Pubdate: Fri, 08 Aug 2003 Source: Philadelphia Inquirer, The (PA) Copyright: 2003 Washington Post Contact: http://www.philly.com/mld/inquirer/ Details: http://www.mapinc.org/media/340 Author: DeNeen L. Brown, Washington Post Bookmark: http://www.mapinc.org/find?142 (Safe Injecting Rooms) GETTING JUNKIES OFF STREET, INTO CLINIC - TO SHOOT UP VANCOUVER, British Columbia - Her fingers travel up and down her arm, feeling for a good vein. Lori-Kim Veenstra opens a $7 bag of methamphetamine and pours some of the crystals onto a clean spoon. She opens a tiny blue bottle of sterile water and fills the spoon, waiting for the chemical to dissolve. Sometimes junkies use water from puddles to break down their drugs, sometimes soda pop or toilet water. Sometimes they use their own blood. Not here. Veenstra, 40, is in a clinic at the Dr. Peter Centre, where junkies who test positive for HIV can shoot up safely under supervision. This is one of the first of what are called "safe-injection sites" in North America. Soon to be sanctioned by the provincial and federal governments, it is an example of a new policy in Canada, called harm reduction, to address a pervasive drug problem plaguing Vancouver and other major cities. In the last year, Canada has drastically shifted its approach to drug users, going from punishing them to instituting the policy of harm reduction. This program makes sure junkies are safe while they are shooting up instead of jailing them. "Before I knew about this room, I used to go outside and shoot in the back alleys," Veenstra says. She ties a blue rubber tube around her left arm and pulls it tight with her teeth. She takes a clean syringe and draws up the liquefied drug, sucking it through sterile cotton, hoping the cotton will capture the impurities in the addictive stimulant, made of substances she is unsure of - her crystal meth could be cut with drain cleaner, baby laxatives or asbestos. The syringe is full now. She steadies the needle and points it at her best vein. "The only thing I ask of you," she says, looking up, "is don't talk to me and don't ask me if I'm OK. OK?" The needle punches her vein, and there is a slight hissing sound. She drops the needle. But there is no hurry. She is not on the street. There is no fear that another junkie might attack and stab her, then run off with her drugs. There is no concern of an overdose. All the time, a registered nurse is watching, guiding her, making sure that she uses sterile water and cotton and a clean needle, and that she inserts the needle correctly, following instructions. "Go flush with the skin," a nurse, Patti Zettel, says. "Then up. Once in the vein, release the tourniquet. Look, she has good blood flow." Throughout Canada, officials are considering radical changes in the country's approach to drugs, rejecting the tendency in the United States to push for law-enforcement solutions. In so doing, officials are taking up the stance of several other countries, including Germany, the Netherlands, Switzerland and Australia, which have various programs for decriminalization, clean needles, and free methadone clinics. The Vancouver-based Harm Reduction Action Society, which advocates changes in drug laws, reported that drug overdoses in Frankfurt, Germany, decreased from 147 in 1991 to 26 in 1997 with the creation of safe-injection sites. In Switzerland, it said, overdoses also declined, and there was a marked increase in the number of people registering for methadone and other treatment programs. U.S. officials have angrily criticized the Canadian policy of harm reduction. "The very name is a lie," John Walters, the White House drug-policy director, said in a telephone interview. "There are no safe-injection sites." He said the United States would continue to treat drug abuse as a "deadly disease that shortens lives." "It is reprehensible to allow people and encourage people to continue suffering," he said. Canada also faced criticism from the United States in May when it proposed decriminalizing possession of small amounts of marijuana. Canadian officials said their approach was intended to combat HIV, rampant among drug users, and to decrease overdoses. Officials in Toronto, Montreal and Vancouver are also debating whether supplying heroin to addicts would save lives and combat criminal behavior. The Dr. Peter Centre does not yet have legal sanction to run its safe-injection program, but officials are allowing it to operate without interference. The provincial government has approved a three-year, $1.1 million pilot program, to be run by the Vancouver Coastal Health Authority, for a safe-injection clinic in the drug-ridden Downtown Eastside district. This includes exemption from prosecution under the Controlled Drugs and Substances Act. Part of the pilot program involves gathering information on whether addicts will be more likely to seek treatment, and whether the number of drug overdoses and cases of infectious diseases decrease. "Somebody said, 'Why are we helping addicts?' " said Viviana Zanocco, a spokeswoman for the health authority. "... Why shouldn't we? Are we only supposed to help heart patients?" The program also makes good economic sense, Zanocco said. "When we get somebody with HIV, it costs $150,000 Canadian [about $107,000 U.S.] to treat over a lifetime," she said. "... If we can prevent 10 people from contracting HIV, the safe-injection site pays for itself." - --- MAP posted-by: Richard Lake