A city of addicts

With 50-85 clients passing through every day, Karen Burton’s office is anything but quiet. Enduring unpredictable line-ups, long wait times and the occasional 9-1-1 call, clients wait patiently for the free product she provides: needles used to inject drugs.

Karen Burton is the co-ordinator of London’s Counterpoint Needle Exchange program, a service set up by the AIDS Committee of London operated from their downtown centre. The exchange helps to prevent the spread of HIV by handing out free needles to injection drug users — giving them a cleaner and safer way to shoot up.

“We realize we can’t stop drug use, but what we can do is not pass judgment on our [clients]. We say to them, ‘We realize you do this, so let us help you do it as safely as possible,’” Burton said.

According to government statistics, needle sharing is the second highest contributor to the spread of HIV in Canada, falling closely behind sexual transmission.

The trouble with drug addiction, Burton said, is that withdrawal symptoms can override common sense. Addicts won’t stop to think about the safety of their needles when they need a quick fix.

“All our clients are doing is trying to prevent sickness,” she said. “If somebody were to offer you half a syringe full of something and you were really sick — you’ve got diarrhea, you’ve got the sweats, your bones are aching, you’re just in agony — chances are you’ll take it.”

The program also offers condoms and snort kits consisting of clean straws — essentially anything that will help reduce the spread of HIV.

Employees are trained to keep an open dialogue with clients to encourage a relationship of trust. Through this relationship, they try to bring clients toward the decision to get sober.

“We run on kindness. Sometimes we’re the only smile [our clients] get that day, sometimes we’re the only conversation,” Burton said.

“Kindness and acceptance of a situation makes people want to come to you when they’re willing to get sober. Clients know that if they go back to injection drug use [after trying to quit] they can still come pick up clean needles. We don’t want them to feel ashamed of coming to us — ever.”

Depending on the client’s needs, workers will refer them to appropriate detox or rehab facilities once they’ve made the decision to get sober. If a client is HIV positive, they will try to get them into specialized group housing like the John Gordon Home — an HIV support home named after a former King’s University College student who passed away from HIV.

The struggle with injection drug use and HIV prevention is found in many communities, including one in Vancouver — home Insite, North America’s first safe-injection site.

“In the neighborhood we live in — the downtown East side [of Vancouver] — people who were doing drugs were dying needlessly from overdose. They were catching HIV and AIDS from dirty needles,” said Mark Townsend, executive director of the Portland Hotel Society and co-manager of Insite. “It was depressing. We knew we had to do something.”

After conferencing with international health and drug professionals, the chief of the drug squad in Frankfurt, Germany, advised the city to try a safe injection site — a sterile and medically supervised environment where people can inject drugs.

The site — like London’s needle exchange — is funded by the government and charitable sources. Since opening in 2003, Insite has had over 1.5 million visitors. In 2009 alone, the site saw 276,178 visits by 5,447 different people.

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