Pubdate: Sat, 27 May 2017
Source: London Free Press (CN ON)
Copyright: 2017 The London Free Press
Author: Brian Lester
Page: A13


The article Needles the cause, cure (May 23) postulates possible
reasons for higher rates of HIV and hepatitis C virus in London.

As an organization that advocates with and for people who inject drugs
(PWID), we note that, while unsafe injection practices may be a
potential driver of these increased rates, it is probably not the only
influence. There are multiple social and systemic influences that may
not only contribute to the increase of disease, but also contribute to
overall diminished health of those who inject drugs.

Canada, like most countries, criminalizes substance users thus
continuing a cyclical and punitive system for this vulnerable segment
of our population. Drug addiction is first and foremost a health-care
issue, but our long-standing criminal response creates insurmountable
barriers for people who inject drugs to access services.

>From an anecdotal perspective, the Regional HIV/AIDS Connection is
witnessing a concerning trend that may be contributing to the recent
outbreak. Across our community, social and health services staff are
reporting a growing and serious concern related to the volume of
crystal methamphetamine use among people who inject drugs.

At the front line we are witnessing the often irreversible damage this
illicit substance is causing. When individuals are experiencing the
effects of meth, their ability to adhere to safe injection practices
is seriously compromised and possibly nonexistent. Compound all these
barriers with pervasive stigma associated with HIV and addiction and
we create a perfect storm for the issues presenting in London.

There is increasing global discourse that acknowledges current global
drug policy is not working. In 2011, Regional HIV/AIDS Connection
signed on to the Vienna Declaration, which calls for a full policy
reorientation on global drug policy, stating, "The criminalization of
illicit drug users is fuelling the HIV epidemic and has resulted in
overwhelmingly negative health and social consequences."

Unfortunately we have not seen significant policy change either
globally or in Canada and we continue to see increasing health
concerns for people who inject drugs.

Overdose, HIV, hepatitis C, endocarditis and the invasive Group A
streptoccol bacterial infection present significant risks to
individuals and contribute to increasing costs within the health-care

There are emerging global drug response models that demonstrate
remarkable results by abandoning traditional drug policy approaches in
favour of pragmatic and progressive policies that link individuals to
health care, hard reduction and addiction services.

Fourteen years ago Portugal shifted its drug policy to a health care,
treatment and harm reduction focus. This resulted in a decrease in HIV
infections within people who inject drugs and a 60 per cent increase
in access to treatment services. Within the context of the current
emergence of fentanyl overdose deaths sweeping our country, it is
interesting to note that Portugal reports the second-lowest overdose
deaths worldwide.

Clearly there is something valuable to learn from their progressive
drug policy.

Brian Lester is executive director of the Regional HIV/AIDS Connection.
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