Pubdate: Mon, 26 Mar 2001
Source: Toronto Star (CN ON)
Copyright: 2001 The Toronto Star
Contact:  One Yonge St., Toronto ON, M5E 1E6
Fax: (416) 869-4322


Officials Claim Program Saves Money By Keeping HIV, Hep C Rates Down

HAMILTON - Hamilton drug addicts scooped up 52,000 free needles last year, 
a nearly fourfold jump from 1997 when a surge of overdose deaths sparked a 
police warning about increased heroin use in the city.

The latest figures show the city's taxpayer-funded needle exchange program 
has seen a dramatic increase in the demand for the disposable needles from 
the 12,182 doled out in 1996 and 14,231 given out in 1997. Volunteers and 
staff handed out nearly 30,000 in 1999 and 52,000 last year, interviews and 
documents obtained by the Spectator under Freedom of Information 
legislation reveal.

The needles are used by intravenous drug users to inject heroin, cocaine, 
the prescription drug dilaudid, and, more rarely, speed (methamphetamine). 
Free needles help reduce needle sharing, and are viewed as a key weapon in 
the battle to cut HIV and hepatitis C infection rates.

But neither police nor public health officials are able to say definitively 
whether the increase is due to greater awareness of and trust in the 
program among the city's tight-knit circles of junkies, or to a true jump 
in the number of drug addicts. That's because the program counts needles 
handed out (and brought in) and client ''contacts'', but doesn't track 
specific individuals.

Suzanne Newark, co-ordinator of The Van, the needle exchange and street 
health care centre, said she doesn't know how many individuals are using 
the program because ''I don't see it as a need.''

There is no limit to how many needles you can ask for at one time - the 
needle exchange program once gave 500 to one person.

Newark admits she doesn't know how many addicts there are in the city but 
says she believes the jump in needle use reflects ''an increased awareness 
of the program.''

In 1997 a string of nine heroin overdose deaths led local police and the 
coroner to warn about an increased availability of the drug - and a upsurge 
in its potency.  A local clinic reported seeing five teenagers seeking help 
for addiction in a two-month span, a previously unheard-of situation.

Police said heroin traffickers were dropping their prices and increasing 
the drug's purity in an effort to win back drug users who had switched to 
crack cocaine. In Hamilton there were 14 overdose deaths in 1996 and 17 in 
1997; more recent figures were not available late last week.

Staff Sergeant Rick Wills, the current head of the Hamilton police vice and 
drug squad, say he often gets asked how many addicts the city has, but has 
no way of knowing.

''It's so close-knit, it's hard to identify heroin addicts - the addiction 
runs through every level of society, including the affluent. A functioning 
heroin addict can go for years'' without coming to police attention, Wills 

Wills said heroin was turning up in crack house raids and his officers were 
finding dealers ''cutting'' crack with heroin as a marketing tool, but 
heroin arrests and seizures were a minor part of their work and relatively 

Studies by researchers with the Centre for Addiction and Mental Health 
identified 450 heroin addicts who were receiving methadone treatment 
services or would if they could get it. An 1990 study identified 176 
junkies who had sought treatment, but estimated they represented just 7 
percent of the total addict population.

Regardless of the true number of intravenous drug users there are in the 
city, officials agree the dramatic increase in clean needles means 
injection drug users, the homeless, prostitutes and society's marginalized, 
are growing to trust health officials.

Newark says ''Hamilton is a very small town in a way, with a closed 
environment. People are still pretty private and it takes a long time to 
build trust.''

The needle exchange is driven by public health goals, and Newark is 
convinced that without the exchange - and the 49,000 free condoms they 
distributed last year - Hamilton would have high rates of HIV and hepatitis C.

There were 11 new HIV infections, contracted mainly through sex, reported 
in Hamilton in 1999, compared to 12 in 1998 and 23 in 1997.

The needles and condoms are given out from a mobile van operating Monday to 
Friday nights from 8 to midnight, driving to wherever in the city drug 
users need clean needles. A user need only call 317-9966, and make 

There are also seven locations in the city where drug users can exchange 
needles, including the Hamilton Aids Network on James Street South, the 
Elizabeth Fry Society on Main Street, and two pharmacies. Newark says the 
return rate of the needle exchange was 94 per cent last year.

The van program also includes a street health clinic for the homeless, 
hookers, and down-and-out at the Wesley Centre on Ferguson Avenue North.

The program is budgeted at a little over $50,000 a year, and a 1997 
McMaster University study found it delivered good value. The study 
estimated Hamilton's program from 1992 to 97 saved taxpayers $1.3 million 
in health care costs.

Still the programs are not without controversy.

In Vancouver last August, an alliance of business and resident groups 
demanded an end to government-funded needle exchange programs because they 
said it was making problem worse by facilitating drug use.

Newmark says Hamilton taxpayers are getting their money's worth. ''In 
keeping the infection rate (of HIV and hepatitis C) low, we keep the costs 
of medication and health care low.''

''Since 1992 (when the program started), HIV hasn't become epidemic, so we 
must be doing something right.''

Ted Myers, a University of Toronto HIV studies professor, like others in 
the health field, is also convinced ''these outreach programs'' reach 
larger numbers of people who need help. But he admits ''I don't know if we 
have good evaluations'' of their cost-benefit ratio.

Hamilton's social and public health services started their van needle 
exchange in 1992. It is now a ministry of health mandated program for 
communities where drug use is recognized as a problem.

Halton has approved a $40,000 pilot van program for this year, although the 
region doesn't know how many will make use of it.

Hamilton's The Van program also offers anonymous HIV testing, methadone 
treatment referrals to help drug users off heroin, addiction counselling, 
and pregnancy testing.
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