Supervised smack shooting

>> A project to open government-run drug-injection sites is progressing, slowly

by PATRICK LEJTENYI

As far as pilot projects go, the multi-government supervised injection one, with sites opening in Montreal, Toronto and Vancouver, is proceeding apace--meaning the ball is rolling, but it is looking kind of mossy. The proposal finally got the government once-over in late September at the Health Ministers' meeting in St. John's, Newfoundland, and predictably there are lots of hurdles left to clear before heroin addicts can have a clean, safe place to shoot their drugs.

"There are a lot of issues here," says Dr. John Carsley of the Montreal Directory of Public Health. "The legal issue is the first and most important. The legal status is unclear because it's hard to have sanctioned activity where drugs are illegal. It requires a legal framework with the agreement of the health, social service, legal and police systems. As well as the users themselves."

According to a Health Canada report leading up to the September meeting, entitled, "Reducing the Harm Associated With Injection Drug Use in Canada," 125,000 Canadians inject drugs, leading to increasing worries about blood-borne diseases. Two-thirds of new hepatitis C infections, one-third of HIV cases and several hundred overdose deaths can be attributed every year to injection drug use. It is estimated that the direct and indirect costs of HIV/AIDS attributed to injection drug use will reach $8.7-billion over a six-year period. Something, it seems, has to be done.

Tell me something I don't know, says longtime drug-addict counsellor Normand Senez. The former addict, while not discounting governmental efforts at pursuing a supervised injection-site project, does think those involved--lawyers, politicians, even doctors--are so far removed from the reality of the streets and the addicts' lives that they will be in for a rude awakening. Not only from non-plussed citizens who will one day wind up with an injection site in their neighbourhood, but also from drug traffickers who will find their clientele being offered methadone and other means of kicking.

"These people will have to inform citizens and they'll have to inform criminals," Senez says. "Things have gone well in other places [with supervised sites, like Germany, Switzerland and Australia], but Montreal criminals are tough. They have to deal with the bikers and the Portuguese, Greek and Iranian families."

A fact not lost on the people who run Cactus, a Montreal needle-exchange service. Louis Letellier, the president of Cactus's administrative council, says that the very nature of the program, involving illegal drugs, attracts the attention of both crime and police.

"We want there to be no police and no surveillance by the police," says Letellier, "but this is a high-crime neighbourhood. We can't avoid a police presence." The Montreal police have not issued a statement on the program.

Still, Letellier is remaining optimistic about the chance for the supervised injection project to go ahead--at least in Quebec, where there is, he says, "a big opening. We can't go further because it involves a law on food and drugs, and that's a federal law with Criminal Code sanctions. But this project is not a panacea," says Letellier. "It won't solve all the problems of drug addiciton in Quebec, but it's a step."