DRUG SITES - WORTH A TRY

The safe-injection site for heroin and cocaine users that opened in
Vancouver this week is an important step toward treating addictions as
primarily a medical problem, rather than a legal one.

Providing addicts a safer place to inject illegal drugs may seem a
radical departure in the context of "the war on drugs." U.S. anti-drug
czar John Walter has denounced the Vancouver program as a form of
"state-sponsored suicide." As the first program of its kind in North
America, it has been accused of legitimizing illegal drug use.

But so many drug addicts have been dying on the shabby streets of
Vancouver's Downtown Eastside, or falling ill with AIDS or hepatitis,
that a radical step was needed. Over the past 10 years, more than
1,200 addicts have died of overdoses in Vancouver. More than one in
five injection-drug users in the city is estimated to have HIV, the
virus that causes AIDS, and a sizable majority have either hepatitis B or
hepatitis C.

Far from the state sponsoring suicide, the city and the federal
government that gave the legal go-ahead for the experimental site are
taking responsibility for this intractable health problem.

Mayor Larry Campbell, a former coroner whose career inspired the
CBC-TV drama Da Vinci's Inquest, and who before that was a member of the
RCMP's drug squad, should be praised for spearheading the project. For the
record, the idea was proposed by an all-party committee of the
federal government, which visited safe-injection sites in Europe,
where they are uncontroversial.

The site is far from a panacea. No one should expect that it will cut the
incidence of robberies associated with drug users. However, with
medical supervision, a ban on sharing of needles, and the chance --
however slight -- that some of the users will gain enough confidence
in staff at the site to seek treatment for their addiction, the hope is
that the centre will save lives. Any such program should be studied
for its effectiveness. Health Canada is spending $1.5-million to do just
that. Police, by the way, will continue charging drug dealers.

Beyond saving lives, the safe-injection site's importance consists in
helping change the way society thinks of addictions. North America has
been slow to embrace the idea of harm reduction. Addicts not only
devastate their own lives, they steal and rob, wind up in hospital or
jail, lose their jobs, destroy their families. A pragmatic policy
aimed at easing this devastation is long overdue.

No single method of trying to reach heroin users will work. Treatment
usually means methadone -- a substitute high --which at up to $5,000
per patient a year is a cost-effective way of reaching addicts for
whom the costs in health, policing and lost productivity have been
estimated at $50,000 annually. But even in the best case, methadone
treatment will not attract more than 50 per cent of heroin addicts,
medical experts say.

Needle exchanges are one form of harm reduction that has come to seem
uncontroversial. Perhaps someday the safe-injection sites will also seem
that way. Discussions are under way to conduct a far more radical
controlled study in which doctors prescribe heroin to long-term
addicts in Toronto, Montreal and Vancouver. When the rhetoric of the
war on drugs dies down, it may be possible -- given some political
courage -- to find constructive new approaches to addictions.