstream and alternative media were
filled with articles about drugs and drug abuse - many of them helped drug
users understand their addictions and the risks inherent therein.

Lionel, 40, began shooting street drugs - Talwin and Ritalin - in 1987, as
the War on Drugs and "Just Say No" campaigns flourished.

"I couldn't find any information," said Lionel. Struggling to stay off
drugs, Lionel now limits his role to advisor and steers clear of exchanging
needles for drug users because "just the sight of a needle is a trigger for
me."

When Lionel was using, what information was available, like the pamphlets
distributed by the Streetworks program, was valued.

"When I started using, there were people who were 15, 16, 17 who were using
and they did look at that (information)."

Jim, the youngest member of the group, says teens often come to him for
information. He makes sure they have the facts on drugs.

"My friends, when they've got a problem, they come to me. They say 'should
I start this (drug)?' or 'I wonder how that (drug) would make you feel.' Or
they want to know how to do it or how much they should take without
overdosing."

Younger people need to get information from peers and it's important their
peers are armed with accurate information, Jim says.

"They'll listen to someone their own age," he suggested. "But if they get
(information) from someone older? They'll just go 'whatever!' "

Each of the Natural Helpers said no one taught them how to shoot drugs -
they did it on their own.

Angie, who began shooting Talwin and Ritalin during the early 1980s, says
it's important that a book like the Vein Care Manual be made available. "If
you look at the doctors when they take blood, you can see how it's done,"
Angie said. "And eventually, kids are gonna try it. So why not make sure
they're doing it in the safest way possible?"

Shooting drugs can be deadly and isn't as simple as it looks. The manual
provides information on "cooking up" drugs - turning a pill into powder,
then into a liquid, then filtering out "rocks." Drug users draw liquified
drugs into needles through a cigarette filter. But that isn't always safe.

"A lot of filters, they have fibreglass in them," explained Bob. "And if
you get some of that in your veins, you get what we call cotton fever. Ugh.
You get the chills and the sweats and a headache - it's like the flu. And
there goes your high."

There are other common mistakes. Some people try to inject drugs against
the direction blood flows through veins. Tiny valves lining vein walls
fight such a move and drug users end up harming themselves. IV drug addicts
often suffer abscesses on their arms or legs, collapsed veins and other
difficulties.

While the medical community is armed with valuable information for IV drug
users, many addicts won't listen to health-care professionals. Sara Berger,
a registered nurse who's working as the Natural Helpers Project
co-ordinator, says the book will hold more credibility because it was
written with the Natural Helpers. A manual written by doctors and nurses
would have little credibility on the street.

"None of this would work if we didn't get the opinions of people on the
street," she said. "I have been so impressed by the amount of knowledge
these people have. This is going to help a lot of people because it's so
collaborative."

The point isn't to prevent people from seeing doctors but to make sure they
prevent injury and disease and know when they need to see a doctor.

"We certainly are going to be recommending people see their health-care
provider," added Taylor, also a registered nurse. "But if they choose not
to, here are things they can do on their own and here is when they need to
go to a doctor."