Mothers and fathers who encounter used needles around Maple Ridge parks and schools and the city workers and volunteers who pick them up got a bit of reassurance Tuesday.
“The actual risk of a needle found outside is about the same as a rusty nail or a piece of glass,” medical health officer Dr. Marcus Lem told council.
Blood-borne diseases such as hepatitis C or HIV don’t survive outside the human body, and to catch a disease would require an actual injection of blood.
“When they’re outside the body, they don’t actually survive very well.”
The risk of transmission of those diseases from a discarded needle outside is minimal, he added. It’s never happened for HIV and only once with Hep C, working out to about a 1 in 100 million chance of contracting the latter.
“There’s never been one transmission that is related to a discarded needle outside a health-care setting. It’s theoretically possible, but it’s never actually happened.”
Drug users, though, can spread disease when they share needles on the same occasion.
Lem, though, shares concerns about the numbers of needles found around Maple Ridge and wants to work with the city.
He, along with Fraser Health harm reduction coordinator Erin Gibson, explained the ideas behind harm reduction and providing clean needles to drug users.
But Mayor Nicole Read wanted more than generalities. While she understands the risk, finding needles in parks and on school grounds is still stressful for people, she added.
How many needles are given out and how many come back, she asked.
“We have actually found needles with blood in them,” Read added.
“We’re finding a significant amount of needles in our community. So it would be helpful for us to understand how you pick them up.”
Gibson didn’t have the number of needles collected in Maple Ridge, but added it would be misleading because drug needles come into the city in many ways, from steroid users, from veterinary use, pharmacies, as well as the harm-reduction programs delivered by Alouette Addictions Services and The Purpose Society.
“The important number is the inappropriate discards.”
People also want to know why there is no one-for-one needle exchange, Read said.
Determining the numbers of needles collected would be laborious and would require breaking open the sharps boxes and counting the needles and separating those used for illicit drugs, from diabetic needles, from needles that come from pharmacies and those used to inject steroids, from those given out by harm reduction agencies.
But Lam knows the number of needles given out has increased in recent years.
“But we still want to be distributing more because we know that distributing more to people who need clean supplies will decrease transmission of disease.
“But we just have to make sure we recognize the fears and concerns of the community,” and put in good measures for disposal.
Read wants Fraser Health to collect the needles so that residents and city workers don’t have to. Currently, the city’s website tells people to call the city (http://www.mapleridge.ca/1047/Harm-Reduction-Programs-The-Needles).
There’s no money for cities to pay for needle collection, Lem said.
But he added later that Fraser Health can work with the city to identify locations where needles are found, install sharps boxes and work with the agencies such as Alouette Addictions Services or The Purpose Society so they can pickup discarded needles. If manpower is an issue, Fraser Health can work to improve that, he said. That procedure is already followed in other cities.
If someone finds a needle, they call Fraser Health, which will contact the agency distributing the needles.
“That’s what we’ve said we can already do.
“Sometimes we have to formalize our lines of communication. That’s what we have to do,” Lem said.
The authority is also paying for the new rig-dig program, in which users collect needles. That’s been in place in Maple Ridge for a month.
The pair told council that providing free needles doesn’t solve the drug problem, but neither did it cause it and it won’t lead more people to try drugs.
“We recognize that drugs are illegal and we recognize that drugs are not a good thing,” Lem said.
Harm reduction is a proven concept, said Gibson.
“There are mountains of evidence around this and it’s been demonstrated as cost effective.”
She noted that 80 per cent of drug users don’t need treatment.
As well, having addicts bring in their used needles for new ones is one way of connecting drug users to the health-care system, which could lead to future changes.
“To have someone tell them that they deserve to be treated with dignity and compassion is quite profound.”
Lem explained later that needle exchanges don’t work because addicts aren’t that organized. If they had everything under control, they likely wouldn’t be drug users.
“Having a one-for-one is actually an impediment to having people access clean supplies.”
Since 2006, thanks to harm reduction, the rates of Hep C and HIV transmission have been cut in half in B.C. because of such measures.
Coun. Gordy Robson, though, said The Purpose Society health van is giving out needles without asking for used ones in return.
“I think you’re part of the problem, not the solution,” he said to applause.
However, Gibson said she has been in the van when it visits Maple Ridge and it does seek to collect used needles. It’s also provided volunteers with needle collection or sharps boxes.
Coun. Corisa Bell wondered, though, if that only enables users.
Lem said he used to think that way when he was a medical student before harm reduction was the norm, when many doctors shunned drug users because they didn’t want to condone drug use.
Then he had a patient who was a drug user who couldn’t get services. He used a dirty needle, got HIV and developed abscesses. He had to go into hospital for weeks at a time and became a health risk to medical staff and cost the medical system thousands of dollars.
“That’s actually what changed my mind.
“I used to think exactly the way you thought,” he said to Bell.
It’s not just street people who are affected, many people are, he added.
“Why do people use drugs?” Lem asked. “People use drugs because there’s something missing and they’re seeking to replace it.”
No one questions harm reduction, countered Read.
“The challenge now is, we need to get the needles off the streets.” It’s not just about providing or installing sharps boxes, needles need to be removed from the street, she added.
“I just really need you to be thinking about that.”
If that involves another area of Fraser Health, the city will work to find a solution, she added.
In 2011, three years after Alouette Addictions Services took over needle distribution from the public health unit, demand increased from a few hundred syringes to 5,000 distributed every three months.
Residents though questioned council after the meeting, with two people saying it took hours for the city to respond to a call about a needle being found.
• According to an article http://www.bccdc.ca/NR/rdonlyres/4E145403-D047-49CA-A592-768FEBF6025A/0/BestPractices.pdf about best practices for harm reduction on the B.C. Centre for Disease Control website, harm reduction programs must “provide a robust recovery and disposal system because inappropriately discarded used injecting equipment undermines the credibility and sustainability,” of harm reduction programs.