HARM REDUCTION CONCEPTS ELUDE COLUMNIST CRAIG

Dear Editor:

Op-ed pieces by their nature reflect their writers' opinions and as
such do not need to be factually based. I would however like the
opportunity to respond to Wallace Craig's column June 13 with the best
available evidence from medicine and health care, and leave it up to
your readers to differentiate fact from ideology.

Whether Craig likes it or not, harm reduction interventions such as
substitution therapies, needle exchanges and supervised injection
sites are recognized internationally as effective ways of improving
the health of people with addictions. Craig may know better than
(among many others) the U.S. Institutes of Medicine, the World Health
Organization and the B.C. Centre of Excellence in HIV/AIDS, but these
are among my sources for citing these interventions as reducing risk,
engaging drug users, improving health and often leading injection drug
users to drug-free lives. If I am a "pure trickster" and a "cunning
deceiver" as Craig would have it, then so by extension are they and
the thousands of physicians, nurses and therapists who daily, far from
seeking to launder addiction out of human agency, are working with
scientifically validated interventions to manage an exceedingly
difficult and complicated health problem.

Substance dependence is a chronic relapsing condition that has no
magic-bullet solution. Demonizing and criminalizing people with
addictions is an approach that has been amply demonstrated to produce
minimal recovery rates. Closing Insite as recommended by Craig would
have some immediate, predictable impacts. Among them: 250,000 very
unsafe, very visible street injections; some overdose deaths;
increases in HCV (hepatitis) and HIV infections; and most tragically,
the termination of a program which has been demonstrated to
effectively get injection drug users into (and remain in) addiction
treatment programs.

Perry Kendall,

provincial health officer, Victoria