Harm reduction model promoted for drug users

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The federal government's drug policy drew heated criticism from delegates at the Canadian Harm Reduction Conference held in Toronto in late November to discuss treatment for drug users.

"Could we design a worst system if we tried?" asked Dr. Diane Riley of the International Harm Reduction Association, at the closing plenary on Nov. 24.

Riley believes that Canada currently relies on an overworked criminal system to deal with drug users, and lacks a comprehensive drug strategy that incorporates harm reduction methods.

"It was the first conference of its kind where it was driven by the people that we're working for, injection drug users," said Albert McLeod of the Manitoba Aboriginal AIDS Task Force and a facilitator at the conference. "People who use injection drugs were part of the planning."

McLeod said it was a step in the right direction, because by including drug users in the planning process, it would dispel a lot of the myths and misconceptions about them.

Other delegates agreed with Riley that the federal policy, or of one, is troubling.

"I'm not a fan of the criminal law," said Eugene Oscapella of the Canadian Foundation for Drug Policy. "It takes all the problems we have with drugs, and makes them worse."

Oscapella pointed out that according to the latest auditor general's report, 95 per cent of federal funding to combat drug use goes to law enforcement and incarceration.

Yet, the rate of infection among vulnerable populations, such as the Aboriginal population, is so high that the National Task Force on HIV/AIDS and Injection Drug Use declared it a public health crisis in 1997.

"I've seen many people die and develop disease, because of our drug policies," Oscapella added. "We need to acknowledge the futility of the war on drugs, and that harm reduction strategies are the way to go."

Harm reduction is a practical approach to drug use that recognizes that quitting drugs may not be realistic or desirable for everyone. Safe and controlled drug use, not abstinence, is the goal of the harm reduction model.

Dwayne Pelletier, a Metis from Regina and a conference delegate, said he used heroin for 23 years.

Pelletier is now involved with a harm reduction methadone treatment program in Regina, and believes that harm reduction is a more effective approach to dealing with addictions.

"With methadone, they're weaning me, by baby steps," said Pelletier. "I've been heroin-free for over two years now."

Unfortunately, Pelletier, who was unaware of the dangers of intravenous drug use, or who did not have the resources to prevent becoming infected, contracted Hepatitis C.

Pelletier believes a big impediment to preventing the spread of infectious diseases amongst drug users is that many still believe that abstinence is the only alternative to unregulated drug use.

"There are people in this city who freeze to death, because people make assumptions that you're high or drunk or stoned, and we can't help you," said McLeod. "And why not? It's just being more open-minded about how we use drugs."

Riley said that Canada desperately needs a national drug strategy that incorporates harm reduction measures such as needle exchange programs, 24-hour dispensing boxes, and methadone treatment programs to halt the rising rates of blood-borne diseases among drug users.

Although some of these harm reduction methods currently are being used, that is only because of the initiative of isolated service providers, who have had little support from government in the development and implementation of such programs.

"We say we're using harm reduction strategies, but we're not; we're still using criminal policy," said Riley.

"Abstinence is not the only way. We're still following a very much prohibitionist, Protestant, puritan tradition."

The fifth annual conference differed from its predecessors in that drug users shaped the core of the agenda.