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Clean Needles and...?

Allan Schwartz, LCSW, Ph.D. Updated: Feb 8th 2011

Clean Needles and...?Today, February 8 2011, important article appeared on the front page of the science section of the New York Times. The title of the article is, "An H.I.V. Strategy Invites Addicts In." Dr. Julio Montaner is the leader of a program in the City of Vancouver British Columbia, Canada, called Insite. He is also the director of a program at St. Paul's Hospital's AID's program.

Insite is located at a poverty stricken section of the city where IV drug abuse is a chronic problem along with H.I.V. There, addicts are allowed to bring the drugs they purchased on the street. Their dirty needles are collected and clean needles are distributed. They shoot up their drug of choice and are medically treated if they over dose. As a result, there have been no deaths due to overdose since the founding of the program six years ago.

There, staff nurses provide medical care, by treating skin infections, offering GYN exams. Condoms are also distributed to help prevent the spread of HIV. For those who have the virus, addicts take medications by injection to reduce the amount of virus in their bodies. No one is forced to receive medical care. Patients know that this is where they can receive clean needles and shoot up in a safe environment. However, many are more than happy to receive medical care, condoms, retrovirus injections, and, etc.

The results of the program in Vancouver are that, new cases of HIV have dropped by 50% annually, crime has reduced, dirty needles littering the streets near the program are reduced and the numbers of cases of Hepatitis due to dirty needles have also been significantly lessened.

Controversy, Questions and Opinions:

Of course, all of this raises serious controversy and questions about addiction and its treatment. Does providing clean needles and a place to shoot up encourage more addiction? Does a program like this send an implied message that drug abuse is acceptable? Does it discourage people from seeking drug rehabilitation? Is something that is illegal made legal by implication? Should the United States provide this type of program? While this country does provide clean needles, it does not offer anything like Insite.

These are serious questions to be explored especially at a time when addiction is increasing at alarming levels. That is why I want to encourage a discussion, here, about these questions.

What are your opinions, pro and con, about the Vancouver experiment and its possible use in the United States and other nations?

Allan N. Schwartz, PhD.

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at for details.

Reader Comments
Discuss this issue below or in our forums.

ignorance is not bliss - Debora Collins, MA, tLLP - Feb 8th 2011

Though I don't know the efficacy of this program toward eliminating IV (or other) drug use, it is naiive and childish to pretend that it either does not exist or that it can be fully eliminated. 

Whatever the opinion is on drug use is not really a concern of mine.  Rather, it is time to face the reality that what we have been doing (in America) does not work, and it is time to think outside of established mores, laws, ideals.  The USA could benefit from expanding its collective mind and being more experimental and understanding.  We can learn from, and then expand on, what we learn from other countries...

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