Vancouver gives harm reduction a shot in the arm with clean needle program

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Vancouver’s clean needle program — Insite — is an excellent example of harm reduction as a public health measure. The New York Times reports that, thanks in large part to Insite, the only “safe injection site” in North America, Vancouver has seen a 52 percent reduction in new HIV infections since 1996, even as other cities are experiencing an increase. According to the most recent data, this decrease in HIV incidence, along with decreases in hepatitis B and C — also spread by injection — occurred even as syphilis rates rose, demonstrating that safer sex practices such as condom use and abstinence did not account for the HIV reduction. Insite provides clean needles to addicts, which they’re not allowed to share with anyone else. Also required are HIV tests leading to treatment with antiretroviral drugs for those who may be infected with HIV. By getting most of the infected people onto appropriate medications, the program has shown the above-mentioned reductions in the whole community’s rate of new infections. Nurses supervise and administer medical care such as bandaging of abscesses associated with dirty needles, STD tests, and even treating drug overdose. In the U.S., the federal government is conducting a three-year study of a similar “test and treat” program in the Bronx and the District of Columbia.

While many cities oppose such programs for fear of enabling and encouraging addicts to continue using drugs instead of quitting, ACSH’s Jonathan Leaf believes these programs are more likely to have the opposite effect. “Do you really think a potential drug user would say ‘Oh yeah, I’m going to be a junkie now because after all, they’re giving out free needles, so it’s ok.’ If anything, that person would say ‘Now that the government is giving out free needles, it’s not cool anymore to shoot up.’”

Further, ACSH’s Dr. Josh Bloom points out that the benefits of these harm reduction initiatives would reach beyond just HIV reduction. “Transmissibility of hepatitis C by needle is ten times higher than HIV. The incidence of this and other diseases associated with intravenous drug use would be dramatically reduced by such initiatives.”