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Doctor fears needle disease outbreak

Tim Edwards
Northern News Services
Published Friday, March 13, 2009

SOMBA K'E/YELLOWKNIFE - Intravenous crack cocaine, a huge factor in the HIV and hepatitis C outbreaks in Vancouver over the last few decades, is becoming a growing problem in Yellowknife, according to one emergency room doctor.

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Dr. David Pontin took a break from his job as an emergency room physician to do an interview about the health problems intravenous crack cocaine poses to our community. - Tim Edwards/NNSL photo

Dr. David Pontin, a physician at Stanton Territorial Hospital, said he is beginning to see IV crack-related cases of hepatitis C in the ER.

In a letter addressed to the territorial government, Pontin wrote: "We have a situation here that is akin to kindling waiting for a flame. Our homeless population is highly addicted already and the introduction of IV crack use is the flame that will cause an explosion of HIV and hepatitis C." Crack cocaine in smoking form has given rise to hepatitis C and HIV problems in the past due to unsafe sex practised while on the drug. But melted down and injected, crack cocaine really kicks the spread of these diseases into high gear, he said.

"A hardcore heroin addict might inject twice a day. A hardcore IV crack user might inject twice an hour," said Pontin. "The chances of spreading illnesses like HIV or hepatitis C through dirty syringes explodes."

Dr. Pontin worked for many years at a downtown Vancouver hospital and saw the monumental problem the city faced with drug addiction and communicable disease.

Upon moving here a few years ago, he saw a strikingly similar demographic. The downtown homeless population accounts for the majority of the ER visits to Stanton, he said, and most of those visits stem from drug or alcohol problems.

"It may be an early alarm bell," said Pontin. "But it's an alarm bell nonetheless, and we need to take this very seriously."

He said if nothing is done now, the costs to the public may be high. Not only is the prevalence of communicable disease a huge risk to public health, but if the diseases are improperly treated, problems like multi-drug-resistant HIV arise.

What Vancouver has implemented in order to curb the rocketing rates of syringe-spread disease is a "syringe exchange program," and the highly-controversial and experimental Insite - a supervised facility where drug users can come and ingest their previously acquired substances in the safest manner possible. The cornerstone of an addictions management program, according to Pontin, is having a needle exchange program in place to curb the spread and then talking to the addicts about getting off the drugs with things like detox programs and long-term treatment programs.

"First of all, before all that, it's a cultural kind of change (that needs to take place)," said Pontin.

"We're moving farther and farther away from this idea that addicts are criminals, but if you look at addiction as a health problem - as a chronic health problem - it is the most treatable and curable of all health problems."

The situation is getting dire, and serious action needs to be taken before this problem has a chance to get worse, said Pontin.

Dr. Cindy Orlaw, the NWT's chief medical officer, said she only recently became aware of intravenous needle use in the city but that doesn't mean it's something that should be taken for granted.

"It's a drug you don't experiment with, because if you do crack cocaine once you're addicted forever and you'll never get that high again," said Orlaw, adding that people try crack cocaine intravenously in an attempt to reach a high they used to get by smoking it.

"It does not do that," said Orlaw.

- with files from Mike W. Bryant