Pubdate: Sat, 26 May 2007 Source: Record, The (Kitchener, CN ON) Copyright: 2007 The Record Contact: http://www.therecord.com/ Details: http://www.mapinc.org/media/225 Author: Terry Pender Bookmark: http://www.mapinc.org/find?137 (Needle Exchange) Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction) NEEDLE-EXCHANGE PROGRAM AWAITS FEDERAL DRUG STRATEGY About 70,000 clean syringes and needles are given to intravenous drug users in Waterloo Region every year in an effort to prevent the spread of diseases among that group. But the new national drug strategy expected from the federal government next week will not offer any extra funding for such harm-reduction programs as the needle-exchange operation overseen by the region's public health department. The needle exchange in this region plays an important role in preventing the spread of viruses causing AIDS, hepatitis B and hepatitis C, said Karen Verhoeve of the region's public health department. When drug users share needles they can quickly transmit deadly viruses. Hepatitis C, which destroys the liver, is 10 times more infectious than HIV. Harm-reduction programs, such as the needle exchange, are not judgmental. Nobody tells addicts they must quit to get help. The main objective is to provide intravenous drug users with the gear to keep them safe from diseases spread through sharing dirty needles. In 1995, the region's public health department started the needle-exchange program. Intravenous drug users brought in used needles, and were given clean ones, sterile swabs and distilled water. They are also provided with a clean cooker -- a container where drugs are mixed with water and heated in preparation for injection. In 2006, public health handed out about 4,500 needles. But after partnering with two community-based agencies -- the Bridges Shelter in Cambridge and the AIDS Committee of Cambridge Kitchener Waterloo and Area, based in downtown Kitchener, the number of clean syringes given out increased steadily to the current level of 70,000 annually. Based on the data Verhoeve collects, the program appears to be working when it comes to preventing the spread of HIV. In 2006, there were 20 new cases of HIV reported in Waterloo Region, but none were related to intravenous drug use. It's been the same story for the past five years. But the trends for hepatitis C are not as encouraging. HEPATITIS C CASES RISING Between 1995 and 2005 1,537 new cases of hepatitis C were reported to regional public health, and about 21 per cent of those people identified intravenous drug use as the their major risk factor. But Verhoeve and other public health officials believe as many as 50 to 70 per cent of new hep C cases are a result of intravenous drug users sharing dirty needles. An estimated 1,175 intravenous drug users live in this region, and it's believed 55 per cent of them are infected with the virus causing hepatitis C. Sharing needles, or sharing drug-preparation equipment such as cookers, spoons, filters and rinse water, can easily transmit that virus among intravenous drug users. Hepatitis C is the most commonly acquired infection from injection drug use. As it is 10 to 15 times more infectious than HIV through blood contact, a single injection with a contaminated needle may result in transmission of the infection, according to a public health report. And that's why harm-reduction programs such as the needle exchange are so important, said Teena Scofield, the executive director of the region's AIDS committee. "Addiction is a disease, not a choice," Scofield said. Her agency distributes about 48,000 clean needles and safe-injection kits a year. "It's continually building, we regularly have new people," Scofield said. She said it is short-sighted for the federal government not to put more money into harm-reduction programs. "I'm very disappointed," Scofield said. In the cold, objective world of health-care economics, each new case of HIV/AIDS costs the system about $500,000. "Even if you disagree with the morality of it, it saves money in the end," Scofield said of needle-exchange programs. "Addiction is a disease and we have a responsibility to provide these services to people in our community." Addicts using the needle-exchange program can drop off dirty syringes at 10 locations around the region. This reduces the number of dirty needles thrown away on streets, lanes and parks. As an outreach worker, Rob Smith has walked some of the toughest, drug-rich streets in the country -- Vancouver's Downtown Eastside. These days Smith works as a street-based outreach worker in downtown Kitchener, focusing on the homeless or people at risk of homelessness. WINNING TRUST He encourages intravenous drug users to use the needle exchange. Often that is the first step in winning the person's trust, and establishing a relationship that leads to requests for medical treatment, drug rehabilitation or help navigating the social services bureaucracy. "I think they are vital," Smith said of harm-reduction initiatives. "If you are working with any folks who are at risk you need to demonstrate that you care enough about them to be healthy, and help them get something they need to be healthy," Smith said. The federal Tories' new national drug strategy is scheduled to be announced in the coming days. - --- MAP posted-by: Jay Bergstrom