Safe drug-injection site sought:

B.C. facing worst hepatitis C epidemic in the Western world

ROD MICKLEBURGH

British Columbia Bureau

Thursday, March 2, 2000

Vancouver -- Faced with the worst

hepatitis C epidemic among needle drug

users in the Western world and continuing

high AIDS infection rates, health experts

here are pressing their call for North

America's first sanctioned site for the safe

injection of illegal drugs.

"We have to stop looking at this as a

criminal issue rather than a health issue,"

Dr. Perry Kendall, the province's health

officer, said yesterday. "There is still a lot

of resistance to the idea, but I think we're

getting there. I'm optimistic."

His comments followed the disclosure by a

leading AIDS specialist that up to 90 per

cent of injection drug users in B.C. are

infected with hepatitis C.

That is the highest reported rate in the

Western world, according to Dr. Michael

O'Shaughnessy, director of the B.C.

Centre for Excellence in HIV/AIDS.

"The projected costs of this epidemic to the

health-care system are estimated to be in

the millions of dollars," said Dr.

O'Shaughnessy, noting that treatment is

complicated by the fact that more than 25

per cent of infected drug users also have

the AIDS virus.

"We need to wake up to the very real

implications of hepatitis C on our

health-care, social-services and justice

systems."

He based his findings on his centre's

continuing study of 1,500 injection drug

users living on the city's drug-ravaged

Downtown Eastside, where an estimated

5,000 to 7,000 people inject drugs such as

heroin and cocaine.

Dr. Kendall said he is disturbed by the high

incidence of infection among drug users.

Unless measures are taken soon to combat

the spread of hepatitis C, the province

will be confronted with an inordinate

demand for liver transplants within the next

five to 15 years, as the disease takes its

toll, he warned.

Hepatitis C, which attacks the liver and

can be fatal, is generally far more acute

among injection drug users because so

many also suffer from other serious health

problems.

Dr. Kendall said anecdotal evidence is

very strong that comprehensive, safe

injection programs in European cities such

as Frankfurt have reduced the spread of

HIV infection and hepatitis C among drug

users and dramatically cut the number of

deaths from drug overdoses.

He said authorities here should even

consider a clinical trial into the effects of

providing prescription heroin to drug

addicts, as is the practice in several

European countries.

Dr. Kendall said Canadians have shied

away from the idea of providing safe

locations for injecting drugs because of

proximity to the United States, where the

emphasis is on crime prevention instead of

harm reduction.

"So, the result is that we have lots of

unsafe shooting sites."

Diane Riley, the Toronto-based deputy

director of the International Harm

Reduction Association, said she was

ashamed of Canada's failure to try to

reduce the harmful effects of needle use

by drug addicts through safe injection sites.

"I have been to extremely poor countries

where they do far more with less than we

do with all our resources. It's shameful,"

Ms. Riley said. "The only barrier I can see

is the political will."

She said very recent data from Australia,

which has a strong harm-reduction policy,

indicate that the rate of hepatitis C

infection among drug users has been cut by

20 per cent, while the incidence among

new users is down 40 per cent.

"We absolutely need to look at this here.

We cannot not do it."

She said the Australian results are

remarkable because the spread of

hepatitis C is harder to control than the

AIDS virus, since there are more methods

of transmission.