In 2002, the province of British Columbia adopted a needle distribution policy that was supported by the BC Centre for Disease Control and the Ministry of Health. The stated intent of the policy, and the province-wide taxpayer funded program of distributing free needles to intravenous drug users that resulted from its adoption, was to reduce the potential health risks associated with re-using and/or sharing needles. These health risks primarily involve the spread of communicable diseases such as HIV, Hepatitis C, and Hepatitis B.
The needle distribution program instituted by the Province is part of an overall “harm reduction” approach to assisting people with substance use addictions that has been accepted as a best practice model world-wide. Harm reduction is formally defined by the International Harm Reduction Association as: “Policies and programs which attempt to reduce the adverse health, social and economic consequences of mood altering substances to individual drug users, their families and communities, without requiring decreased drug use.”
The provincial needle distribution program initially required users to exchange used needles for new ones, but that model was abandoned by the Province some time ago as it was ineffective at addressing the main intent of the program because the strict “one-for-one” exchange policy simply caused many users to re-use dirty needles and/or break into sharps containers to get discarded needles to exchange for new ones. Harm reduction supplies are now provided freely and without questions asked or the requirement for individuals to return used supplies or to seek assistance for their addictions. Harm reduction kits include needles and other drug paraphernalia, condoms, and a small sharps container so the intravenous drug users can safely dispose of their needles.
Unfortunately, not all users use those sharps containers or others that are available in public places around the community. This has led to an increase in the incidence of discarded needles being found in various places throughout all communities, including playgrounds and parks. The safety issues associated with these discarded needles, especially the potential risk to children, has caused many to question who is now being exposed to “harm” by the Province’s “harm reduction” program.
In a 2005 publication entitled “Harm Reduction, A British Columbia Community Guide,” the Province recognizes that municipalities end up bearing “the brunt of the mounting costs for policing and enforcement” associated with drug and alcohol abuse and that “public order and safety may be put at risk by open drug use in communities.” The solution offered in this provincial document is that local governments take the lead in creating a coordinated approach to the community impacts of drug and alcohol abuse because “municipalities can exercise influence on policy areas such as public and community health, housing, social services, community safety, recreational services, development and zoning, licensing and by-laws.”
While municipalities may be able to “exercise influence” on social policy, they do not have any direct control or say in provincial policy development and provincial programs that may have unintended negative impacts in their communities. Local governments also receive no incremental funding or staffing to address the increased public safety and community health issues associated with the Province’s approach to harm reduction.
However, the provincial “Guide” challenges all municipalities to “provide leadership to support, or at least not impede, local responses to harm reduction” and sets out a process any local government can follow to facilitate a coordinated approach to harm reduction. Next week I’ll outline the steps we’re taking here to facilitate a coordinated response, one that also attempts to reduce the potential for community harm from the Province’s harm reduction strategy.