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.