ADDING UP DAMAGE DONE BY DRUGS

But Is Ottawa Ready For Safe Injection Site

Would Ottawa benefit from a safe injection site for intravenous drug
users, like Vancouver's?

Those in the addictions field tend to say yes.

But is Ottawa -- city of symbols and tulips and all that is clean --
ready for a state-sanctioned shooting gallery? Probably not.

The contrasting views were on display yesterday at an open forum
organized by the Ottawa Coalition on HIV/AIDS.

It brought together about 120 participants for a half-day panel on
the city's "open drug use," and a remarkable gathering it was.

The newsiest presentation came from Dr. Lynne Leonard, a University
of Ottawa epidemiologist. She has been monitoring the city's addicts
for about 15 years.

She approaches the subject as a scientist -- dispassionately, letting
the evidence speak for itself.

Her numbers did the talking. There are clear health benefits, she
explained, to having intravenous users take their drugs in a clean,
supervised facility.

Among them: fatal overdoses are greatly reduced; access to health
care and addiction treatment is available; the transmission of
blood-borne infection is cut back; and the disturbing sight of
addicts using in a public space is curtailed.

Some of the collected numbers are worrisome.

In 2005, a team of researchers interviewed 250 intravenous drug
users, paying them $15 for their time.

Of the group, 72 per cent were men, the average age was 37, but the
oldest user was 62. Aboriginals made up 13 per cent of the total, a
figure highly disproportionate to their standing in the general
population. The majority had never finished high school and almost
half had an annual income below $10,000.

The average length of intravenous use was 16 years.

A follow-up survey in 2007 uncovered alarming rates of infection. Of
405 drug users, 10 per cent were HIV-infected, while 61 per cent were
carrying the Hepatitis C virus.

Other surveys probed the issue of overdosing, with 43 per cent
responding they had overdosed at least once, with the average being four times.

Related health problems were numerous: liver trouble, abscesses,
depression, pulmonary problems.

Crack-smoking, meanwhile, was almost universally practised by IV drug
users, leading Dr. Leonard to raise the subject of a safe inhalation room.

Sharing and re-using needles is also relatively common, the surveys suggest.

"There is real evidence we need to step up our harm reduction," said
Dr. Leonard.

She provided photos of Vancouver's site, which consists of a number
of mirrored cubicles, adding there are 70 similar sites in six
countries around the world.

Ottawa's problem with open-air drug use spiked a couple of years ago
when used needles and old crack pipes were commonly found scattered
across downtown. Community groups were livid.

Ever since, the city has been grappling with its proper role in this
complicated problem: to freely provide drug gear to regular users --
in the interest of harm reduction -- or a crackdown on the criminal
aspect of drug use?

There are an estimated 3,000 to 5,000 drug addicts in the city, where
about 300,000 needles are given away every year.

There was a presentation from the Canadian Mental Health Association
that served to underline the difficult job of working with the drug addicted.

It focused on those with "concurrent" conditions -- an addiction and
a mental illness. Of those with a severe psychiatric disorder, an
estimated 40 to 60 per cent will develop a substance abuse problem in
their lifetime.

A worker also explained how it can take three to five years to help a
concurrent client get back on stable footing, with housing often
being a big barrier.

Officially, the city favours a "four-pillar" approach to the problem
- -- prevention, treatment, harm reduction and enforcement.

There were a couple of senior police officers present yesterday and
it was evident that, despite their differences, the lines of dialogue are open.

Chief Vern White is known to oppose safe injection sites, just as he
is credited with the creation of a street crimes unit that has
attacked the problem at the neighbourhood level.

Insp. Alain Bernard has visited Vancouver's site and spoken to the
west-coast department about its experiences.

He said the force had to deploy an extra 32 officers just to deal
with the nuisance and disorder complaints associated with the
injection site. "It's a case of good intentions with unintended consequences."

He also questions the description of the facility as a "safe" site,
noting there is nothing safe about shooting an illegal substance into
your veins.

Dr. Leonard, meanwhile, did not pretend that a safe injection site is
a cure-all, but just another piece of the treatment puzzle. She
appreciates, too, that the broad public might find it difficult to
understand why a state-sanctioned facility for drug use contributes
to the greater good.

"We need to keep talking this through."