NEEDLE EXCHANGE MODELS EXAMINED

Victoria Mayor Looks At Combining Service With Suburban Health Clinics

The idea of locating needle exchanges in suburban medical clinics is
being greeted skeptically by local mayors.

Victoria Mayor Dean Fortin, who recently toured similar facilities in
the Lower Mainland, says using medical health units as needle
exchanges in areas like Saanich, Esquimalt and Langford might work here.

The mayors of those communities aren't so sure.

"I'm a little concerned. I would prefer to see one central location.
I think that's the best way we're going to be able to provide the
specialized service and expertise that is needed," said Esquimalt
Mayor Barb Desjardins.

"My understanding was that there wasn't the demand in the suburbs for
that service," said Saanich Mayor Frank Leonard. "It's supply and
demand. If there's no demand, and you create the supply you might
create the demand."

"I appreciate the mayor of Victoria generating ideas but I tend to
like homework done before proceeding. There's a right way to go about
it and I think it would be through the medical health officer and
through VIHA through to us and through to neighbours. There are some steps."

Langford council has not discussed the idea of a local needle
exchange said Deputy Mayor Denise Blackwell. "I know they had a lot
of problems in Victoria and we wouldn't like to see a repeat . . . my
knowledge of the issue in Victoria was that it was over-subscribed
and under-funded," Blackwell said.

Fortin said on the lower mainland every hospital and health clinic
has integrated a needle exchange as part of its operations.

"It was interesting to see that even in Kerrisdale and the West End
of Vancouver that they have them. Although the use was nowhere near
what they're seeing in the Downtown Eastside, it was effective in
that they were put into health care centres and usually tied to some
sort of addiction services," Fortin said.

He said there were no social disorder problems in the area.

Dr. Murray Fyfe, a Vancouver Island Health Authority medical health
officer, said it would be impossible to mirror exactly the
distribution model used by the Vancouver Coastal Health Authority,
since it has health clinics throughout the area offering addiction services.

He said needle exchanges are associated with the addiction offices,
which he felt was a good idea, particularly if it is a site where
users were obtaining other services.

Victoria's fixed needle exchange on Cormorant Street, funded by the
VIHA and operated by AIDS Vancouver Island, was evicted last May when
operators were unable to control problems that spilled onto the street.

Neighbours complained that people congregating outside presented a
frightening face to the streetscape and clients left a trail of dirty
syringes, blood and human feces.

Unable to find a new location for the exchange, a mobile unit has
been set up. The number of needles being handed out is down
significantly and the return rate is also down. That's a concern to
public health officials as re-using and sharing needles puts people
at risk of diseases such as HIV and hepatitis C.

But Fyfe said in the 11 months since Victoria's fixed needle exchange
closed, VIHA hasn't recorded a spike in incidents of hep C or HIV.
The last survey in 2005 showed the HIV rate among injection drug
users at 12.5 per cent and the hep C rate at 75 per cent.

"It will be interesting to see what it is right now given that the
fixed needle exchange has been closed for one year in Victoria."

In addition to the mobile needle exchange there already are other
needle distribution points in the city. Those include the Cool Aid
Clinic, the Cook Street Public Health Clinic, PEERs (Prostitute
Empowerment Education and Resource Society), SOLID (Society Of Living
Injection Drugusers), Victoria Aids Resource and Community Service
Society) and three VIHA street nurses.