B.C. injection site risks offending world

What do people not understand about this clinic?!

No one is helping anyone obtain any drugs. They are not providing, nor informing people of sources!

They are simply making sure these people have somewhere to shoot up with clean needles and dont die in the process. I dont think many of you understand the problem that is occuring on the mean streets of vancouver. its horrendous, people ODing left and right.

And for those who are saying it advocates drug use, that is absurd! They are helping addicts not non drug users get started!

Regardless of whether this center existed or not, addicts will be addicts. They will continue to use drugs whether this place is open or closed, But instead of being assured a certain amount of safety they will be left to fend for themselves. we have one center, ONE! and where the problem is at its worst!

People get your information straight!

and ps. police dont arrest them because there is so many. and if they did arrest them, they would be dying in their hands. the majority of these people will die if they dont get their next dose. These addicts used to be average people, the working class, they are not monsters.

And Kkool if you don't want your money going to these centers do you realize how much is going to people who smoke!? there are far more smokers suffering than heroin junkies, so your comment is highly flawed. maybe you should be more concerned about banning smoking before shutting down this ONE center.
 
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clamjuice said:
What do people not understand about this clinic?!

No one is helping anyone obtain any drugs. They are not providing, nor informing people of sources!

They are simply making sure these people have somewhere to shoot up with clean needles and dont die in the process. I dont think many of you understand the problem that is occuring on the mean streets of vancouver. its horrendous, people ODing left and right.

And for those who are saying it advocates drug use, that is absurd! They are helping addicts not non drug users get started!

Regardless of whether this center existed or not, addicts will be addicts. They will continue to use drugs whether this place is open or closed, But instead of being assured a certain amount of safety they will be left to fend for themselves. we have one center, ONE! and where the problem is at its worst!

People get your information straight!

and ps. police dont arrest them because there is so many. and if they did arrest them, they would be dying in their hands. the majority of these people will die if they dont get their next dose. These addicts used to be average people, the working class, they are not monsters.

And Kkool if you don't want your money going to these centers do you realize how much is going to people who smoke!? there are far more smokers suffering than heroin junkies, so your comment is highly flawed. maybe you should be more concerned about banning smoking before shutting down this ONE center.

It doesn't quite advocate drug use but it supports it. Providing needles is one step away from providing the drug. Yes I know it doesn't create addicts, but that's not the issue. And, "fend for themselves?", please. I'm sure these drug addicts know how to fend for themselves, if they can get a hold of drugs, they can get a hold of their own clean needles.

Mind you, I don't think this is a bad idea, just a bad idea for the government. This should be the responsibility of a non-profit organization or a charity, not tax dollars.

And I don't understand how money is being "given" to people who smoke. Maybe I should smoke, so they'll give me money?

If you're referring to health care costs, that is paid for by their insurance most likely, which is by no means given to them by the government. In any case, junkies have the same health care available to them.

I don't see the government giving out free cigarettes or lighters, so it seems your logic is flawed.

Edit: And quantity is not a valid issue, as it's a slippery slope.

Also, how is saying that I don't want my money going to help drug users flawed? It's my opinion, and the majority of the United States agrees with me.
 
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ilikeacid said:
awe and i was planning on moving to Canada one day... Canada was once a major leader in harm minimisation, I hope the winds haven't changed :(
Same. I wasn't heading out there any time soon, but I was hoping to be ready in the next 10 years or so.
 
Kkool said:
.......................I'm sure these drug addicts know how to fend for themselves, if they can get a hold of drugs, they can get a hold of their own clean needles..

Actually they often find real difficulties in organising some very important aspects of their lives. Clean needles can become a very low priority. It's just not pragmatic to expect many opiate dependent people to achieve this level of control over their lives/habits. And this has huge implications for public health, and could affect non-drug dependent people (perhaps even you) directly. ........

Kkool said:
Also, how is saying that I don't want my money going to help drug users flawed? It's my opinion, and the majority of the United States agrees with me.

Perhaps the "tyranny of majority" is a bit short-sighted here. Dirty needle users may spread infections amongst each other, and with a large proportion of female street workers using heroin, cross infection of the wider community will inevitably take place. Far enough down the line, people with no connection to sex workers or heroin users might well succumb to HIV infection. From this perspective, harm-reduction money is money well spent. At the risk of using crappy management-speak, there is a bigger picture to be considered.

But then the "majority" of the United States does seem to put its name to a wide variety of less-than-well considered causes. Quite a few of them seem to end up in massive loss of life. Quite often innocent civilians who just happen to be in the way of the US's "just" causes.

Hmmmmm.

E
 
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EntheoDjinn said:
Actually they often find real difficulties in organising some very important aspects of their lives. Clean needles can become a very low priority. It's just not pragmatic to expect many opiate dependent people to achieve this level of control over their lives/habits. And this has huge imlications for public health, and could affect non-drug dependent people (perhaps even you) directly. ........



Perhaps the "tyranny of majority" is a bit short-sighted here. Dirty needle users may spread infections amongst each other, and with a large proportion of female street workers using heroin, cross infection of the wider community will inevitably take place. Far enough down the line, people with no connection to sex workers or heroin users might well succumb to HIV infection. From this perspective, harm-reduction money is money well spent. At the risk of using crappy management-speak, there is a bigger picture to be considered.

But then the "majority" of the United States does seem to put its name to a wide variety of less-than-well considered causes. Quite a few of them seem to end up in massive loss of life. Quite often innocent civilians who just happen to be in the way of the US's "just" causes.

Hmmmmm.

E

Oh, I like the US bashing. Let me rephrase, I don't want my money spent on drug users, and a majority of the known world agrees with me.

Our money could be better spent catering to educating about safe sex to prevent HIV transmission than helping drug addicts. You provide a tenuous link at best between drug users and the rest of the population, it is not imminent that the spread of HIV from drug users to non users will be rampant. This is a moot point, you're just grasping for straws.

If drug users are too lazy to get clean needles, then what makes you think they would travel all the way to this clinic to shoot up, and be taught about the safe way to inject? They just want their next fix.

This is not a government issue, that's the end of it. The government shouldn't be responsible for any harm reduction other than, "don't do drugs". This is a matter for private organizations and charities, like I've said countless times.

The U.S. hate was definitely uncalled for, as well as immature, and purposefully vague. If you have a specific point to make, make it.
 
If the BC safe injection site can manage to keep a few addict's from getting HIV or hepatitis then it's done it's job. It will save the canadian public money in the long run because then you dont have to pay for treatment for people who get AIDS. Not to mention the fact that junkies with AIDS often pass it on to other people as well.
 
paranoid android said:
If the BC safe injection site can manage to keep a few addict's from getting HIV or hepatitis then it's done it's job. It will save the canadian public money in the long run because then you dont have to pay for treatment for people who get AIDS. Not to mention the fact that junkies with AIDS often pass it on to other people as well.

Oh, hahaha, I forgot about Canadian national healthcare :D
 
Kkool said:
It doesn't quite advocate drug use but it supports it. Providing needles is one step away from providing the drug. Yes I know it doesn't create addicts, but that's not the issue. And, "fend for themselves?", please. I'm sure these drug addicts know how to fend for themselves, if they can get a hold of drugs, they can get a hold of their own clean needles.

Mind you, I don't think this is a bad idea, just a bad idea for the government. This should be the responsibility of a non-profit organization or a charity, not tax dollars.

And I don't understand how money is being "given" to people who smoke. Maybe I should smoke, so they'll give me money?

If you're referring to health care costs, that is paid for by their insurance most likely, which is by no means given to them by the government. In any case, junkies have the same health care available to them.

I don't see the government giving out free cigarettes or lighters, so it seems your logic is flawed.

Edit: And quantity is not a valid issue, as it's a slippery slope.

Also, how is saying that I don't want my money going to help drug users flawed? It's my opinion, and the majority of the United States agrees with me.

Canada has OHIP. so our tax dollars go to other peoples problems. Im far more concerned with giving money to the millions of smokers out there who are dying than the hundreds of junkies who want a clean needle center. I was under the impression you may have been from Canada.

so in the end its worth the couple bucks a year to stop some people from contracting serious ailments from dirty needles.

and i think you would need to be a junky to understand that a clean needle isnt a priority when if you dont get your next dose you could die...
 
Kkool

Kkool said:
Oh, I like the US bashing. Let me rephrase, I don't want my money spent on drug users, and a majority of the known world agrees with me.

Our money could be better spent catering to educating about safe sex to prevent HIV transmission than helping drug addicts. You provide a tenuous link at best between drug users and the rest of the population, it is not imminent that the spread of HIV from drug users to non users will be rampant. This is a moot point, you're just grasping for straws.

If drug users are too lazy to get clean needles, then what makes you think they would travel all the way to this clinic to shoot up, and be taught about the safe way to inject? They just want their next fix.

This is not a government issue, that's the end of it. The government shouldn't be responsible for any harm reduction other than, "don't do drugs". This is a matter for private organizations and charities, like I've said countless times.

The U.S. hate was definitely uncalled for, as well as immature, and purposefully vague. If you have a specific point to make, make it.

I will start my counter point by arguing that it's a good idea, than I will address your libertarian crap.
Perhaps it could be argued that transmission of HIV by addicts is not very significant at the moment, but who's to say it will not lead to, or contribute to something that is very much significant in ten years. Truth is addicts do transmit the virus amongst each other, and to non addicts. I work in a hospital, and I have met many who contracted the virus through sharing needles, and there was a paramedic of ours a few years back who contracted HIV by being poked with a needle on the floor next to an over dosed addict. I've seen these things, they are in close proximity to high drug traffic areas, it wouldn't be that far of a travel for an addict to go to one of these.

From some of your comments you seem to imply that addicts aren't worth helping? If that is how you feel than I have quite a few things to say on the subject.

In regards to health is a personal matter, well that's really working out well in your country, with your health system. Like it or not Kkool the industrial revolution did happen, and taxes have become a tool of the federal government, as you probably know they don't need your permission to use your money for a cause. Who better than the government to address this issue? The addicts? We wouldn't be talking about this if they were capable of doing that, and some would argue that sometimes you require tools to take care of yourself, and this would be considered one of them. If not the addicts then the public through charity? In the end these things are run by charities, the just receive economic aid through taxes, but I don't see anything wrong with that, it is probably only costing each Canadian citizen a dollar of their taxes to run these programs. I don't think the government has the right to regulate it citizens behavior, but I don't see how it doesn't have the right to address it's citizens shared problems.

in conclusion, I don't like libertarians, they seem like nothing more than Republicans with one eye slightly open. The US hate comments were completely reasonable as far as I'm concerned, if you didn't live in a bubble you'd be far more use to it. I hate you Kkool.
 
I will start my counter point by arguing that it's a good idea, than I will address your libertarian crap.

Why don't you go back and read my earlier post: I specifically said, I'm not saying this is a bad idea. It seems like it could work, addicts are people too, and require help. My point is that the government shouldn't fund things of this nature.

Perhaps it could be argued that transmission of HIV by addicts is not very significant at the moment, but who's to say it will not lead to, or contribute to something that is very much significant in ten years.

Who's to say that in ten years I won't come up with a cure for all diseases? That means you should give me millions of dollars for funding, right?

Truth is addicts do transmit the virus amongst each other, and to non addicts. I work in a hospital, and I have met many who contracted the virus through sharing needles, and there was a paramedic of ours a few years back who contracted HIV by being poked with a needle on the floor next to an over dosed addict.

Doctors and nurses on occasion get pricked by a needle in the process of helping an HIV positive patient and contract it themselves. Accidental transmissions are just that, accidents; they have nothing to do with the topic at hand. They could transmit it accidentally to the workers in the clinics. As far as sexual transmission, money could be better spent preventing the transmission of HIV through safe-sex education, like I said earlier.

From some of your comments you seem to imply that addicts aren't worth helping? If that is how you feel than I have quite a few things to say on the subject.

Bank robbers sometimes get shot, prostitutes get beat up by pimps, addicts sometimes overdose and contract HIV. Criminals (I know you don't think drug users are criminals but technically they are breaking the law) put themselves in dangerous situations because their activities are outside the realm of the law, where it is considerably more dangerous. It's their own fault they are there.

In regards to health is a personal matter, well that's really working out well in your country

Yea, why doesn't the US just adopt national health care like yours so the government can take ludicrous amounts of money away from hard working people in the form of taxes.

as you probably know they don't need your permission to use your money for a cause.

LOL, exactly my point, it is funny that you address it as one of yours. The government doesn't want to help drug users, so why should they? You're the one who wants them to spend it on addicts. The government acts based on the will of the people, and most people don't want to spend their money on heroin addicts. Don't like it? Too bad.

but I don't see anything wrong with that, it is probably only costing each Canadian citizen a dollar of their taxes to run these programs. I don't think the government has the right to regulate it citizens behavior, but I don't see how it doesn't have the right to address it's citizens shared problems.

1 Dollar taxes pile up. As far as citizen concerns, I agree. However, this isn't a shared citizen concern, it is a drug user concern. Citizens don't care about them and don't want to pay for their troubles.


in conclusion, I don't like libertarians, they seem like nothing more than Republicans with one eye slightly open. The US hate comments were completely reasonable as far as I'm concerned, if you didn't live in a bubble you'd be far more use to it. I hate you Kkool

LOL, you know, there's a reason the United States is regarded as the best country in the world, regardless of our military initiatives. You are just talking out of hate and ignorance, probably jealousy as well.

I don't hate you though, you're not significant enough to affect me so deeply. I am mildly amused by your antics.
 
Kkool said:
LOL, exactly my point, it is funny that you address it as one of yours. The government doesn't want to help drug users, so why should they? You're the one who wants them to spend it on addicts. The government acts based on the will of the people, and most people don't want to spend their money on heroin addicts. Don't like it? Too bad.



1 Dollar taxes pile up. As far as citizen concerns, I agree. However, this isn't a shared citizen concern, it is a drug user concern. Citizens don't care about them and don't want to pay for their troubles.




LOL, you know, there's a reason the United States is regarded as the best country in the world, regardless of our military initiatives. You are just talking out of hate and ignorance, probably jealousy as well.

1. Umm actually the center was approved and was approved for a nother year. Does that not tell you that we want the center. the only reason the center is now currently at risk is because Steven Harper the moron got elected.

I live in canada, im not complaining about a couple bucks off my pay check. Nor are others complaining. See in Canada we understand that everyone has problems that need to be addressed. Arguing that the government is stealing out money for this center isnt really valid because the amount taken is minimal.

2.Umm who said the US is the best country in the world. I bet if you were to take a poll it would be quite the opposite. You regard it as the best country in the world.

Why don't you take a look at the UN's human development index, you are not number one. In fact Canada, is above you. The United States is number 8.

If you didn't know every highly developed country in the world has a national health care plan...except for the US. You don't care about the little guy, the guy that cant pay for medication and otehr services that he needs to live.

This isn't a patriot thread buddy.

2.
 
clamjuice said:
1. Umm actually the center was approved and was approved for a nother year. Does that not tell you that we want the center. the only reason the center is now currently at risk is because Steven Harper the moron got elected.

I live in canada, im not complaining about a couple bucks off my pay check. Nor are others complaining. See in Canada we understand that everyone has problems that need to be addressed. Arguing that the government is stealing out money for this center isnt really valid because the amount taken is minimal.

2.Umm who said the US is the best country in the world. I bet if you were to take a poll it would be quite the opposite. You regard it as the best country in the world.

Why don't you take a look at the UN's human development index, you are not number one. In fact Canada, is above you. The United States is number 8.

If you didn't know every highly developed country in the world has a national health care plan...except for the US. You don't care about the little guy, the guy that cant pay for medication and otehr services that he needs to live.

This isn't a patriot thread buddy.

2.

Hey, this isn't a patriot thread, but I'm allowed to defend my country if it's under fire. God Bless America :)

Maybe it's not number one in terms of HDI, but as far as what the United States has contributed to the world and the human species, I'd say it's matched by none.

The fact that there is contention within your government suggests that there is no overwhelming majority in support of these clinics.

One dollar isn't much, but these things stack up.

And since you and your country are so keen on helping people, consider this:

Suppose a program was proposed, to be funded by the federal government, that helps pedophiles relocate (because of harassment) to different, far away residences. Yes, these people are in need of help, but do you think they should get any money?
 
I'd respond but I'm to busy cleaning the regurgitated libertarian vomit off my off my computer screen. Calling America the best country in the world is some what laughable. You may have made your share of contributions, but your entire society belongs to corperations, who hold all the control, where your oblivious citizens have absolutely none.
 
narco anonomous said:
I'd respond but I'm to busy cleaning the regurgitated libertarian vomit off my off my computer screen. Calling America the best country in the world is some what laughable. You may have made your share of contributions, but your entire society belongs to corperations, who hold all the control, where your oblivious citizens have absolutely none.

You have made no valid points whatsoever, so you resort to attacking America. Good for you! :|

You don't even so much as address my points. Are you trying to debate me or just trying to display your stunning lack reasoning and wit?

Even your attacks on America are vague and unspecific. I'm assuming this strategy has been taken out of ignorance and frustration. When you actually know what you're talking about, come back and give me some clear and pertinent points.
 
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This is straight from the public health agency ---and this harpocitter --does the exact opposite --it seem right across this country police, military and other law enforcement agencies are getting huge amounts of monies to "protect" them from the rest of the country ----

Prevention and harm reduction are the only areas where real results have been seen



I'm ashamed of my government at this point --there have been so many programs cut --we haven't even seen the vast majority --the Con government has sliced and diced taking millions away and replace it with pennies

we in Canada are left with either idiots or thieves at our helm --this is not the "new government" I want

http://www.phac-aspc.gc.ca/hepc/hepatitis_c/pdf/harm_reduction_e/canada.html



th
Harm Reduction and Injection Drug Use:
an international comparative study of contextual factors influencing the development and implementation of relevant policies and programs
Harm reduction in Canada
The latest version of the Federal/Provincial/Territorial report (2001) provides an excellent summary of harm reduction and related initiatives concerning injection drug use in Canada. What follows is intentionally a brief overview that draws on the FPT and other reports and on information provided by key informants.

Overview
Canada has had needle exchange services since 1987, but the is a general consensus that more needs to be done to increase coverage especially in rural areas. Methadone maintenance treatment has increased significantly in the past few years, but the need still far exceeds the supply. Injection drug use is a major cause for concern in large cities across Canada such as Vancouver, Toronto, Ottawa and Montreal. The HIV/AIDS program of Health Canada reports a public health crisis concerning HIV/AIDS and other infections, such as hepatitis C, among injection drug users in Canada.

There is, however, a momentum to address injection drug use across Canada. The serious harms associated with injection drug use have been identified as a priority issue in Canada by various federal and provincial/territorial committees addressing related issues, including substance abuse, HIV/AIDS, infectious hepatitis, correctional services, Aboriginal issues, and enforcement and justice issues. It has been recognized as a key issue within Canada's Drug Strategy, the Canadian Strategy on HIV/AIDS and the Hepatitis C Prevention, Support and Research Program and by the Advisory Committee on Population Health. All three strategies highlight the need for enhanced harm reduction programming to address the concerns related to injection drug use. Proposals for a scientific trial of heroin prescription, supervised injection sites, and needle exchange in prisons are moving up the political agenda.

The policy context for harm reduction
Canada's Drug Strategy (CDS) has the stated aim of reducing the harm associated with alcohol and other drugs to individuals, families, and communities. The CDS endorses needle exchange, methadone maintenance, abstinence-oriented treatments such as therapeutic communities, and the enforcement of laws pertaing to the use of illegal drugs. Thus, harm reduction is used in a broad sense to refer to any policy or program that aims to reduce drug-related harm (Single, 2001). This contrasts with a more narrow use of the term "harm reduction" to refer to policies and programs that give priority to the reduction of high-risk drug use and related behaviours among current drug users.

The strategy reflects a balance between reducing the supply of drugs and reducing the demand for drugs. It involves a variety of partnerships among 14 federal departments, provincial and territorial governments, addictions agencies, non-governmental organizations, professional associations, law enforcement agencies, the private sector, and community groups.

The Office of Canada's Drug Strategy in Health Canada is the focal point within the federal government for harm reduction, prevention, and treatment and rehabilitation initiatives concerning alcohol and other drugs. The Office works collaboratively with other federal departments and provincial and territorial governments, and provides national leadership and coordination on substance abuse issues, conducts research into the risk factors and root causes of substance abuse, synthesizes and disseminates leading-edge information and best practices to key partners, and collaborates with multilateral organizations to address the global drug problem. Major partners in Health Canada for whom injection drug use is a significant health concern include the HIV/AIDS Policy, Coordination and Programs Division and the Hepatitis C Prevention, Support and Research Program.

There have been no funds for new programs under Canada's Drug Strategy since 1997. Cutbacks in other areas have severely limited new initiatives and have had negative effects on established programs. However, the federal government has announced plans for drug strategy that many hope that this will make more funds available and have clearer goals and priorities than the current strategy.

Recently, the Advisory Committee on Population Health (ACPH), and four federal, provincial and territorial (FPT) committees representing substance abuse, AIDS, corrections and justice, prepared a strategy document on reducing the harm associated with injection drug use. The role of the ACPH is to advise the Conference of Deputy Ministers of Health on national and inter-provincial strategies that are required to improve the health of Canadians and provide a more integrated approach to health. The report stresses

...(t)he misuse of injection drugs is a health and social issue that has and will continue to have significant consequences for individuals, families and communities in Canada. Failure to act now will result in escalating health, social and economic impacts. It is time for all jurisdictions and stakeholders to work together to renew their commitment to reducing the harms associated with injection drug use. (p. 8)

The proposed framework for action represents an extraordinary level of consensus among a broad range of stakeholders and calls for a number of priority actions in the areas of prevention and outreach treatment and rehabilitation research, surveillance and knowledge dissemination; and national leadership and coordination. Among the many recommendations, those most germane to the present report include:

Leadership and coordination to establish an inter-sectoral, multi-level dialogue regarding injection drug use.
Work with law enforcement, justice, all levels of government, community groups and others to enhance the implementation, accessibility and effectiveness of needle exchange programs and reduce the barriers in all settings in Canada, including the consideration of pilot projects in correctional facilities.
Support for outreach and networking initiatives at all levels to foster and increase harm reduction initiatives, increase access to effective health, social and treatment and rehabilitation services, and enhance social integration and reintegration (e.g., prisoners returning to their communities upon release from a correctional facility).
The involvement of drug users and drug user networks in reducing the harm associated with injection drug use.
Addressing barriers to effective substance misuse treatment and rehabilitation programs, including methadone maintenance treatment, and making these programs more available in all settings, including correctional facilities.
Support, in principle, for clinical trials to assess the treatment effectiveness of prescribing heroin, LAAM, buprenorphine, and other drugs in the treatment of people who inject drugs.
The establishment of a task group representing (at a minimum) law enforcement, correctional services, justice, health and social services, addiction and community perspectives to study the feasibility of establishing a scientific medical research project regarding a supervised injection site in Canada.
Improved surveillance of the injection drug use situation and its consequences in Canada through data collection, targeted studies, and research to assess causes, co-factors, and effectiveness of interventions.
A Task Group on the feasibility of a medical research project on supervised injection sites has recently been established.

British Columbia has taken a leading role in responding to injection drug use at the provincial level. A recently released discussion report, "A Framework for Action: A Four-Pillar Approach to Drug Problems in Vancouver", contains an urgent appeal for the development and implementation of a coordinated, comprehensive framework for action to address the problem of substance misuse in the city of Vancouver. The framework seeks to balance public order and public health and calls for a strong, comprehensive drug strategy that incorporates four pillars: prevention, treatment, enforcement and harm reduction. It is a framework that ensures a continuum of care for those suffering from addiction to substances and support for the communities affected by their drug use.

The approach responds to those who need treatment for addiction, while clearly stressing that public disorder, including the open drug scene, must be stopped. "In short," says the report, "addiction needs treatment and criminal behaviour needs enforcement."

The framework, however, is not without opposition. There are those who fundamentally resist the expansion of harm reduction measures, including some members of the enforcement community and city council. Endorsement by all levels of enforcement, as well as the federal and provincial government, will be necessary for the framework to reach fruition. There is, however, a general feeling that support is strong.

Funding for harm reduction
Funds for new programs under Canada's Drug Strategy have been limited. Most alcohol and other drug treatment and rehabilitation programs and services are funded directly by provincial and territorial governments, and indirectly by the federal government through transfer payments. The federal government also provides direct funding for addiction treatment and rehabilitation services for some specific groups, including Aboriginal people living on reserves, members of the RCMP and the armed forces, and people in the federal corrections system. With the exception of Quebec, there are few specialized private programs that require clients to pay for treatment.

The current status of specific harm reduction initiatives
Needle and syringe distribution and exchange
Syringe exchanges were first established in Canada in 1987, with the first official exchange opening in Vancouver in March 1989. Services were initially provided through fixed sites and street outreach, and had limited representation at other agencies providing services to drug users in downtown areas. Over time, mobile vans have been added to services in several cities. Kits containing needles, bleach and condoms are distributed through these agencies. Between 1989 and 1993, the Federal government cost-shared pilot outreach programs in four provinces. At the present time, there are more than 200 syringe exchanges in rural and urban areas in Canada, with more under development. In addition, there are now numerous pharmacies that provide syringe exchange services.

The availability of needle exchange has not led to an increase in drug use. On the contrary, needle exchange programs have reduced rates of needle sharing among clients and have linked many drug users with health services. In Canada, needle exchange programs are an important strategy in a harm reduction approach to injection drug use, but various reports have indicated the need to increase and expand these programs to increase their availability. This is particularly the case in rural communities and in correctional facilities (Canadian HIV/AIDS Legal Network. Info sheet #8, 1999). Needle exchange programs are not available in any correctional facilities in Canada.

Drug substitution treatment
Methadone
The sale and manufacture of methadone is controlled by the Office of Controlled Substances within Health Canada. To prescribe methadone, physicians must receive an exemption under the Controlled Drugs and Substances Act. There are currently 699 physicians authorized to prescribe methadone. Stakeholders have indicated that this number is too low, especially in smaller communities and rural areas.

Methadone maintenance treatment is available in federal correctional facilities only for inmates who were enrolled in a methadone treatment program prior to incarceration. There are "exceptional circumstances" under which this rule may be set aside, but generally inmates cannot start methadone in correctional facilities. At the provincial level, British Columbia, Saskatchewan, Manitoba, Ontario, Quebec and Nova Scotia offer methadone maintenance treatment programs in prison as a continuation of participation in a community-based methadone maintenance program.

Waiting lists for methadone maintenance continue to be a problem in many communities. In response, the federal government has streamlined the authorization process for physicians. For example, the authorization does not place a limit on the number of patients, and physicians are not required to release information concerning patients to the government. The HIV/AIDS Policy, Coordination and Programs Division of Health Canada provides funding to a low-threshold methadone project in Montreal. Others have recommended further expansion of methadone maintenance treatment to correctional facilities and rural areas. However, attracting physicians to provide methadone prescriptions for opiate dependency is an ongoing challenge.

Other substitute drugs
Buprenorphine is not currently available on the Canadian market. However, physicians can access it through Health Canada's Special Access Program under the Food and Drug Regulations. A North American scientific consortium - the North American Opiate Medication Initiative (NAOMI) - is developing a proposal for a clinical heroin trial. Heroin substitution has been used in some countries with heroin users who are unable to benefit from substitution treatment such as methadone. There is no cocaine substitution treatment available in Canada.

Drug user education and outreach
Education and outreach programs, with a harm reduction focus aimed at users of injection drugs, are readily available throughout Canada, and Health Canada recently commissioned a report on ways of improving these programs (Wiebe, 2000). These programs are most often provided through needle exchange programs, and drug user groups and networks. Involving those who are former or current users of injection drugs in outreach efforts and the provision of services have proved to be effective in expanding the segment of the population reached. Formal groups exist in some major cities in Canada. For instance, the Vancouver Area Network of Drug Users (VANDU) is a group of active and former injection drug users who work to improve the lives of people who use illicit drugs.

User groups
VANDU is the most active of the support and advocacy groups of users and former users that are currently developing in several cities. VANDU holds bi-monthly member meetings with occasional guest speakers, and includes a methadone users group and a program to engage members as volunteers. Members also speak to other agencies in the community. Since its formation in 1998, membership has grown to over 500 and VANDU now is one of the largest organizations of its kind in the world

VANDU has collaborated with local health professionals and researchers to produce written material on drug use and proposals for new approaches based on harm reduction principles. A proposal for a supervised injection facility was recently presented to a federal task force on this issue (Kerr, 2000).

Harm reduction within the justice system
Injection drug use, needle sharing, and the transmission of HIV and hepatitis C are prevalent in correctional facilities. In 1994, the Expert Committee on AIDS and Prisons released a report that took a strong harm reduction approach to drug use in prisons. Among its numerous recommendations, the report called for the availability of household bleach, and access to methadone and sterile injection equipment in correctional facilities. The Correctional Service of Canada supported many of the recommendations, but access to methadone maintenance and sterile injecting equipment remains an unresolved issue. Some of the barriers affecting progress toward harm reduction initiatives within correctional facilities are resistance by prison administration and staff, safety concerns, perceptions that such strategies would be sending a contradictory message (that is, if the prison tolerates the use of drugs in prisons, then they are not taking the law seriously), and beliefs that injection drug use will increase.

Although they do not have clearly stated harm reduction objectives, drug treatment courts offer an alternative to incarceration for minor drug crimes. The first drug treatment court was established in Toronto on December 1, 1998, as a pilot project. The target group is non-violent offenders who are addicted to heroin or cocaine. Participation is voluntary. On completion of the program, participants receive a non-custodial sentence, or may have their charges withdrawn. The Toronto project has a comprehensive evaluation component attached. The results are still too preliminary to draw any conclusions about the effectiveness of the program.

Factors influencing harm reduction policies and practices
Trends in injection drug use
It is estimated that Canada has between 75,000 and 125,000 people who inject drugs such as heroin, cocaine or amphetamines (Single, 2000). In addition, 29.4% of young steroid users, or approximately 25,000 Canadians, report injection use (CCDFS, 1993).

Approximately 30,000 people who inject drugs reside in Toronto (Remis et al., 1997), and 15,000 in Vancouver (Millar, 1998). In Montreal, the number of people who inject cocaine is estimated between 6,000 and 25,000 and for heroin between 5,000 and 15,000 (Roy and Cloutier, 1994). Injection drug use has also been report in many other towns and cities and also in rural communities.

The proportion of injection drug users who report sharing needles varies considerably, but is exceedingly high in many communities: 76% in Montreal (Bruneau et al., 1997), 69% in Vancouver (Strathdee et al., 1997), 64% in a semi-rural Nova Scotia community (Stratton et al., 1997), 54% in Quebec City (Bélanger et al., 1996) and Calgary (Elnitsky and Abernathy, 1993), 46% in Toronto (Myers et al., 1995) and 37% in Hamilton-Wentworth (DeVillaer and Smyth, 1994).

Trends in the rates of HIV and other infections
The proportion of reported adult HIV-positive cases attributed to IDU has increased from 9.1% prior to 1995 to 29.9% in 1995, 34.3% in 1996, 33.6% in 1997 and 29.2% in 1998 (LCDC, 1999). In Canada, IDU is now the main route of HIV transmission and the proportion of new cases attributable to IDU is increasing. Surveillance data for 1999 indicate that almost half (46.8%) of all new HIV infections are among IDUs. In Vancouver, HIV prevalence among IDUs increased from 4% to 30% between 1992 and 1998, in Montreal from 5% before 1988 to 19.5% in 1997, and in Ottawa from 10.3% in 1992-93 to 21% in 1997.

In a recent draft report from the Canadian Strategy on HIV/AIDS Annual Direction-Setting Meeting, it was noted that since 1996, there have been fewer infections among injection drug users. The report cautions, however, that national aggregate information may be misleading, since it does not reflect local and regional trends; that is, although rates of HIV infection among injection drug users has been declining in large Canadian cities (Vancouver, Toronto, Montreal), there may not be a decline in small or mid-size Canadian cities.

It is estimated that 70% of new HCV infections in Canada each year are related to sharing needles, syringes, swabs, filters, spoons, tourniquets and water associated with injection drug use. Worldwide estimates of HCV infection range from 50% to 100% among drug-injecting populations. For this reason, people who inject drugs are a key group, and central to the persistence of HCV in Canada. HCV spreads quickly. Consistently, research shows high rates of HCV among short-term users of injection drugs who share needles, syringes, swabs, filters, spoons, tourniquets and water.

The most commonly injected drugs are cocaine and heroin. This is a cause for concern in itself, as cocaine use involves particular risk. People who inject cocaine may do so as often as 20 times a day, increasing the problems associated with sharing contaminated needles (McAmmond and Associates, 1997). Information obtained through detailed interviews with 610 individuals who inject drugs in Winnipeg, Manitoba (Elliot and Blanchard, 1998) found that cocaine was the predominant drug injected, and was associated with binge use and frequent injection. Talwin, Ritalin, amphetamines and steroids have also been used intravenously in some areas of Canada at various times (Single, 2000).

There are various injection practices that increase the risk of transmission of blood-borne diseases such as HIV or HCV. For example, in a practice called "front-loading or back-loading", the drug is mixed in one syringe, and then the mixture is divided by squirting some of the solution into one or more syringes. Although the needle is not shared, HCV can be transmitted if the syringe used for mixing has been previously contaminated. Limited research suggests that people with a history of intranasal or inhaled drug use may be at risk for HCV. Because users of cocaine often have nasal erosions and ulcers, sharing of cocaine straws can transmit HCV. Dehydrated and cracked lips, another common side effect of injection drug use, make pipe sharing a potential risk
 
Kkool said:
Maybe it's not number one in terms of HDI, but as far as what the United States has contributed to the world and the human species, I'd say it's matched by none.

How old is the human species?

You yanks have been around since 1776..

You're taking the biscuit now really.. it's the premise of your government to 'benefit' the human species which results in the US being the most disliked country to date.

Vietnam..

Funding the Contras..

Afghanistan.. (where opium production sky-rocketed, resulting in a flood of heroin to the global market, THANKS TO YOU!!!)

Iraq..

You'd rather pay taxes funding a war on terror which results in illicit heroin reaching the streets of your very nation? Pssch..
 
well, i mean, we want to do what we feel is right, but then again we dont want to offend anyone...

hideous ideology. fuck all of they take offense, they cant rightly justify their offense other than the fact that they are afraid of deviating from the conservative iron fist.
 
Sgt. Stadanko said:
How old is the human species?

You yanks have been around since 1776..

You're taking the biscuit now really.. it's the premise of your government to 'benefit' the human species which results in the US being the most disliked country to date.

Vietnam..

Funding the Contras..

Afghanistan.. (where opium production sky-rocketed, resulting in a flood of heroin to the global market, THANKS TO YOU!!!)

Iraq..

You'd rather pay taxes funding a war on terror which results in illicit heroin reaching the streets of your very nation? Pssch..

Wow, the ignorance and hate in this thread is astounding. Whatever, if you're number 1, you gotta deal with the hate. Good day sir.

Let's think of best country in a different way: if we wanted to, we could wipe your planet off the face of the earth and not break a sweat.

God Bless America =D

I love how everyone in this thread ignores my points and goes directly to attack America. Are you that daft and immature? Did you seriously come here just to insult an entire country? Those events come from different presidents, do you know how ignorant it is to put it into one category and label it as "America" ? I didn't even attack anyone else's country, just defending my own.

Let's get back to the topic at hand, which is not the contras, nor is it Vietnam.
 
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It's a shame you had to celebrate your centennial post with a shambolic display of blind patriotism.

Kkool said:
if we wanted to, we could wipe your planet off the face of the earth and not break a sweat.

My planet? Or my country?


Meh, I'm done with this anyways..
 
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