NEEDLE EXCHANGE OFFERS MANY SERVICES

I am a Public health nurse at the Downtown Health Centre and Needle
Exchange. I'd like to explain what I see, what I do and why I do it.

I work with a committed and skilled group of outreach workers and
nurses who provide a broad range of services to promote health and
reduce harm. These include traditional public health nursing services
and harm reduction activities offered in a non-traditional environment.

The Downtown Health Centre is so much more than a needle exchange -
offering HIV and hepatitis testing and follow-up, and STI (STD)
testing and treatment, routine vaccinations, reproductive health
services (PAP and pregnancy tests, emergency contraceptives), wound
care, routine health promotion, health prevention and risk-reduction
counseling. We can and do provide these services to everyone and
anyone who comes through our doors. While the downtown clinic is
designed to help people with addictions, we also provide health
services to any others requesting care.

Handing out crack pipes and clean needles for injection drug users is
only a part of our work to reduce the harm caused by drug addiction -
harm not only to users themselves, but to the broader community
through the potential spread of disease, and the enormous cost of
treating the many dire health consequences that those caught in the
cycle of addiction can suffer.

The clients we see are often people who would not otherwise access
health support and services until they were already very sick. But
while our clients are accessing harm-reduction supplies, we have the
opportunity to encourage them to take advantage of other nursing
services, including education, referral to addictions services,
testing and follow-up for communicable diseases. (It's estimated that
30 per cent of HIV positive people don't know that they're positive
and aren't taking precautions to avoid infecting other people.)

No perfect solutions or quick fixes have been found for the complex
problems of addictions. It is critical that we use the tools that are
available to us and continue caring for those members of our
community who are suffering. These people aren't "others"; they are
our children, our sisters, our brothers, our friends and neighbours.
Harm-reduction services are a humane, reasonable and cost efficient
way to provide services to this client group.

In response to suggestions that harm-reduction services support or
encourage drug use, I can assure you that this is not the case. The
majority of our new clients are people who have been involved in
serious drug use for more than a year. We actively discourage drug
use, while promoting the reduction of risk. Our goal is to assist the
person to stay as healthy as they can be. We cannot force them to
stop their drug use, but we can certainly encourage them to live a
healthier life, and we do just that every day.

If our client was your loved one, wouldn't you prefer they have
access to safer supplies and health-care professionals who work to
ensure that if they were ready to start the process of recovery, they
weren't infected with a life-altering disease?

Addictions problems and solutions are extremely complex and I don't
mean to suggest that we have the answers. We are health-care
providers and one thing that I can absolutely guarantee is that if
one of your friends or family members comes through our service, they
will be treated with competence, caring, dignity and respect. We will
do everything that we can, to see that they are as healthy as
possible, given the reality of their individual situations.

Linda Keefe is co-ordinator Downtown Health Centre and Needle
Exchange for Northern Health.