HRV demands: 1. abolish 'no-service area,' 2. fixed site needle exchanges, 3. supervised consumption services, 4. a new “Four Pillars” Strategy

Establishing comprehensive health services for drug users entails developing multiple sites that provide the full gamut of harm reduction supplies and a variety of service delivery options.

Services include fixed site needle exchanges, mobile needle exchanges, outreach services, peer distribution programs, and supervised consumption services. Ensuring 24/7 access to services and supplies in multiple locations throughout the city is essential.

Most importantly, people who use drugs must be involved in the development, delivery and evaluation of these services.

As essential components of comprehensive health services for drug users, HRV is making the following immediate demands:

1. Abolish VIHA’s “no-service area”

VIHA’s “no-service zone” restricts mobile needle exchange workers from distributing safer drug use supplies in the blocks between Blanshard, Chambers, Balmoral and Yates. This area, which represents a two-block radius surrounding St. Andrew’s School, is heavily populated by people who use illicit drugs. The “no-service zone” further reduces already inadequate access to harm reduction and support services for the health authority’s primary target groups. The “no-service zone” contravenes VIHA's mandate of targeting high risk groups and providing “appropriate care, treatment and support to those already infected, regardless of where they live” (2006, p. 17). HRV demands the immediate abolishment of VIHA’s “no-service zone.”

2. Establish fixed site needle exchanges

VIHA’s service plan (2006) attests to the need for “comprehensive needle exchange” services, which include testing, counselling, health referral and contact tracing, among other services, offered together at accessible locations (p. 2). Since the eviction of the fixed-site needle exchange on Cormorant Street in May, 2008, no new site has been located in Victoria. All available evidence shows that relying solely on mobile exchanges results in a dangerous lack of associated health services, such as health referrals, and counselling. Mobile exchanges have also led to a dramatic reduction in distribution and recovery of syringes (Pauly, 2008; VIHA, 2009). HRV demands the establishment of suitable and well-equipped fixed-site needle exchanges throughout Victoria.

3. Supervised consumption services

The Health Officers Council of BC has called on health authorities to develop supervised consumption services, maintaining that “supervised injection services have been studied enough as research project, and that it is time to move them into the mainstream of health service provision” (Health Officers Council of BC, 2008). This recommendation follows nearly a decade of recommendations in reports commissioned by both VIHA and the City of Victoria (Fischer, 2007; City of Victoria, 2007; VIHA, 2006; City of Victoria, 2005; Stajduhar et al, 2002). These reports echo research conducted across the globe indicating that providing safe, clean and supervised environments for people using illicit drugs prevents overdose deaths, reduces harms, and connects drug users to other treatment and service options. In the wake of these reports, multiple public planning documents have committed to harm-reduction services in Victoria. Support for the development of multiple, integrated safe consumption services in Victoria has been voiced from the city, the police, the provincial health officer, service providers and drug users. A feasibility study for such services was even commissioned by the city and VIHA in April, 2007. HRV demands that VIHA and the City of Victoria work in active cooperation with drug users to create supervised consumption services (SCS) by 2011.

4. A New “Four Pillars” Strategy

Strategies to address the harms related to drug use must recognize the importance and interconnected nature of suitable housing, health care, income and supports. The importance of housing, income and supports in accompanying the provision of health care services for drug users has been recognized in numerous recent reports. VIHA’s Closing the Gap (2006), for example, mentions community care, mental health services, supported self-care and housing support (p.2). HRV holds that all strategies developed to reduce the harms of drug use must take an integrated approach to a new “four pillars” strategy: health care, housing, income and supports.