REGINA — Saskatchewan is banning health providers from giving out pipes used for smoking drugs and has changed how they can exchange needles, a move harm reduction workers say will exacerbate the transmission of viruses.
The province said Thursday that third-party providers won't be allowed to use government funding to offer pipes or instructions on how to use them.
It also announced providers can only give out the same number of needles they receive. Previously, many providers gave out more than what they collected.
"Needle exchanges were always intended to be a one-to-one exchange and over time that has drifted, unfortunately," Mental Health and Addictions Minister Tim McLeod said in an interview.
"We want to ensure that the same number of needles that are going out are coming back through the exchange program."
Before the change, McLeod said pipe kits were made available through Saskatchewan Health Authority facilities and third party organizations.
He declined to say whether the province would pull funding from organizations that don't comply with the new mandate.
About five years ago, the province began supplying clean pipes to harm reduction organizations as a way to transition users to safer alternatives, such as smoking.
It was also meant to reduce the spread of HIV and hepatitis C. Saskatchewan has the highest HIV rate in the country, and most transmissions are acquired through intravenous drug use.
Robert Kraushaar, a harm reduction specialist with the Regina Area Network of Drug Users group, said he thinks the change will cause users to go back to using needles, as pipes won't be readily available.
"I don't think it's well thought out at all, and I think it'll be very detrimental."
He said those who use needles are at higher risk of transmitting infections. They also have a greater chance of overdosing, he added, as the drugs go directly into the blood stream.
A Saskatchewan Coroners Service report says 291 people died of confirmed drug toxicity in 2023, and an additional 193 died due to suspected drug overdose.
Kraushaar said he gives out clean needles but doesn't expect used ones in return. Instead, he goes out and collects them from the street.
He said he worries people will share them more often if they can't get clean ones.
"It's just going to be craziness. I'm not looking forward to seeing the after-effects of all this," he said.
Barb Fornssler, a professor at the University of Saskatchewan with expertise in public health and harm reduction, said the changes will increase disease transmission and go against established best practices.
She said having clean pipes readily available prevents users from sharing. Users can cut their lips on old and cracked pipes, she said, and if they have HIV and share the pipe with someone else who has lip wounds, they could pass on the virus.
"It doesn't seem to matter to (the province) the number of lives that are going to be lost because of secondary infection," she said.
"As someone who follows evidence and cares about people in the community, I am devastated."
When asked how the change prevents disease, McLeod said education and awareness campaigns will help.
He said funds not spent on pipes are to go toward community wellness buses, which are to provide primary health care and assistance to access additional support.
"There's a balance to be struck with community safety and public safety," he said.
"We understand the spread of blood borne illnesses is a very significant problem."
McLeod said providers can continue to use spectrometers to check drug toxicity. Drug testing strips will also continue to be available to police and those who use substances.
He added naloxone, a medication used to reverse opioid overdoses, will remain available at more than 400 locations in Saskatchewan.
In the fall, the province announced it would add 500 more addictions treatment spaces. More than 160 spaces are underway, and the province is also looking to establish a central intake system to make treatment more accessible.
Fornssler said treatment is part of the solution, but there are other measures, such as supplying clean needles and equipment, that can reduce harm and save the health-care system money in the future.
This report by The Canadian Press was first published Jan. 18, 2024.
Jeremy Simes, The Canadian Press
