NANAIMO IS NOT YET READY FOR CRACK-PIPE KITS

The Vancouver Island Health Authority has an uphill battle in getting
to the point of distributing crack-pipe kits in Nanaimo. The health
authority now has the blessings to start such a pilot program in
Victoria, but in Nanaimo council and staff have not forgotten VIHA's
first effort here.

About two years ago, health nurses just started distributing
crack-pipe kits, without any consultation with the city or residents,
and apparently without the knowledge of senior VIHA staff in Victoria.

The immediate result was an end to that project, but in the long run
it created a distrust of VIHA. Since that time, the reputation of
VIHA hasn't exactly improved in Nanaimo.

There has been the C. difficile outbreak at Nanaimo Regional General
Hospital, in which several people died. The inability to get the
outbreak under control has been traced to VIHA mismanagement.

To quote Health Minister Kevin Falcon: "(A) big part of the problem
seems to be just how management responded to this incident."

And then there was the move of the VIHA funded health clinic from
Robarts Street to Franklyn Street. Despite promises after the initial
crack-pipe kit fiasco that the city would be consulted about any such
VIHA programs, it never happened.

Whether it's a missed phone call or not, it remained VIHA's
responsibility to inform the city in a timely way.

Nanaimo is not saying no to distributing crack-pipe kits, yet. But we
want a chance to say yes or no.

VIHA makes a good case for the kits. They are a simple and effective
way to prevent infections that are chronic in those who smoke the
toxic concoction. The medical officer of health, Dr. Lorna Medd, says
there is good scientific evidence that such kits reduce disease.

What VIHA has to keep in mind is one of the issues that emerged
during the first failed Nanaimo experiment along these lines.

That effort was put forth as harm reduction. That makes sense in the
context of reducing disease. But harm reduction is about much more
than reducing disease.

Harm reduction includes reducing harm to the community as well as to
drug users. Harm reduction must not be seen as tolerating drug abuse
while minimizing the harm to drug users alone. In that context we
will only end up with VIHA distributing an ever-increasing number of
crack-pipe kits. This community will not tolerate VIHA building up an
industry in which crack smokers are the consumers.

If that will be the end result, then perhaps it would be best if the
city declines the program. There is a real risk that the program will
only facilitate an expansion of crack smoking in the city without an
effective backstop that offers treatment.

Real harm reduction must come with a commitment of funding that
includes detoxification, treatment and follow up care.

Mayor John Ruttan has not shut the door on the program, and nor
should he or any other city councillor. And nor should they heartily
endorse it without first giving long thought to the exact type of
service that VIHA is offering. We need to wait until the Victoria
pilot project is completed and see how it has worked for the City of Victoria.

While VIHA must honour its commitment to talk with the city, they
also have an obligation to speak with residents.

The proposal of any such program must be preceded by real engagement
with residents in the area where the program would take place.

Residents understand and accept the idea of harm reduction. Given the
decency of being consulted they may take a different view.

And we must remember that VIHA is now facing some very significant
funding cuts. The priority for VIHA is acute care. Community programs
like crack-pipe kits, and others, may fall victim to budget trimming.

VIHA's responsibility may be health, but they also have a moral
responsibility to the people of Nanaimo.