Pubdate: Tue, 05 Oct 2004
Source: National Post (Canada)
Copyright: 2004 Southam Inc.
Author: Larry Campbell
Bookmark: (Treatment)
Bookmark: (Harm Reduction)
Note: Larry Campbell is the Mayor of Vancouver.


Despite Vancouver's rating as one of the top cities in the world in
which to live, the crisis of poverty and drug addiction that has
engulfed our Downtown Eastside in recent years -- with its associated
rash of disease, overdose deaths and drug-related crime -- poses a
threat to our community's future.

After four years of debate, our city settled on a radical departure in
drug policy based on four pillars: prevention, harm reduction,
enforcement and treatment.

At the heart of this strategy was the opening of a supervised
injection site -- known as Insite -- where drug users could come into
contact with health professionals and, with any luck, begin the
journey to treatment. Found in more than two dozen European and
Australian cities, such facilities allow users to inject previously
obtained illicit drugs under the supervision of medical staff.

Operated for the past year by the Vancouver Coastal Health Authority
with the permission of Health Canada, Insite is the first project of
its kind in North America. Now, it is undergoing the most detailed
scientific evaluation of any such site in the world. And the early
results are overwhelmingly positive: This strategy is saving lives,
improving health outcomes and reducing street disorder.

The statistics show that Insite was heavily used from the day it
opened. But those numbers -- almost 600 injections per day with more
than 3,000 individuals attending it over a six-month period -- tell
only part of the picture.

The site is operating almost at capacity. While it has seen over 100
overdoses, there has not been a single fatality. On a weekly basis,
people are seeking treatment, counselling and other services.
Demographic analysis shows that women, aboriginals and those with
unstable housing are using it in high numbers, and that nearly 70% of
attendees live in the neighbourhood.

Researchers report that the site has made "measurable improvements in
public order." That means less public drug use, fewer discarded
needles and less injection-related litter on the streets. Local
businesses in nearby Gastown and Chinatown report a noticeable and
positive change in their environment, and a subsequent increase in
business and investment.

The Vancouver Police Department has also noted the program's impact
upon the open drug scene. An independent evaluation found that the
initiative has been successful in disrupting the open drug market,
reducing the general levels of social disorder and making people who
live and work in the neighbourhood feel safer and more secure.

Although access to treatment is always a concern, the Vancouver
Coastal Health Authority has worked hard to streamline access and to
make sure that those seeking help are able to get it. And we're
developing the prevention pillar as well: Incorporating input from
community forums, a prevention strategy for problematic drug use will
be released in November.

The Four Pillars approach is showing results. And I'm convinced that
other initiatives, such as the North American Opiate Medication
Initiative (NAOMI) trial set to begin in Vancouver and Montreal this
winter, will further contribute to harm reduction and community safety
by offering prescription heroin to drug users as part of a scientific

I'd like to build on Insite's success by including a supervised
inhalation room within the facility, so that those who smoke their
drugs -- both heroin and crack cocaine -- could also benefit from
additional health services and harm reduction measures. (This would
require further Health Canada approval.) And I would like to see
supervised injection sites wherever there is demand, as is currently
the case with needle exchanges.

Does any of this mean that we are through dealing with Vancouver's
drug problems? Hardly. But all told, it represents an important step
toward the comprehensive approach we believe is necessary. The "Just
Say No" message has failed dismally, so we are looking for innovative
methods that fit the needs of our citizens.

Each city must find its own solution to addiction problems, but
Vancouver's experience proves there is an alternative to the sort of
war on drugs that has been waged for the past couple of decades.

It's an alternative that saves lives, improves the health of our
citizens, reduces street disorder and strengthens communities. Isn't
that what citizens expect from their government?
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