Applauding the Start of the Harm Reduction Era

posted on April 25, 2016

By Dr. Julio Montaner, OC, OBC, MD, FRCPC, FCCP, Director of the BC-CfE

The BC Centre for Excellence in HIV/AIDS (BC-CfE) firmly supports a move towards a more people-centred and evidence-based approach to drug policy, as pledged by the Honourable Health Minister Jane Philpott in her statement at the UN General Assembly Special Session (UNGASS) on drug policy last week.

The global War on Drugs has for years forced people who use drugs -- and often their loved ones -- into the shadows. This creates barriers to accessing health care and addiction treatment; making it harder for public health services, care providers and support groups to do their important job of connecting with those hardest to reach.

Treatment as Prevention, pioneered by the BC-CfE and implemented in British Columbia with support of the provincial government, has shown that bringing HIV services to those in need where they are at saves lives, prevents new infections, and contributes to health care sustainability. The roll out of harm reduction, coupled with expanded HIV testing and treatment in BC, has led to a 90% decrease in AIDS cases and HIV mortality among HIV infected injectino drug users (IDUs) in the province, and a 65% decrease in the number of new HIV cases within this demographic, from 1994.

Since the opening of Insite in 2003, still North America’s first and only supervised injection facility, there have been no overdose deaths at the site. The number of fatal overdoses in the surrounding neighbourhood has decreased markedly, according to our BC-CfE research. Our research has also found people who use safe injection sites are 30% more likely to enter detox programs and 70% less likely to share needles. The rest of the world is taking note as places like Ithaca, NY, and rural parts of Indiana are now considering implementing life-saving supervised injection facilities.

Our data clearly shows when pushed into alleys and hidden spaces, drug users might engage in unsafe behaviour to acquire or use drugs. Sharing needles can lead to the spread of some of the most costly health burdens of our time, including HIV and other blood-borne diseases such as infection with the hepatitis C virus (HCV). It is in this context we applaud Health Minister Philpott’s visionary pledge at the Special Session on Drug Policy at the last UNGASS.

On Thursday, April 21, our BC Ministry of Health announced $5 million in funding for the BC-CfE to lead the monitoring and evaluation of hepatitis C treatment in BC, with a special emphasis on core transmitters, including IDUs, MSM and HIV co-infected individuals. Similarly, as we have shown in HIV, the individual and public health impact of highly effective HCV treatment will only be optimized if individuals can be proactively linked to testing, support, treatment and ongoing wrap-around programs. These programs must prioritize harm reduction strategies, as well as access to addiction medicine services.

Our Canadian government has taken a bold new step with the endorsement of a drug policy supported and validated by years of peer-reviewed, evidence-based science. We applaud this effort and look forward to working together with all Canadian partners to support, monitor, evaluate and refine the implementation of these life-saving programs.

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Applauding the Start of the Harm Reduction Era

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