Thursday, July 12, 2007

Ottawa City Council chooses NIMBYism over public health

I can only describe my mood today as "infuriated, but not surprised." Yesterday, Ottawa City Council voted to shut down a crack pipe exchange program, despite the strenuous objections of city health officials and local community workers. This came on the heels of an anti-drug demonstration staged by the Sandy Hill Business Improvement Association, who argued that the program led to increased drug use in Ottawa's touristy Byward Market.

The business owners arrived to a sympathetic audience at city hall. Mayor Larry O'Brien had promised to end the program as part of his municipal election campaign, and yesterday, he teamed up with councillor Rick Chiarelli (and 13 others) to cancel a program that cost a mere $8,000 a year, and had the potential to save a significant number of lives.

Local bloggers are going apeshit about this. Vicky Smallman points out the fact that "Ottawa has an alarmingly high rate of HIV and Hepatitis C infection among Intravenous Drug users - at 21%, it is 9 times greater than Toronto’s infection rate." Yep, you heard her right. Nine times higher.

And even through city councillors claimed that there was no evidence to suggest that the program was working, they simply chose to ignore a study that the city itself commissioned last year from epidemiologist Lynne Leonard. The study demonstrates that while the program did lead to an increase in crack smoking, it also radically reduced users' sharing of drug paraphernalia, providing "significant scientific evidence" that the program reduced the harm associated with crack smoking.

As Adam Graham from the AIDS Committee of Ottawa explains, pipe and needle exchange programs also act as a first point of contact between users and health professionals, allowing them to access health services, therefore increasing the likelihood that they'll also seek out addiction counselling. In the case of crack smoking, a program like this prevents people from using burning metal pipes and cans, which cause open sores, and lead to HIV and hepatitis transmission.

But of course, these rational, health-based, scientifically-proven arguments mean nothing to bunch of city councillors who are more concerned about the "messaging" associated with handing out crack pipes. They've chosen to protect knee-jerk sensibilities over people's lives. It's simply shameful.

Still, local activists haven't given up the fight. The AIDS Committee of Ottawa announced that it would continue the program, even without city funding. And the new Ottawa Police chief has urged the city to conduct another study before burying the program for good.

Let's hope that city council smartens up, and chooses to listen to the facts. I'm not holding my breath.

-- Cross posted to BlogThis!


Anonymous said...

The study demonstrates that while the program did lead to an increase in crack smoking...

Funny, but this is exactly what the supporters of the program promised would NOT happen. Guess what? It did. This is precisely what happened in Vancouver as well when they opened up the "shooting gallery" and promoted the free needle exchange. Drug use went up (surprise!), and the crime rate continued to escalate.

There is one sure way to slow down the rate of infection for drug users -- GET THEM TO STOP USING DRUGS. This is not achieved by giving away drug paraphenalia, as has been proven by both the Ottawa experience and the Vancouver disaster. This is not the only possible strategy, although you would never know it by the bleating that has accompanied the canning of this failed program.

People have a right to live in the area and operate businesses there without having their neighbourhood ruined by illegal drug use. (If you want to legalize crack, take your fight to Parliament Hill, not City Hall. The left consistently tries to achieve at the City level what they can't achieve at the provincial and national level due to the fact that a majority of citizens disagree with your world view.) It doesn't make them bad citizens when they fight for the right to keep their streets clean and accessible to all -- in fact, I would argue it makes them good and responsible ones.

Just thought you could use some right wing balance here. Have a great day!

Ariel said...

Thanks for your comment. I invite you to read more of what leading health experts have to say about the importance of harm reduction as part of a larger strategy to help addicts and keep neighbourhoods safe. Just google "AIDS Committee of Ottawa" and "crack pipe," and you will have a lot to read from Ottawa's leading harm reduction advocates.

If you look at the data from Lynne Leonard study, you will see that yes, crack smoking went up, but there was also REDUCTION in the number of people who have been injecting drugs. This means less infections, better health overall, and less of a burden on the health care system.

The reality is that you can't just "get people to stop using drugs." Addiction is a disease, and there are numerous social and political factors which make the problem worse. Insecure housing, lack of proper nutrition, few community supports, poverty -- these are just a few.

Harm reduction is the first step, and for some people, the only step, in improving users' overall health, and reducing the burden on communities.

Besides, it is simply not rational to suggest that this is a "failed" program, in fact, it was showing significant signs of success.

This was a case of a Conservative ideology trumping public health. But the fight's not over.

Anonymous said...

It's a shame to see the same thing now happening in downtown Ottawa as happened in Vancouver throughout the '90s. Stop it now, or it will only get worse. Sandy Hill is starting to remind me of the West End...a fantastic neighbourhood that is rapidly going to shit.

"Harm reduction" has to be for the whole community, not just for the clients of the drug trade and drug services. Medical 'experts' involved in this kind of outreach have started to act more as ideologically-motivated activists rather than scientists. They never talk about prevention. For a high-profile example of this disingenuous activism by 'experts', take Dr. Tom Lampinen's (of the BC Centre for Excellence in HIV-AIDS) totally laughable comments to the effect that meth use among gay men is really about combatting the daily fatigue caused by anti-viral meds. C'mon - how about the fatigue caused by the high-octane non-stop Party-&-Play subculture which urban gay men are bombarded with (particularly the HIV+ among us). Besides, weren't anti-viral side effects also the rationale medical professionals gave for prescribing testosterone shots & viagra pills to an otherwise healthy generation of medicated HIV+ gay men? Brilliant prevention strategy, wouldn't you say? Such is the short-sighted judgment of the 'experts'.

Harm reduction on its own is pure ideology, not medical science. It was never meant to be a stand alone solution. Its proponents never mention the other three pillars that are supposed to accompany it: prevention, treatment, and enforcement. On its own, harm reduction undermines true prevention, dangerously tampers with accepted cultural norms by presenting hard-core drug addiction as a lifestyle choice rather than a social pathology, and ultimately creates more drug users & drug sellers...and, not surprisingly, creates more clients for medical 'experts'.

Dr. Tom Lampinen said...

The previous blogger suggests many harm reduction "medical 'experts'...have started to act more as ideologically-motivated activists rather than scientists." Count me out. I co-authored none of these harm reduction reports.

For 25 years, my career focus has been the "ounce of prevention", NOT "pound of cure". However, when treatment affects prevention, I study that too.

I am no 'expert' in meth use and - along with the previous blogger - I advocate healthy skepticism of statements made by those who purport to be. If there be meth 'experts', they are individuals who use it.

For that reason, our team solicited stories from more than 80 meth-using gay men, then spent months pouring over the audiotape transcripts. Among less-frequently mentioned motives for using this stimulant: to counter fatigue from HIV infection itself (not "fatigue caused by anti-viral meds", misrepresented by the previous blogger).

The very reason we inquired about motives for first and subsequent use of meth? To inform initiatives that aim to prevent its use!