Pubdate: Sun, 21 Sep 2014
Source: Victoria Times-Colonist (CN BC)
Copyright: 2014 Times Colonist
Contact: http://www2.canada.com/victoriatimescolonist/letters.html
Website: http://www.timescolonist.com/
Details: http://www.mapinc.org/media/481
Author: Adrian Fine
Page: A11

HEALTH AUTHORITIES ARE WASTING LIVES AND MONEY

Imagine a holistic health-care program that could reduce death rates,
almost eradicate two major complicating diseases, improve quality and
quantity of life and be more cost-effective than many cancer
treatments or cholesterol-lowering drugs.

A health economist's dream come true? A political vote-winner?
Something our health care administrators should be falling over
themselves in a rush to implement? An obvious yes to all three. Except
for intravenous drug users in Victoria. They don't qualify for proven
and humane therapy.

Twenty per cent of Canadians will have substance-abuse issues in their
lifetimes. The total yearly medical cost for drug abuse in Canada is
$1.8 billion. For alcohol, it is $3.3 billion, and smoking costs us
$3.7 billion.

IV drug users have an astounding 60 per cent chance of acquiring
hepatitis C. The lifetime cost of this infection is more than $100,000
per person. HIV rates are high (30 per cent), with costs exceeding
$150,000 per person. These two infections are acquired mainly from the
re-use of needles and syringes.

The overall death rate for IV drug users is greater than for many
types of cancer and is 10 to 14 times greater than non-users. Fifteen
per cent of all Vancouver ER visits used to be drug-abuse related.

Because of these crisis numbers, which earned Vancouver the title of
being the IV drug capital of Canada, a comprehensive care facility -
Insite - was set up in 2003, the first (and still only) such facility
in North America.

It provides a safe injection site, sterile injection supplies
(excluding drugs), counselling, addiction and detoxification programs
and facilitates referrals to various health programs. The facility is
extensively monitored and researched, leading to many scientific
publications.

The results have been dramatic. HIV and HCV infection rates have
plummeted. Up to 12 fatal overdoses per year have been prevented.
Insite users are 30 per cent more likely to engage in
addiction-treatment programs than non-Insite users. The homeless rate
for Insite users has dropped from 45 to 10 per cent. Reports of recent
incarceration have dropped from 30 per cent to seven per cent.

Every dollar spent on this facility saves the taxpayer between $1.50
and $5 in health-care costs. This type of analysis does not include
non-medical benefits, including better quality of life and, of course,
life itself.

And on Vancouver Island, in spite of our police and several
councillors being in favour of such a program, our own health
authorities refuse to follow suit.

How can that be? Our island has one of the highest HCV infection rates
in Canada - 11 fatal overdoses occurred in Victoria in 2011.

Opponents to the Vancouver Insite claimed that having such a facility
would legitimize IV drug use, leading to higher numbers of such users.
Research has shown repeatedly that this is not the case.

It was felt that crime and general public disorder would gravitate
around the facility. The opposite has occurred and the immediate area
around the facility is now free of needles and other supplies. There
are no reports of increased crime in the area.

The Vancouver Police Department, the Canadian Medical Association,
Canadian Nursing Association, Vancouver city council, Vancouver
Coastal Health Authority and the Vancouver public strongly support
this facility. Why are we so different?

Some of our health authorities might be sticking to the outdated view
that to supply these illegal drugs is against the law. The Harper
government, in its rampage through socially beneficial programs,
attempted to remove Insite's exemption from this law. The Supreme
Court threw out the petition, giving a clear message to our own health
authority that there would be no legal challenges to opening up a
similar facility in Victoria.

Given the extraordinary success of Insite and taxpayer money saved, it
can safely be said that the Vancouver Island Health Authority is not
acting in the public's best interest in this regard. This is not acceptable.

In fairness, the apathy of Victorians might have to share some of the
blame.

I recently encountered evidence of this. A church that I attended ran
a workshop on this very topic immediately following Sunday service (to
provide information on the need for such a facility in Victoria). The
session had been widely advertised in the church, even announced twice
from the pulpit.

Only three members of the church attended.

Nevertheless, harm reduction is one of the pillars on which our
health-care system is based. Access to safe and dignified health care
is a right for all people, regardless of financial, housing or health
status. We offer health care to smokers with lung cancer and to
hopeless alcoholics with cirrhosis.

It is discriminatory not to offer effective care for IV drug users. It
is unethical.

Dr. Adrian Fine is a retired medical specialist. He works with YES
2SCS, a Victoria group raising public awareness of IV drug issues. His
views do not necessarily represent the views of that organization.
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MAP posted-by: Matt