Pubdate: Mon, 16 May 2005
Source: Ottawa Citizen (CN ON)
Copyright: 2005 The Ottawa Citizen
Contact:  http://www.canada.com/ottawa/ottawacitizen/
Details: http://www.mapinc.org/media/326
Author: Carly Weeks
Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction)
Bookmark: http://www.mapinc.org/find?143 (Hepatitis)
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)
Note: Online SoundOff at webpage

NEEDLE EXCHANGE CAME TOO LATE: CUSHMAN

HIV, Hepatitis C Cases Linked To Hesitancy To Confront Drug Problem

Ottawa's reluctance to confront its drug problem in the late 1980s is the 
main reason the city is home to more intravenous drug users with HIV and 
hepatitis C than Toronto or Montreal, says the city's medical officer of 
health.

While Toronto adopted the provincial needle exchange program in 1989, 
Ottawa's regional council opted to wait until 1991 to begin giving out 
clean needles and syringes, Dr. Robert Cushman explained this week, 
recalling the "bitter debates" at regional council about the idea, similar 
to current debates about Ottawa's crack pipe distribution program.

Adopting needle exchange two years after Toronto is only a partial 
explanation for today's high levels of infectious disease among intravenous 
drug users in Ottawa. But, the answer becomes clearer when one considers 
the limits imposed on the exchange program after it was approved, said Dr. 
Cushman.

"You can't afford to be behind on this. That's why we think we're worse 
than all the other cities but Vancouver -- because we got behind," he said.

In the early days of the exchange program, there were strict rules about 
only giving out a needle if a drug user exchanged a used one. There was 
also a limit on the number of needles public health had to distribute, said 
Dr. Cushman.

"Considering these people need scores of needles, we weren't coming close 
to dealing with the problem. It was more of a token than a real solution."

It's estimated that there are between 3,000 and 5,000 intravenous drug 
users in Ottawa. Of those, 21 per cent are infected with HIV, while 76 per 
cent have hepatitis C, according to research by Dr. Lynne Leonard, 
professor and research scientist at the University of Ottawa's epidemiology 
and community medicine department.

The department has been working with Ottawa Public Health to track the 
rates of people who inject drugs and have HIV or hepatitis C.

Paul Lavigne, co-ordinator of the harm reduction program with Ottawa Public 
Health, echoed Dr. Cushman's views.

"We started later and it took a while as a program to grow, to meet the 
needs," he said, suggesting that the late start and program limitations 
helped make Ottawa second only to Vancouver in terms of the number of 
intravenous drug users with HIV and hepatitis C.

While the program was eventually expanded and more needles made available, 
treatment and rehabilitation options for people addicted to drugs are still 
underfunded, said Dr. Cushman.

There are only three community-based methadone clinics in Ottawa, plus a 
methadone treatment program operated by the Royal Ottawa Hospital. "It's 
fair to say services are inadequate in Ontario, but unfortunately, they're 
even worse here," said Dr. Cushman.

The ongoing effort to get the resources needed to fight the city's drug 
problem is a key indicator of why it's such a problem in the first place, 
said Dr. Cushman. "I think it's fair to say, except in the city core, it's 
been an invisible problem," he said. "When you look at where the votes are 
distributed, it's problematic because the downtown core, where this plays 
heavily, is under-represented in the council chamber."

The city adopted an integrated drug strategy last week, which aims to bring 
city officials, the police, public health and other community leaders 
together to tackle Ottawa's drug problem with a unified voice.

The new strategy followed an intense debate between police Chief Vince 
Bevan and Dr. Cushman at the city's health committee last month over the 
merits of the crack pipe distribution program.

The city began giving out crack pipe stems and other drug equipment April 1 
as a way to stop the spread of disease among users who share pipes.
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MAP posted-by: Elizabeth Wehrman