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Needle exchanges a Canadian success story

Dear Editor,

I am writing in response to the letter “Drug users need tough love, not needle exchange”, by Chansokhy Anhaouy (October 2). Anhaouy is mistaken in her assessment of needle exchange generally and of the impact of needle-exchange services in Vancouver, British Columbia, versus New York city.

Needle-exchange services are a key component of a comprehensive approach to preventing HIV and other avoidable harms associated with injection drug use.

This fact is recognised by numerous international health organisations, including the World Health Organisation, UNAIDS and the UN Economic and Social Council. Not providing sterile syringes puts not only injection drug users, but also the general population at risk.

I was born and raised in Vancouver and have followed the injection-drug issue here for 20 years. During the 1990s, HIV and drug overdoses in Vancouver were at epidemic proportions.

However, in the last decade – after the widespread implementation of needle exchange – these problems have been reduced significantly. In 1994, British Columbia’s rate of new HIV cases was 23 per 100,000, but by 2006 this number had been reduced to fewer than nine per 100,000.
By contrast, New York city’s rate of new HIV case in 2006 was 72 per 100,000 – three times the US national rate of 23 per 100,000!

Anhaouy’s “tough love” suggestion reveals a callous attitude that does not reflect the values of most Vancouverites, who overwhelming support harm-reduction services. Addiction is a complex health problem, and simplistic “just say no” attitudes are no solution. If criminalisation were a useful approach to public health, then we ought to start arresting and imprisoning people who engage in other unhealthy activities, such as tobacco-smoking, alcohol-drinking or sedentary lifestyles.

However, there is ample evidence showing that treating people who are sick as criminals does not help them to recover from their illness, it only makes things worse.

It is cruel and inhumane to advocate that governments withhold a proven health intervention such as needle exchange.

Kenneth Tupper
University of British Columbia

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