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Harm Reduction: Less harm from drugs and drug policy

People have used psychoactive substances since prehistoric times, and only in the past century or so did it gain the stigma of illegal status, and only a seemingly random pattern of determination as to what is legal and what is illegal. Alcohol use is Constitutionally protected, but that status is not afforded all drugs of equal or lesser harm to society. The FDA approval process allows truly dangerous drugs to be mass marketed. The National Institute on Drug Abuse (NIDA) recognizes studies that are selected on a political rather than scientific basis. And the legal status of medicines is determined not by doctors, but by law enforcement -- Drug Enforcement Administration.

Harm reduction is a policy approach that minimizes the harms caused to the individual and society by drugs and drug laws. The Drug Policy Alliance is a leading proponent of this approach.

Vancouver injection room a success * Vancouver crack room planned * European Union * United Nations * Drug crackdown makes things worse

Tell me about marijuana to help get off hard drugs

Tell me about ibogaine

Tue, 21 Sep 2004 18:20:29 EDT Written by CBC News Online staff

Canada: Addicts, health officials trumpet success of safe injection site

VANCOUVER - One year after the opening of Vancouver's safe injection site for heroin addicts, health care officials say it is a resounding success.

Safe drug injection sites aim to fight the spread of blood-borne diseases.

The injection site in the city's Downtown Eastside is meant to provide a safe place for addicts to shoot heroin or smoke crack and crystal meth under the supervision of health care workers.

Proponents said the clinic has saved lives, cleaned up the streets and slowed the spread of diseases like HIV. The clinic is part of a three-year, $3.7-million pilot project funded by Health Canada and the B.C. government.

Greg Liang credits the site with saving his life by preventing an overdose. "It was really good heroin," recalled Liang. "I just started to fall asleep. And what people do is they stop breathing and my breathing got really shallow and they picked up on it right away and gave me oxygen."

Ida Goudreau, CEO of the Vancouver Coastal Health Authority, said more drug users than expected are visiting the site, and many are being directed to treatment to wean them off heroin.

"It has exceeded the expectations that we within the health authority had for it," Goudreau said.

The harm-reduction approach works, according to Alex Wodak, the director of alcohol and drug services at St. Vincent's Hospital in Sydney, Australia.

"If it is easier to get help from drug treatment than a drug dealer, it's possible for that community to make progress," said Wodak.

"On the other hand, if it is easier to get help from a drug dealer than it is from drug treatment, then that community is going to go backwards."

A report commissioned by Health Canada on the site's first year of operation will be released on Thursday, outlining its successes and failures.


Vancouver Courier (CN BC) Mon, 30 Aug 2004. Contact:

Website: Details:

Vancouver mayor says legal crack smoking room is no pipe dream

Author: Mike Howell

Despite opposition from the Vancouver Police Department, Mayor Larry Campbell supports opening a room inside the city's legal injection site for addicts to smoke rock cocaine. Campbell told the Courier Wednesday he will speak to Health Canada next month about getting the appropriate exemption to open a safe inhalation room.

"I'm completely for it," said Campbell, who is chair of the police board. "We've already got the room there, it's set up, how much more does it take?"

Two weeks ago, the Rock Users Group, a branch of the Vancouver Area Network of Drug Users, announced it wanted Insite-the current supervised drug injection site on East Hastings-to provide a safe inhalation room in the building.

In response, the police commander for the Downtown Eastside told the Courier the group's request wasn't based on credible research proving smoking crack in a government-approved site would benefit addicts. Insp. Bob Rolls said an inhalation room would move criminal activity indoors and create potential violent situations from addicts suffering from cocaine psychosis.

The mayor, who was recently on holidays, said information from Europe and Australia supports the merits of safe inhalation rooms. He laughed when told of Rolls' comment regarding moving criminal activity indoors, pointing out that addicts injecting heroin and cocaine at Insite also moves criminal activity indoors.

"I don't think Bob thought that through, but obviously what we need to do is bring scientific evidence together so that everybody is comfortable with it," Campbell said. "I'm quite certain that if I spoke to the chief of police [Jamie Graham] about this, that we would have them on board. It certainly lessens their job."

When he visited Switzerland earlier this year, Campbell said he toured an injection site that also had a room for crack smokers. Authorities there told him the smoking site made sense and its clients hadn't caused problems.

"I sat in a room in Zurich and watched people smoking crack. It was calm. The place was no different than the injection site."

Insite employs nurses and counsellors on staff to offer support for addicts requiring medical attention and to help them break their addictions. Campbell said he would like to see the same attention paid to crack smokers, despite Rolls' concerns about cocaine psychosis and violence.

Health care providers on site could diagnose a psychosis, he said, noting "any time you can get people off the streets and into a place where you can get contact with professionals, it's a positive."

Crack addict Rob Morgan, who belongs to the Rock Users Group, said he was encouraged by the mayor's comments. "It's great news, I'm going to have to talk to him about this," Morgan said.

Morgan used a megaphone Tuesday in a rally along East Hastings to alert those attending about the needs of crack smokers. Addicts are met with violence in alleys and suffer from lung-related ailments from inhaling the chemicals contained in crude pipe screens, he said.

"We've got to make this happen."

His group also wants to distribute "crack kits" to addicts. The kits would include one Pyrex pipe, five brass screens, polypropylene mouth pieces, Vaseline, condoms and harm reduction reading material.

To open a room for crack smokers, the Vancouver Coastal Health Authority-which operates Insite in conjunction with the PHS Community Services Society-would have to apply to Health Canada for an exemption.

Clay Adams, spokesman for the health authority, told the Courier two weeks ago that there are no plans to lobby Health Canada to open a safe inhalation room.

Next month marks the first anniversary of Insite, a facility Campbell promised would be open-if he got elected-when he campaigned for mayor two years ago.

"Crack" is the street name given to cocaine processed from cocaine hydrochloride to a free base for smoking. The term "crack" refers to the crackling sound heard when the mixture is heated.

Common street terminology for crack cocaine is "rock" referring to the pellets of crack ( as opposed to a powder. ) Smoking crack delivers extremely high doses of cocaine to the brain very quickly and brings an intense and immediate high.

In a Vancouver study involving more than 1,400 injection drug users between May 1996 and December 2000, frequent crack use, defined as weekly or greater, increased from 18 per cent to 40 per cent between 1997 and 2000 among drug users in the city.

The study revealed crack use was more common among women than men ( 42 per cent versus 30 per cent ), those who had unstable housing ( 71 per cent vs 45 per cent ), and those who were HIV positive at the time of the study ( 28 per cent versus 20 per cent ).

Among women, those who were involved in the sex trade were more likely to use crack, which sells for $10 a rock in the Downtown Eastside.


UN Secretary-General addresses needle exchange programs and the AIDS Challenge

Report: Final Draft 2.doc [1/2]: Syringe Exchanges are safe and effective

21. The bulk of new infections continues to occur in men who have sex with men and injecting drug users, however. While prevention programmes consisting of AIDS education, condom promotion, needle exchange and drug treatment have proven effective, strong political determination is now needed in order to apply energetic prevention measures and reach out to marginalized people and their partners

74. However, recent political and legal reforms in some countries are opening more effective avenues to HIV prevention. Ukraine and Belarus, for example, now have multisectoral committees at the highest political levels, and have removed legal barriers to needle exchange programmes, substitution treatment and other approaches to HIV prevention among injecting drug users.

High-income countries

86. In high-income countries, HIV infections are concentrated principally among injecting drug users and men who have sex with men, although transmission through heterosexual sex is on the rise. Prevalence in the total population remains low. While some communities and countries have acted aggressively to limit HIV infection among injecting drug users, other countries have not. Needle exchange and other prevention programmes have been effective where implemented, but often the political costs of these programmes have been considered too high for implementation on a large scale. Among men who have sex with men, prevention programmes are more widely accepted and implemented, and as a result risk behavior and the resulting HIV infection rate has dropped significantly since the mid-1980s.

However, there is some recent evidence that risk behaviors may again be on the rise in some communities. There is a strong need for continued support for increased preventive efforts among men who have sex with men.


European Council to focus on Harm Reduction

The Council of Europe's Parliamentary Assembly's Social, Health and Family Affairs Committee on Tuesday adopted a report calling for member states to concentrate on harm reduction, saying legal sanctions against drug possession and use have no effect. The report will be part of draft recommendations to be debated in the Parliamentary Assembly later this year. The URL to access the COE's press release is:


Anti-Drug crusades often make things worse

Here are two links that explore the question of how repressive drug policies often lead to worse consequences, such as turning people to heroin, crack, methamphetamine and ice by making it more difficult to get a relatively safe drug like cannagbis.  

NIDA study links marijuana crackdown to increase in methamphetamine "ice" in Hawai'i.

FCDA literature and PDF files



Medical Marijuana

Judge Young on Medical Marijuana

Prosecutor's Advisory Panel

Needle Exchange, Harm Reduction


Death Rates




Other Voices

Effective Policy

International, Peru, Colombia. Mexico



Drug Truce

Shattered Lives

Safety, Vaporizers

Zero Tolerance

Medical Marijuana Updates


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