Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Sunday, November 29, 2009

516,000 Too Many

The City of Ottawa has a long-standing active program to assist people with a drug habit, supplying them with needles in an effort to prevent the re-use of needles in an attempt to halt the incidence of HIV/AIDS and other disease transmission such as Hepatitis C-virus, among the homeless population of the city. This is a tough issue, amounting to enablement in the sense that public health is assisting drug users by default.

When it might seem far more intelligent to construct a program to deflect people away from recreational drug use, toward full rehabilitation, not what might seem like encouragement toward ongoing drug use in an environment obviously more sterile than a city sidewalk. It is a tough call. To their credit the city's Clean Needle Syringe Program, considered a required public health measure, is meant to provide access to harm reduction equipment.

It also provides a forum for health education to promote safety and to help minimize risks associated with substance use, providing referrals to addiction treatment services and social service agencies. In theory. The question is what percentage of clients take advantage of those additional services? It also provides anonymous HIV tests, tests for Hepatitis B and C, gonorrhea, Chlamydia and syphilis.

Contraception-use advice, pregnancy tests, and general counselling are all available for these societally-marginalized people strung out on drugs. And whose homeless mode of living sees them suffering ill health from both addiction and lifestyle. The controversial (among the general public) program references a harm reduction approach to reduce further health risks associated with drug injections. The intention is good, and needed, but something seems to be missing.

First of all, the condition of homelessness itself must be addressed. Until the homeless are convinced that they stand to gain from taking advantage of a permanent, secure address, not an awful lot can be accomplished. Unless thinking that lecturing people utterly disinterested in the content of those lectures, waiting them out to secure their free needles is really accomplishing anything but a miserable holding pattern of tragic existence.

How can health authorities, concerned for the well-being of these afflicted people feel they are accomplishing anything remotely useful, when all those educational programs, and the attempts to provide services that are not sufficiently made use of, hit their mark? When the most basic of indices, a sense of personal responsibility to properly discard the free needles hasn't been instilled in those same users?

Ottawa Public Health, among other concerns has had to make a strenuous effort to retrieve over a half-million carelessly discarded needles thus far in the year, an increased total over last year. The public can call into a hotline to report needles littering the streets, and needle hunters do find that enormous number heedlessly discarded on the streets. "It's an ongoing challenge", is the understatement expressed by Ottawa's chief medical officer of health.

The focus needs to be on total remediation, on fundamental programs that assist the addict to find their way out of their life-consuming addiction. The patchwork program currently in use hasn't resulted in an improvement of the situation. Rather, it appears that the addiction demographic has increased, judging from discards. The free-needle program emphasizes to people the need to return them for safety-disposable reasons. Even that little message is not getting through.

It's time the city got really serious about this. Committing resources to placing the homeless in permanent, reliable and secure housing situations. Where social service agencies can make house calls, encourage the residents to begin to take small steps to personal responsibility beginning with taking that huge step toward commitment to their rehabilitation, shedding drug use and aspiring toward a normal life.

It could not possibly cost more in planning, energy, dedication and funding than the current patchwork of emergency medical treatment, incarcerations and utter social dysfunction currently in practise.

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