By Marie-Jo Proulx
In the dead of night, somebody is making sure Centretown’s junkies have access to clean needles. For now.
The sharing of infected syringes among injection drug users has long been a public health concern in urban centres.
Following the AIDS epidemic of the 1980s, a number of Canadian cities developed community initiatives to reduce the spread of communicable diseases like hepatitis C and HIV. These programs have been successful at building supportive relationships with users and lowering transmission rates.
In Centretown, the Site Harm Reduction Program (the Site) was established in 1991. From a walk-in clinic in downtown Ottawa, it operates an exchange program where infected syringes can be turned in and replaced with clean ones.
The Site serves a cross-section of at-risk populations: low-income residents, sex trade workers and the chronically homeless.
But in the evening, when the doors close, the craving for drugs continues.
And so does the need for sterile needles.
To ensure overnight access to the service, a mobile van is staffed by nurses and outreach workers.
Every night of the week, from 6 p.m. to 11:30 p.m., the van rides across Centretown to supply clean needles to those who are willing to dispose of old ones safely.
But first, users have to call a number (613-232-3232) posted on the clinic’s door. A recorded message instructs them to leave a location and time for the transaction.
Beyond that point, very little is known about what goes on in and around the van.
An employee of the Site who said she is one of the people who goes out with the night van refused to provide any information about the service or its clients, citing a fear of losing her job for speaking to the media.
The Site is administered by the City of Ottawa’s Public Health and Long-Term Care Branch. Paul Lavigne, harm reduction project officer, currently runs the program.
Last year, he was appointed by the McGuinty government to a 16-member Ontario task force on hepatitis C.
Repeated requests for interviews with Lavigne were denied by the City of Ottawa’s Media Office.
Both the Site clinic and the van service are publicly funded. The latest available numbers put the program’s annual budget at $390,000.
The bulk of the funding comes from provincial coffers, but municipal taxes cover $82,000 of the total cost.
When newly-elected mayor Larry O’Brien unveiled his electoral platform on Sept. 7, the cancellation of Ottawa’s needle exchange program featured high on his “First 100 Days” list of priorities.
This was part of his much touted “tough on crime” stance, which also included measures like cracking down on youth crime and homelessness.
Hannah Cowen is a registered nurse at Oasis Health Services on Lisgar Street.
She says opposition to needle-exchange locations frequently comes from individuals in the community who don’t know the social benefits of the programs.
“People should find out more. Then, if they still want to object, at least they will know what they are talking about,” she says.
Kevin Barlow, executive director of the Canadian Aboriginal AIDS Network, which is headquartered on Bank Street near Cooper Street, says he understands those who may favour more prevention instead of increased access to clean needles.
But he insists that needle exchanges are an essential tool in the fight against disease transmission.
“For hard-to-reach individuals, we need a multi-prong approach. The costs and lives we save are definitely worth the investment.”
A 2002 University of California-Davis study supports Barlow’s contention. Researchers examined 29 needle exchange programs in Canada, the U.K. and the Netherlands.
They observed on average a six-fold reduction in HIV infections among injection drug users who swapped their dirty syringes for clean ones.
In 2005, according to official statistics, the Site recorded 19,000 encounters with injection drug users.
The exact number of needles exchanged under the cover of night is not available.
As an additional service to the community, every morning between seven and nine, the Site sends out small teams of people to look for and collect recklessly discarded needles in pre-determined locations. The so-called “Needle Hunter Program” is out-sourced to a social service agency and it operates from April to November.
Until further notice, and barring political intervention while taxpayers sleep, a mysterious van will continue to sweep the streets.