In the past year, Canada has shifted its approach to drug users, going from punishment to a policy of harm reduction. The Dr. Peter Center in Vancouver, British Columbia, is one of the first "safe injection" sites in North America. Addicts who test positive for HIV can shoot up safely, under nurses' supervision. Safe injection sites provide clean needles, sterile water, cotton, and rubber tubing.

Although the provincial and federal governments have yet to sanction the policy through law, police are allowing the clinics to operate without interference. Vancouver's provincial government has approved plans for a three-year, $1.1 million pilot program, to be run by the Vancouver Coastal Health Authority, for an official safe injection clinic in Downtown Eastside that will open in September.

Canadian officials said they intend to combat HIV and to decrease overdoses. The Vancouver-based Harm Reduction Action Society, which advocates changes in drug laws, noted that drug overdoses in Frankfurt, Germany, decreased from 147 in 1991 to 26 in 1997 with the creation of safe injection sites. In Switzerland, the group said, drug overdoses also decreased, and markedly more people registered for methadone and other treatment programs.

"Somebody said, 'Why are we helping addicts?'" said Viviana Zanocco, a spokesperson for the Vancouver Coastal Health Authority. "The question is: Why shouldn't we? Are we only supposed to help heart patients?"

Zanocco also said the program makes good economic sense. "It costs about $150,000 Canadian [about US$107,000] to treat somebody with HIV," she noted. "If we can prevent 10 people from contracting HIV, the safe injection site pays for itself."

U.S. officials have criticized the Canadian policy. "The very name is a lie," said White House Drug Policy Director John Walters. "There are not safe injection sites. It can't be made safe."

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