Vancouver Tests Efficacy of ‘Safe-Injection Sites’ to Battle Canada’s Worst Drug ProblemVancouver Mayor Philip Owen has asked city officials to consider the "radical" notion of setting up "safe-injection centers," where intravenous drug users can get clean needles and inject drugs under the supervision of health care workers, in order to clean up an "epidemic" drug problem that is spreading HIV and hepatitis C, the Washington Post reports. Such "harm reduction" programs that treat addiction as a "disease rather than a crime" are gaining favor in Canada, but have been slow to catch on in the United States, where officials tend to focus on law enforcement (Brown, Washington Post, 8/21). Among men in British Columbia between the ages of 30 and 49, drug overdoses are the leading cause of death, according to two studies published in today's edition of the Canadian Medical Association Journal. One study examined the medical records of 598 IV drug users over a three-year period and found that those users accounted for 2,763 emergency room visits and 495 actual admissions to Vancouver's St. Paul's Hospital. Almost all of the hospital visits were due to problems caused by "unsafe injection practices." Patients who self-identified as using "risky" injection practices, such as using dirty needles or sharing needles, had annual medical bills $1,752 higher than IV drug users who practiced "safe" needle use, according to the study. The second study found that 28% of 776 drug users surveyed had shared needles "at least once" in the previous six months. Safe-injection sites, such as the ones proposed by Owen, are "an investment to prevent medical problems that we would otherwise end up paying for downstream," the researchers concluded (Mickleburgh, Globe and Mail, 8/21).
Reducing Morbidity and Mortality
As IV drug use has increased in Vancouver, so has the rate of HIV and hepatitis C infections. According to Heather Hay, regional network director for addiction services for the Vancouver-Richmond area health board, the board declared a "public health emergency" after HIV/AIDS cases "escalat[ed]" among the area's IV drug users in 1997. The board also endorsed the idea of safe-injection sites as a means of reducing the 147 annual deaths due to drug overdoses. The safe-injection sites, also known as "consumption rooms," provide drug users with a "safe, secure environment" where they can shoot up "away from the dirt and dangers of the street" under the supervision of health workers who are "trained in safe-injection techniques and overdose response," Owen said. The centers also provide users with "dignity," according to Ann Livingston, project coordinator for the Vancouver Area Network of Drug Users, a group comprising former and current drug users. However, the Vancouver plan has been met with "strong opposition" from business groups that say the sites would "only lure more addicts to the area and harm legitimate businesses." Monty Jang, chair of the Chinese Cultural Center, which is located a half block from a proposed injection site, said he does not disagree with the plan itself, only with the site's location. "Let me put it this way: with that kind of treatment, you may be attracting a lot of those drug addicts hanging around, and maybe creating some prostitutes to make money and to buy drugs. So that is the only reason why we're against it," he said, adding that the center's Chinese language school attracts 1,500 students a week. Safe-injection sites have operated in Germany and Switzerland for several years, and officials in Sydney, Australia, and Madrid, Spain, said that programs in those cities have "dramatically" reduced crime and the spread of disease. Montreal has considered starting safe injection sites as well, and Robert Lesser, chief superintendent of the Royal Canadian Mounted Police, has asked cities to study the feasibility of such programs, saying, "It's something we have to look at" (Washington Post, 8/21).