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Vancouver's Harm Reduction Approach Is Working

A 15-year study shows that fewer people use and inject drugs since the city adopted a public health approach and opened a safe injection site.

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By McCarton Ackerman

06/25/13

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A newly published 15-year study indicates that Vancouver's progressive efforts in harm reduction have effectively reduced illegal drug use and improved public safety. The report by the BC Centre for Excellence in HIV/AIDS examined drug use from 1996-2011 in the city's impoverished Downtown Eastside, once known as "Ground Zero" for HIV and overdoses. The city then adopted a harm reduction approach that included opening Insite, Canada's first legal supervised injection sitein 2003. Dr. Thomas Kerr, co-author of the report and co-director of the center's Urban Health Research Initiative, says fewer people in the area are using drugs—and out of those who still do, fewer are injecting. Almost 40% of users reported sharing needles in 1996; that number dropped to 1.7% in 2011. The percentage of users who accessed methadone treatment jumped from 12% to 54% during that time period. The study also found fewer new HIV and Hepatitis C infections related to sharing needles. "A public health emergency was declared here because we saw the highest rates of HIV infection ever seen outside of sub-Saharan Africa—in this community," says Kerr. "At the same time, the community was being leveled by an overdose epidemic."

However, Canada's Conservative government still opposes Vancouver's programs. It introduced the Respect for Communities Act earlier this month, which will require applicants to consult with community, provincial and municipal authorities and law enforcement officials before setting up new supervised injection facilities. "We have a federal government that ignores science in favour of ideology, and people are sick and dying as a result," says Kerr. "When we're dealing with matters such as life and death, I think we're obligated to base our decisions on the best available scientific evidence. I think it's unethical to do otherwise." Canada's Supreme Court decided in 2011 that Insite could continue to operate, but the new federal legislation will make it much harder for similar sites to open. There are no legal safe injection sites in the US.

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