POINTED ISSUE

The Province's Chief Medical Officer Is Among Those Advocating A Needle
Exchange Program For P.E.I. To Stop The Spread Of Diseases

Recovering drug addict Daniel Nowogorski says the number - and diversity -
of IV users in the province should serve as a sharp stab in the gut to the
many Islanders oblivious to the alarming problem.

"See, a lot of people have to understand that it's not just a typical
picture of a junkie," he said.

"It's not this homeless guy standing on a street corner or shooting it in
alleyways. It's professionals, it's mothers, it's fathers, it's brothers,
it's sisters - and people we talk to every day of the week."

Nowogorski, 24, of Charlottetown estimates about 600 Islanders use a needle
to inject drugs into their bodies. He bases the estimate on Statistics
Canada data and his ongoing research into this potentially deadly form of
drug abuse.

Chief Health Officer Dr. Lamont Sweet doesn't try to put a number on the
problem, but he is quick to note intravenous drug use is prevalent on
Prince Edward Island.

"From what we know about use of needles in the province, it's just not
confined to the Charlottetown area," he said. "There is extensive IV drug
use outside of Charlottetown."

Sweet is particularly concerned with the common practice of users sharing
each other's needles.

The frequency of this dangerous practice was highlighted more than seven
years ago when the province interviewed 113 IV users that came through its
addiction services system. Sweet said it was alarming to hear 63 of those
users state they shared needles to inject drugs.

One IV user, Steve (not his real name), who is currently serving time at
the Provincial Correctional Centre in Sleepy Hollow, told The Guardian some
people on the street with HIV (the virus that leads to AIDS) share needles
"with a no-care attitude."

Steve, who now has AIDS, contracted HIV through intravenous drug use.

Sweet said the province has not experienced a dramatic increase in HIV
cases in the past seven or eight years.

Hepatitis C, which is very contagious and easily spread through the sharing
of needles, is a more unsettling story on P.E.I.

"There is harm being done because there are continued new cases of
Hepatitis C through the use of needles," said Sweet.

He said the majority of the 319 positive cases of Hepatitis C in the
province are due to IV drug use.

Hepatitis C can lead to progressive liver problems. Treatment for the virus
is extremely expensive and doesn't work in 40 per cent of cases, he added.

Sweet said he has wanted a needle exchange program in the province since
1996 when the survey of IV users showed a high incidence of needle sharing.

He and other advocates of such a program, including AIDS P.E.I., have
consistently encountered strong resistance to implementing a province-wide
needle exchange system.

"To get a needle exchange program going in the community is admitting that
there are needles being used in the community," said the chief health officer.

Sweet said protocol guidelines were established and sent to the health
regions in the province in June 1998 so they could consider adopting a
needle exchange program. Each region, however, cited one guideline or
another as being a barrier to establishing such a program.

"One group said they couldn't manage to get insurance for their staff,
another one said they didn't have the security for handling it 24 hours a
day," said Sweet.

In the end, the guidelines seemed to kill any movement towards adopting a
needle exchange program here.

Yet Sweet is confident a program will be adopted in the province,
particularly with the current push from people promoting harm reduction.

"There's a few people in the system now working very hard for it and I have
a feeling they will be able to get something going in that area."

Nowogorski has taken the bull by the horns himself, regularly charging out
to the homes of 12 "clients" to provide clean needles to help reduce the
risk of spreading disease. He is also conducting a needs assessment for a
needle exchange program in the province.

He envisions a "delivery service" as being the most effective approach.

However, Barb Gibson, executive director of AIDS P.E.I., is skeptical the
government will be willing to buy into a needle exchange program. That, she
notes, would require the province to compromise its firmly-held philosophy
of abstinence-and-only abstinence as an approach to addressing drug addiction.

"I do know that the biggest gap is that P.E.I. does not have a harm
reduction strategy that is comprehensive or progressive," said Gibson.

"The philosophy needs to change from abstinence-based to one that is much
more encompassing, one that is more sensitive to injection drug users and
people who use opiates like heroin and cocaine."

Sweet also runs into such opposition.

"Many of the people who have the complete abstinence approach don't buy
into the harm reduction," he said.

"It's a different philosophy. Needle exchange program philosophy is more on
the harm reduction side. It accepts the fact that you're not going to be
able to stop everyone using needles."

After several years of IV drug abuse in Nova Scotia, Nowogorski returned
home to P.E.I. determined to kick his addiction. He tried going to the
Provincial Addictions Treatment facility in Mount Herbert for
detoxification but discovered they had no protocol for opiate withdrawal.

Instead, he relied on having an Island physician prescribe a drug to "take
the edge off and I went through the entire process (of becoming clean) by
myself on my mother's couch."

Steve, meanwhile, believes he would benefit from being on a methadone
treatment program while in prison.

The province won't provide him with that potentially helpful drug. Sweet
said people have great difficulty getting methadone prescribed on P.E.I. to
help in treating a drug addiction.

"We appear to be the only province that doesn't have some program for
methadone," he said. "I think that the information on it is that it does
some good and if it was available it would be of some value . . . If
someone is on a safe methadone program the communicable disease part of the
problem is stopped. It's gone."

Ironically, former inmates say prisoners do manage to get their hands on
other drugs that they inject while in the Provincial Correctional Centre.

Sweet would like to see methadone available to inmates as well because he
believes intravenous drug use does take place in Island jails.

"I would be extremely surprised if it didn't - very surprised," he said.
"It would be very likely that it does happen."

Yet Attorney General Jeff Lantz isn't ready to believe inmates are
injecting drugs.

"From what I'm told it's not happening there," he said. "It's a lot harder
to smuggle something like that in there."

A recent report, however, considers the two prisons managed by Lantz's
office - the 96-bed facility in Charlottetown and the 24-bed facility in
Summerside - ripe for the spread of infectious diseases.

"The provision of HIV-prevention measures to prisoners in P.E.I. is among
the worst in Canada," concludes a report by the Canadian HIV/AIDS Legal
Network.

"The province is one of the only jurisdictions in Canada that does not
provide condoms, dental dams and water-based lubricant to prisoners. Bleach
and needle exchange are not available, nor are measures to reduce HIV and
HCV transmission via tattooing. Methadone is not available in the province
and is therefore not provided to prisoners."

The province received the worse grade in Canada, along with Nunavut, in the
Legal Network's report called Action on HIV/AIDS in Prisons: Too Little,
Too Late - A Report Card.

Donna Myers, provincial manager of custody programs for Community and
Correctional Services, said a concerted effort is made to steer inmates
towards a healthy lifestyle through education and treatment.

"We certainly believe that what we are doing today is assisting the
population that we're dealing with," she said.

Myers said her department will review the critical report, which was
released last month.

Sweet said more should be done in Island prisons to reduce the risk of
spreading infectious diseases like HIV and Hepatitis C.

"It would be wonderful if we could get rid of intravenous drug use in the
facilities but I don't think that is realistic."

Sweet said he would support a needle exchange program within the prison system.

No prison system in Canada has tried needle exchange programs.

"Hundreds of needle exchange programs (existing) in the community and
prison systems in Western and Eastern Europe have successfully introduced
them into prisons," said Rick Lines, a researcher and author of the
Canadian HIV/AIDS Legal Network report.

"Scientific studies show that they reduce the spread of infections, do not
lead to increased drug use, pose no risk to the safety of prison staff and
are well accepted by prisoners, staff and prison administrations."

Gibson is urging the government to implement far more measures to reduce
the risk of infectious disease being spread within Island prisons.

"The prison system has to seriously look at harm reduction and to become
more realistic in understanding what needs to be done because people who
are in prison deserve the same type of opportunities to protect themselves
and their health as anybody on the outside," she said.