Pubdate: Fri, 03 Feb 2017
Source: Vancouver Sun (CN BC)
Copyright: 2017 Postmedia Network Inc.
Author: Michael McCarthy
Page: A9


Harm-reduction focus oversimplifies problem, writes Michael

Breaking news! There is actually a place called hell. No, it's not
where you think it is. On a recent trip to Norway I learned that
"Hell" is a sleepy rural village. Actually the word means luck, from
the overhanging cliff caves in the area known as hellir in old Norse.

Gosh, all this time I thought hell was located in the Downtown
Eastside. In reality, it is.

Hell is found in those DTES alleyways where any hour of the day you
can find some poor soul doing the funky chicken, "tweaking" from an
overdose on crack cocaine. These days the drug of choice is the opioid
fentanyl, which leads to a lot less dancing and lot more dying. The
body count is edging towards a thousand a year.

But fentanyl is just the latest drug of choice. Coming next is
carfentanil, 10,000 times more potent than morphine, marketed under
the trade name Wildnil as a general anesthetic agent for large animals
like elephants.

Full disclosure: Between 1992 and 1997 I was editor of a "street
newspaper" called Spare Change, sold on the streets by homeless people
across Canada. I wrote or edited over a thousand articles about
"solutions to poverty," including drug addiction. I guess you could
say I know a lot more about the DTES than most reporters. Back then
the drug of choice was crack cocaine, which arrived in Vancouver in
1995, and then crystal methamphetamine.

In 1997, the local health authorities declared a public health

Rates of HIV infection, spread by needle-sharing drug users, were
worse than anywhere in the world outside sub-Saharan Africa.

This era marked the beginning of "harm reduction," many years later
still pushed by activists as a solution to drug overdoses.

In truth, the real fight at the time was to stop AIDS infections from
spreading from the inner city to the suburbs by prostitutes passing on
the disease to their customers.

I remember writing that "if harm reduction continues as the same rate,
we will soon have eliminated the entire problem." More than 1,000
people died of drug overdoses.

Harm reduction then moved to the opening of a needle exchange and
North America's first legal safe injection site, ostensibly to help
stop the spread of AIDS. Rates of HIV infection did indeed drop from
8.1 cases per 100 person-years in 1997 to 0.37 cases per 100
person-years by 2011. So did drug overdoses.

By 2015, the 40-block area surrounding the safe injection site had
also seen a 35 per cent decline in overdose deaths.

But now addicts are once again dying in droves despite the enormous
amount of taxpayers' money being spent on "prevention."

Two major daily newspapers (The Province, The Globe and Mail) recently
estimated the amount of money being spent on the 8,000 to 10,000
people in the DTES at approximately $1 million per day, or $350
million a year. This includes the salaries of firefighters, police,
social workers, activists and so on, but not the sale and profits of
drugs. Do the math: In the 20 years since harm reduction was first
implemented, that's $7 billion wasted, and for what? Just imagine if
that money had been invested in detox services, rehab and housing.

The solution is found in countries like Switzerland.

In the early 1990s up to 1,000 drug users gathered daily in Zurich's
infamous Platzspitz Park, dubbed "needle park." Soaring HIV infection
rates sparked alarm among the conservative Swiss public.

Authorities authorized exchange programs and safe rooms offering
injections, showers, beds and hygienic conditions under certified
medical supervision with drugs like methadone supplied. Addicts didn't
need to rob or prostitute themselves. Some 70 per cent of the
20,000-30,000 opiate or cocaine users in Switzerland now receive
medical treatment.

The ongoing political focus on harm reduction serves to oversimplify
the issue and distracts from a larger issue.

The real question is how so many people (and not just in the DTES)
have become reduced to such a state of despair that they are willing
to risk killing themselves through self-medication. Or, more
importantly, what would all the social workers in the DTES do if they
had no elephants to protect? The neighbourhood has been named by
activists as "Canada's poorest postal code."

Truth is, the DTES is Canada's richest postal code, only all the money
goes home at night. Poverty is a very lucrative business, it appears,
but that's a sad story for another day.
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MAP posted-by: Matt