The "war on drugs", with its basis on prohibition and ignoring the problem of addiction altogether, is ineffectual and illogical. Abstinence-touting school programs such as D.A.R.E. have been shown to be ineffective at preventing or even providing accurate information regarding drug use; in 2001, the U.S. Surgeon General placed D.A.R.E. on its list of "Ineffectual Programs." (Drug Policy Alliance, 2003). Additionally, harsh and punitive "zero tolerance" laws have in fact made HIV and hepatitis C problems worse by restricting access to clean needles. It is safe to say that simply ignoring the problem or incarcerating drug users will not cease to make drugs available. Harm reduction programs realistically acknowledge that no society will ever be completely drug-free, and that people should not be punished as criminals for what they put into their bodies. (Drug Policy Alliance, 2010).
Vancouver, British Columbia has had a notorious problem with HIV and hepatitis C infections among IV drug users – one of the highest rates of infection in the world. (CBC, 2006) To combat this, the B.C. Ministry of Health and Vancouver Coastal Health Authority implemented a groundbreaking harm reduction program in 2003 known as InSite. InSite is a supervised injection site – the only one in North America – staffed by medical professionals trained to recognize and deal with overdoses, treat injection site abscesses, and instruct IV drug users how to inject safely. Additionally, they operate a needle exchange program and addiction counseling for its clients. Since its inception, InSite has had over 1.5 million visits. In 2009, they had nearly 500 overdose interventions with zero fatalities. (Vancouver Coastal Health Authority, 2010).
Risky behaviors such as sharing needles can be an etiological factor in how HIV and other bloodborne pathogens are transmitted amongst IV drug users. Kerr, Tyndall, Li, Montaner, and Wood (2005) found that IV drug users who frequented InSite were 70% less likely to share needles than those who did not visit the facility. Remarkably, the study also showed that IV drug users who frequent InSite were, prior to InSite's opening, as likely to share needles as those who do not use the facility; "in other words, the reductions in syringe sharing observed among InSite users only occurred after InSite opened, suggesting that InSite may have been responsible for this important behavioural change." (Kerr et al, 2005). This sharp decrease in the frequency of sharing needles can lead to a reduction in the spread of HIV and hepatitis C.
Wood, Tyndall, Zhang, Stoltz, Lai, Montaner, and Kerr (2006) performed an observational study of over 1000 repeat users of the InSite facility and found that weekly use of the clinic and contact with an addictions counselor were strongly associated with entry into detoxification programs; individuals who came there at least weekly were 17 times more likely to enroll in a detox program than those who visited less frequently.
Wood et al. (2006) maintain that "greater use of the supervised injecting facility is associated with markers traditionally associated with reduced access to care, including a higher intensity of drug use and homelessness." These extrinsic factors make the InSite facility even more vital to maintaining the health of all Vancouverites, including its most vulnerable citizens.
Jessica Slover - Medicine, cuisine, travel, voluntary simplicity, and helping others are my specialties! Some of my other interests include fat activism, ...
Join the Conversation