IDEA OF NEEDLE EXCHANGE EXPLORED

The Fraser Health region has one of the largest populations of
injection drug users in the province, yet distributes the
second-lowest number of clean needles in B.C.

According to data provided by Ann Livingston, a volunteer with the
Vancouver Area Network of Drug Users, about 14,000 to 16,000 people
in the Fraser Health region inject drugs -- the same number as in
Vancouver Coastal. However, she said Fraser Health distributes few
clean needles compared to other health authorities.

Vancouver Coastal gives out three million needles per year, compared
to only about 400,000 on the part of Fraser Health, according to a
report by Livingston.

"Fraser Health has the lowest number of syringes given to injection
drug users and the very highest rate of hepatitis C ... They're just
not moving forward," Livingston said. "There isn't even a needle
exchange in the Tri-Cities at all."

Livingston said a Lower Mainland strategy is needed, which could
include harm reduction techniques like needle exchanges or injection sites.

"If you do an injection site, you don't even need a needle exchange
because a lot of people don't like them. And further to that, you
could get really smart and give prescription drugs to people who are
addicted to drugs," she said.

"Then you don't have a black market. You don't have gangs shooting
each other. You don't have jails full of people that cost huge amounts.

"You can prevent HIV and hepatitis C among drug users. It's been done
elsewhere. All the science is in. We don't need any more studies. We
can implement the harm reduction strategies and save ourselves
millions of dollars and, of course, save all those people all that misery."

For Dave Portesi, public health director for Fraser Health,
improvements need to be made.

"We distribute the second-smallest number of clean needles in the
province and yet have the largest population overall. So I can tell
you from a Fraser Health leadership perspective in public health, we
absolutely recognize that we need to increase the number of needle
distribution partners. We need to get more needles out into the
community to have a more effective harm reduction system," Portesi said.

"But we also recognize that we must engage other partners in this
effort. We don't want it to be just Fraser Health because we know
other providers -- such as peer-to-peer providers, pharmacy based
providers in needle distribution -- they create border access to a
community that's often hard to reach."

Portesi said it's difficult to measure the number of active drug
users in a small geographic area like the Tri-Cities.

"For Fraser Health, we have some pockets of high use such as the
Whalley area, and certainly in Burnaby and New West and out in
Chilliwack. For that reason, the needle exchange services we do have
or needle distribution services we do have are based out of those
areas," he said.

"But we certainly realize in an area such as the Tri-Cities, it's
very likely that they have active users. But folks who live in the
Tri-Cities would have to travel to other communities to get needles.
That's where we need to bring in alternate providers to help us with
this mission."

The best practice is to strive for a seven-day-a-week needle
distribution service that's available through multiple sites, Portesi added.

"I think we're certainly in the planning stages to try to increase
access. We've certainly recognized that there's a problem. With the
resources we have, we are getting needles out there, but we know we
need to expand that access beyond what we have now.

"We're very interested in partnering with other organizations to
distribute needles in the community, and we encourage any
community-based organization that wants to promote health through
effective harm reduction to contact [Fraser Health] to partner with
us on this issue."

Fraser Health is trying to build support and start a dialogue at the
community level about supporting harm reduction in a non-judgmental
way, Portesi said.

"The fact is, handing out needles to people who are addicted to drugs
and using drugs is also an effective way to engage them in a
discussion around quitting and making healthier choices. It's a
critical discussion. If a community's shut off to the idea, they're
also saying that we're open to the idea of disease transmission and
allowing that to happen in our community.

"I certainly am a believer in that where there's the highest need,
that's where you locate services. I think the services need to be
accessible -- if not in their town, it's in the next town over.
Ultimately any health service needs to be accessible to be effective.
So if that means it should be in every town, then yes, it should be
in every town."

But Hope for Freedom Society director Rob Thiessen does not want to
see needle exchange services in the Tri-Cities -- or anywhere else.

"We, frankly, are philosophically opposed to any sort of needle
exchange. Evidence suggests that it just simply increases needle use,
and there are dirty needles on the streets and alleys and so on. You
just have to check out the Downtown Eastside to see that," Thiessen said.

"What's happened since the needle exchange was introduced in the
Downtown Eastside, contrary to claims that it was going to reduce
dirty needles in the Downtown Eastside, their dirty needles have
actually gone up exponentially in that region."

Similar to other regions, heroin is the second most-used drug in the
Tri-Cities, Thiessen said.

"By far, the majority of drug of choice in the Tri-Cities region is
crack. Heroin users aren't nearly as many as people who use crack.
It's a small second compared to crack. Crack's No. 1 pretty much everywhere."

Thiessen said the Hope for Freedom Society, which provides addiction
recovery services, would not promote or partner in a needle-exchange
initiative.

"I'd like to see it stopped everywhere. We would do absolutely the
opposite of promoting it. And anybody in the health department that
thinks it's a good idea is wrong," he said. "The health departments
in the province have gone for this ... harm reduction model with
respect to dealing with addictions. We just believe people can stop.
We don't believe that you need to give them new and different ways of
continuing their addiction.

"So our philosophy is way cheaper because we don't have to spend
money on legalizing drugs or giving out drugs, which is being
proposed in the Downtown Eastside ... In a time of restraint and
everything else, we can't really afford it."

The Hope for Freedom Society offers a long-term recovery program that
takes seven months to a year to complete, Thiessen said.

"Why not just teach people to stop? We've successfully been doing it
for almost 15 years. We've helped thousands and thousands of men and
women stop, so it's possible. It's not easy.

"We believe that most people are medicating something. There's not
very many drug addicts out there who became drug addicts simply
because they partied too much as young people. Most of them are
medicating a hurt of some sort. So we help them dig that out, figure
out what that is and then help them deal with it in a healthy
fashion, rather than an unhealthy fashion."