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Enjronit + RioxcTiON tr «nate et Hyena {eter + React age one ite Tal nematic ‘Asoc ters» Rédaceussos Tom tne en ee Sep aha er Se mes Haney os ‘torial Felon «oar on réaction méiale ‘eWnlesen wre stent ca) anit Ric natn er aps termi duper News tor ect, rations les parcilnanipancesuivenec.c vei git pai “Sons Frc ernpecreertca Seamer acho eric reheat ‘he Scr ftnochro cn sutra Sadat bse ‘Seco Wary tee above) trl Adis + Nina de réaction ‘ane Cae coke comesy eo) tol Asians Ata acton wena casein ita rnca tener ean ey tote snoyecca Tejera ocemanasecmac) “amon Corner inaction Tiaie Source entating tr« Rédaciceiis Gs be hare Cay Peay Bobinon Editorial sed «Cane de actin lM Arango "al cama Tema borin Co ruin ‘ia en ark de Gu Ges, te eres ‘aid Fon Enanon Waith Gta Vnconer (Cool veer anon ‘lis ener ea ad Maher Onan ‘sen Pies Rinson) ‘di Pd ee ‘opal A Resin Teta) Note t set Nance chard Sh sh Medal ora, oon, ean Sander veh aan a ‘Sims amen Ai eile in CMA repens th pron Sethu al nx cet ee a Cane Shad ei Seana NAL The CA aes teers ar ay orcas og ram tar ar amis orion he ay naa Myst in CMA etc et ME Siac repro ade To ares cae el dar AM (ipl cere ANC) CAN WE ln ce emai cleo ae qu} ‘St gree crn ou eg a sel a cig ie Jt ra Sloper Eres epemions yore Cs CuayAMC Editorial Francais la page suivante Harm reduction: closing the distance ty ate har redon progr WwW a rough sell? One answer is that they appear to tolerate social phenom ena that are undesirable, hazardous or, depending on one’s perspective, the re sult of moral turpitude. Whether the is- sue is condom dispensers in high school ‘washrooms or methadone maintenance, for many people harm reduction repre- sents a capitulation before social ills that we ought to be routing out As for teen sex, the genie is out of the bottle. And, as to drug addiction, the chances of a rout are slim. Roughly 100 000 Canadians inject cocaine and heroin, Over one-third of new cases of HIV infection and more than 60% of now cases of hepatitis C resule from in- jection drug use.’ As Anita Palepu and Colleagues report in this issue (page 4415), emergency department visits for preventable injection-related complica- tions are common. In British Cokumbia, drug overdose is the leading cause of death in people aged 30 to 49. “Harm reduction is not a retreat from the high ground. Ir is the anly ground ‘on which to meet drug users in the here and now — a here and now that may include, in addition to the consuming fire of a chemical addiction, poverty, limited education, unemployment, a history of abuse and family dysfunction. Until now, in Canada, that meeting ground has taken the form of outreach and education, methadone maintenance and needle exchange. Methadone main- tenance, about the only effective treat- ment for heroin addiction,’ has been implemented only sporadically, mainly because of ideologie opposition. Simi- larly, needle exchange has had lirnted success. As Evan Wood and colleagues report (page 403), despite needle ex- change programs in Vancouver's Downtown Eastside, a substantial pro- portion of injection drug users still share needles. Th response to the growing crisis of (©2001 Canadian Metical Assocation rts Hcemars

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