COUNCIL SPLIT ON ADDICT AID

Vancouver city councillors' attempts at unity over the health crisis
in the Downtown Eastside have been dashed against the rocks.

The catalyst was a 34-page report put out by City of Vancouver
drug-policy coordinator Donald MacPherson and drug-policy program
planner Zarina Mulla. Councillors received the report for information
at the October 2 council meeting. During the process, Non-Partisan
Association, Vision Vancouver, and COPE councillors discussed the
update on the status of local and international drug substitution and
maintenance treatments, but disagreed on the wording of a subsequent
NPA recommendation.

MacPherson, who first unveiled the Four Pillars drug strategy in late
2000-flagging prevention, treatment, enforcement, and harm reduction
as its components-fielded questions in a quiet meeting in a City
Hall bereft of CUPE inside workers.

"There are people still on the street," he said during the meeting.
"Until you deal with that [treatment], I don't believe we're going to
get to prevention. The solution is to get people off the street first."

MacPherson placed a $10 million price tag-to be garnered "from a
variety of sources"-on implementing the projects, including
methadone maintenance and heroin-assisted treatment.

Vision and COPE councillors supported the initial intention of the NPA
recommendation, asking that council request Sullivan write a letter to
the federal government for funding from a proposed national antidrug
strategy to go toward ongoing, extended support for the Four Pillars
approach. However, the last section of the recommendation read:
"including the Chronic Addiction Substitution Treatment (CAST)
research trials"; it was this addition that Vision and COPE
councillors objected to.

Vision councillors Raymond Louie and Tim Stevenson pushed to defer the
report, but were defeated 6-5 along political lines. COPE councillor
David Cadman voiced disgust that Sullivan was "favouring one agency",
CAST, at the expense of others to aid addicts. (CAST is a proposed
research trial that will target the chronically addicted and has a
primary goal of a significant reduction in crime by 2010.) Sullivan
has touted CAST in recent months, but steadfastly denied he is doing
it to placate Prime Minister Stephen Harper, whose Conservative
minority government would not grant Insite-North America's first
supervised injection site-a full extension.

"You, sir, have got your fingers all over it," Cadman told Sullivan at
the meeting. Vision councillor Heather Deal added: "Pulling one agency
[CAST] out and weighting it is not appropriate."

It prompted Deal to move to sever the original NPA recommendation,
allowing all councillors to endorse the Four Pillars strategy and
pressuring the federal government for continued funding. Then all five
opposition councillors-Louie, Stevenson, Deal, Cadman, and George
Chow-opposed the segment of the recommendation keeping CAST as the
solitary listed agent, but were again defeated 6-5.

Outside the chambers, after three hours had elapsed on the topic, a
relieved MacPherson told reporters he was "glad" the Conservative
government had just hours earlier announced they were temporarily
extending the exemption for Insite until June 30, 2008. Alongside him,
Richard Mulcaster, executive director at the InnerChange Charitable
Society, which oversees CAST, shook his head as he glanced back at the
council chambers. "We want everybody working together," he said,
dismissing allegations that CAST was Sullivan's favourite agency.
"It's about working with everybody to solve this."

MacPherson's report notes that InnerChange was set up in early 2007
for the purpose of initiating a treatment program (CAST) "for the most
difficult to reach" addicts.

"The InnerChange Society is looking for close co-operation with many
experts in the field, including family and user organizations," the
report states. "Currently, InnerChange has supported work towards the
development of five clinical research trials that will be put forward
to Health Canada for approvals. The society is seeking funding sources
for the research trials from a range of government, foundation, and
private sources."

[sidebar]

METHADONE SUBSTITUTION BEGAN IN B.C.

Year that Dr. Robert Halliday pioneered first methadone program in the
world in B.C.: 1963

Number of licensed pharmacies in Vancouver providing methadone: 76 (to
2,729 patients)

Number of participants in North American Opiate Medication Initiative
(NAOMI): 192 in Vancouver and 59 in Montreal

Number of Vancouver-based clinical trials
receiving support from InnerChange Charitable Society: 5

Areas of five trials: HIV/addiction treatment integration; optimized
opioid substitution; heroin-assisted treatment (HAT) versus
hydromorphine; intra-venous versus oral administration; and treatment
of stimulant dependence and treatment of crack users with contingency
management and amphet- amine substitution

Name of InnerChange treatment program: chronic addiction substitution
treatment (CAST)

Source: Drug Substitution and Maintenance Treatment report, City of Vancouver