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In early 2004, the AIDS Committee of
Newfoundland and Labrador (ACNL) received funding from the AIDS
Community Action Program/Population and Public Health Branch of
Health Canada to carry out a needs assessment with Injection Drug
Users (IDUs) in St. John’s. The impetus to carry out this project
came from a rise in the number of people living with HIV/AIDS, and
the increased awareness of the levels of injection drug use (IDU).
Since the beginning of the project, eight people have been newly
diagnosed HIV+, and three more with AIDS.
The goal of the project is to reduce
the risk and spread of HIV/HCV and other infections related to
injection drug use in the St. John’s metro area by increasing
awareness and understanding of issues related to IDU. The project
will engage directly with people who inject drugs and the front-line
services they have contact with in order to: increase the knowledge
base around the risks involved, and safer practices related to IDU;
and, to identify the specific needs of IDUs and the barriers to
getting these needs met. An advisory committee made up of
representatives of the IDU community, health care providers,
addiction services, various community agencies, and the police
supports the work of this project.
The issue of drug use, and injection
drug use in particular, can be a very controversial topic. In
addressing this issue key points to remember are: that drug users
are human beings, trying their best to survive; and, that we all
deserve to be treated with respect and dignity, regardless of our
life choices and/or circumstances. It is also essential to recognize
that total abstinence from drugs and alcohol is not a viable option
for many individuals, and for youth in particular. The best way to
help people is to meet them “where they are” in their lives, and
that means working from a harm reduction approach.
Harm reduction looks at drug use from a
public health perspective, rather than from one of law enforcement.
It accepts, for better or for worse that drug use is part of our
world and chooses to work to minimize its harmful effects rather
than simply ignore or condemn them. It sees drug users as people in
need of care, treatment and support rather than punishment. Harm
reduction strategies attempt to reduce the specific harms associated
with drug use, without requiring abstinence. Thus, they seek to
reduce the likelihood that drug users will contract/spread HIV,
Hepatitis C and other infections, or otherwise harm themselves or
members of the general public.
Sharing drug-using equipment such as
syringes, spoons, water, filters, etc. are obvious avenues for the
transmission of infections (harms). Other potential sources of harm
related to this activity include the unsafe disposal of used
syringes and the spread of infection through unsafe sex.
The ACNL has operated a needle exchange
since the early 1990s. To date this service has not been “funded”,
therefore supplies have been either paid for from our general
operating budget or donated. This lack of funding also means that
needle exchange services are only available during our regular
office hours — 8:30 a.m. to 4 p.m., Monday to Friday (closed noon–1
p.m.). We provide needle exchange (i.e., provision of clean syringes
and proper disposal of used ones), filters, alcohol swabs, condoms,
lubricant, etc., along with information and support. We also offer a
drop-in health clinic on Thursdays from noon to 3 p.m. Among
services the nurse provides are free, anonymous testing for HIV, HCV,
STIs etc., wellness check-ups, and safer injecting and vein
maintenance information. With funding, the ACNL would be able to
expand access to these services both in terms of hours of operation
and through partnerships with other community agencies via satellite
locations and street outreach.
The final report of the Oxycontin Task
Force contains a number of recommendations regarding harm reduction
services. Two of these recommendations are specific to work the ACNL
is doing: expanding the IDU needs assessment to include the entire
province and annual funding for the needle exchange. Implementing
all of the report’s harm reduction recommendations would be a giant
step towards making our communities healthier and safer for all of
us.
For more information or to
contribute, contact Tree Walsh at
709-579-8656 or toll-free at 800-563-1575. |
