Harm reduction drug policy

Abstract

Evan Wood and colleagues refer negatively to the Institute on Global Drug Policy and the peer-reviewed medical journal The Journal of Global Drug Policy and Practice. The Institute, founded in 2000, consists of physicians, attorneys, and other highly regarded international experts on drug policy. Rather than accepting harm reduction policies in the way that so many in the Canadian drug policy community have, we have looked closely at the science and eff ect of such policies. Much like the emperor’s new clothes, harm reduction policy has been blindly accepted rather than critically examined. I feel that the meta-analysis we published, which clearly delineates the questionable eff ect of needle handouts, and the fi ndings of others, showing that needle exchange programmes have had marginal eff ects, should be considered. The assertion is made in another article by Wood and co-workers that one of the reasons for a high HIV incidence of 18% in the needle exchange programme was that those addicts using the programme daily constituted a sicker and less functional addict population. However, the fact remains that the longer the exposure to the needle exchange programme and continuing cocaine use, the greater the risk of HIV conversion. The risk is higher for the addict who takes cocaine daily and who also uses the programme daily, but even the non-daily use of cocaine and non-daily programme use showed increasing risk from 4% at 12 months to 9% at 48 months. By publishing a full-page opinion piece such as the one by Wood and colleagues, The Lancet Infectious Diseases has engaged in the “dissemination of opinion essays” that Wood refers to in such a critical manner.