HARM REDUCTION: LIFESAVER OR TRAP?

From a safe injection site in Vancouver's Downtown Eastside to
Victoria's former troubled needle exchange on Cormorant Street, no
aspect of addiction services grabs more headlines than harm reduction.

For advocates, harm reduction is a lifesaver and a possible
introduction to a better life. It's a non-judgmental contact point
where someone struggling with addiction might, along with the health
benefit of getting clean needles or crack kits, ask for help to get
clean and sober. It's a chance to keep people alive until they are
ready for treatment.

"The old saying in harm reduction is that you can't treat someone
who's dead," says Victoria Coun. Philippe Lucas. He argues that
handing out clean needles is about keeping people alive and reducing
the spread of disease. "Keeping people alive through their alcohol
and drug using has to be a main goal of getting people into treatment."

Others say it's enabling addicts and trapping them in their
addiction. And that it's a service that society only finds acceptable
for street-level addicts and alcoholics - not for their parents,
children or friends.

David Berner, executive director of the abstinencebased Drug
Prevention Network of Canada, says "harm reduction" is really "harm seduction."

"It's bad science because it doesn't recognize the science of
addiction," he says.

"Addicts want more. You can give them a clean place to shoot up at
10: 15 in the morning and at 2: 30 they're in a back alley doing what
they always do because that's who they are and that's what they do.

"It's bad ethics because it's ugly and immoral. It's like walking up
to a drunk and handing him a clean shot glass. It's counter
intuitive. . And it's really bad public policy because we have to
spend public dollars efficiently and wisely."

Over the past 15 years, the harm reduction philosophy has been
embraced by the province. It is at the foundation of virtually all
provincially funded addictions services.

Those services have steadily expanded and now include clean needle
and crack pipe distribution; supervised consumption sites to prevent
overdose deaths; methadone maintenance treatment; and education and
outreach teams.

This year, Victoria council backed a policy paper that argued the
city should consider incorporating harm reduction opportunities in
its social housing strategy. The proposal foresees the possible
inclusion of supervised injection sites or provision of alcohol at
supportive housing complexes.

But the issue is coming to a head.

This month, the Supreme Court of Canada heard arguments about Insite,
the safe injection site that has been operating in Vancouver for
eight years. The court has to decide whether the facility falls under
provincial or federal jurisdiction. The federal government argues
that its Criminal Code jurisdiction trumps the provincial
responsibility of health care.

If the court rules in the federal government's favour, the facility
could be shut down. If it rules in the province's favour, more sites
will likely pop up around the country - perhaps including Victoria,
where advocates have been vocal about the need.

Yet society remains skeptical about harmreduction services.
Victoria's fixed-site needle exchange closed in 2008 due to repeated
disturbances, criminal activity, violence and refuse. Since then,
attempts to find a home for a needle exchange or distribution system
have been met with community objections.