SIX MONTHS LATER, NEEDLE EXCHANGE STILL OVERDUE

The benefits of such a facility are clear, so why are the city and
VIHA waiting?

Six months have passed since the closing of Victoria's only fixed-site
needle exchange. What has happened in that time? Have things improved?
Where will we be six months from now?

All attempts to re-establish a new location for needle exchange and
support services have failed. The biggest failure was the rejection of
the plan to locate the services in the old St. John's Ambulance
building due to criticisms from a nearby school and neighbours.

Reports on the mobile needle exchange reveal that while the service
provided by the vans is vital, it is also dangerously inadequate.

Vancouver Island Health Authority reports indicate that fewer needles
are being handed out. Even more distressing is that the percentage of
needles being returned is significantly lower than before closure of
the fixed-site exchange.

The fact that fewer needles are being collected indicates increased
risk of harm. Individuals could be sharing needles, leading to
increased transmission of HIV and hepatitis C; individuals could be
reusing old needles, resulting in abscesses and increased ER use; and
individuals could be disposing of needles elsewhere.

The most recent reports from the B.C. Centre for Communicable Diseases
indicate that the rate of new HIV infections on south Vancouver Island
has not significantly decreased and the targets for reduction in HIV
infections outlined by VIHA in its strategic plan are not being met.

The current situation is not sustainable. In this first year since the
release of the report of the Mayor's Task Force on Breaking the Cycle
of Mental Illness, Addictions and Homelessness, we have not moved
forward on the recommendation to "strengthen harm reduction services
to help mitigate public health and public order issues."

Instead we've actually cut harm reduction services in our
community.

The situation defies all available evidence and fails to account for
the clear recommendations contained in multiple reports over the past
seven years to enhance needle-exchange services and develop supervised
consumption sites.

Simply stated, we have closed a harm reduction service that has proven
effective in reducing the transmission of disease as well as reducing
other negative consequences associated with drug use, and replaced it
with an ad hoc mobile service that cannot match the previous level of
services.

It is time for a new "four pillars" approach to addressing the harms
related to drug use, based on housing, health care, income and
supports. The best safe consumption site is a home. But Housing First
requires more than ACT teams. It requires access to essential health
services and addressing poverty.

There must be a six-month strategy. We need to ensure that one year
after the closure of the Cormorant Street facility, we can be assured
that Victoria is better served than when it closed.

VIHA and the city need to spend less time on appeasing neighbourhood
associations and private schools and much more time and resources
replacing the inadequate Cormorant facility with the implementation of
comprehensive primary health care services for those affected by drug
use and poverty.

There is overall consensus to not simply replace the old Cormorant
facility with the same services in a new location. We have heard
support for the development of multiple, integrated safe consumption
services from the city, the police, the provincial health officer,
service providers and drug users. The feasibility study for such
services was commissioned by the city and VIHA, completed by Benedikt
Fisher in April and hopefully not shelved.

Since the needle exchange was closed, a court decision regarding
Insite in Vancouver has provided a legal argument that would assert
that adequate harm reduction services must be offered in order to
protect the fundamental rights of individuals with an addiction.

Similarly, provincial and national nursing associations have confirmed
that providing supervised consumption services is very much in their
scope of practice and in compliance with standards that strive to
provide competent, evidence-based and ethical care.

The newly elected Victoria council, the established Coalition to End
Homelessness and VIHA must make firm commitments to the general
population and to those individuals and families most affected by drug
use.

What services will be in place by May 31, 2009, a year after the
closure of the Cormorant Street needle exchange?