Many of the city's needle exchange programs don't require addicts to turn in a dirty needle in order to get a clean one, but that's not why used, dirty needles are littering the streets of Ottawa, says the head of a health centre that runs a needle exchange site.

Jack McCarthy, head of the Somerset West Community Health Centre, said the dirty needle problem has more to do with the fact that crack cocaine is more available than heroin in Ottawa. Crack produces a shorter high so must be injected more often, he added.

"People who inject crack through needles need a lot of needles to inject it," he said. "That's why you're seeing this proliferation of needles in Ottawa."

McCarthy said he believes a number of drug users went back to using needles after the city decided to stop funding its crack pipe program.

The program is still funded by the Ontario government, but McCarthy said users may not know where to get the pipes now that the city isn't supporting it.

The needle-exchange programs, funded by Ottawa Public Health, are intended to reduce the transmission of hepatitis C and HIV among drug addicts.

McCarthy's comments come after a homeless shelter in the Byward Market area decided to start giving out clean needles only to people who return dirty ones.

The Shepherds of Good Hope announced the policy last week after conducting an audit that found its needle exchange program gave out 2,000 needles and took back just 500 over 25 days.

McCarthy said a study by Ottawa Public Health in 2007 found very different results — the city received 118 needles for every 100 it gave out.

Serious problem

"So the program's working," he said.

McCarthy acknowledged that dirty needles in the streets are a serious problem.

"I think one needle on the ground is too many for sure," he said.

But one-to-one exchange programs don't work, McCarthy added, because many addicts put their needles into proper disposal containers such as a black box outside the centre before coming in to get new needles.

The number they have given back that way can't be verified, he said.

"But again, there still are dirty needles out there. That's why we've got to have the right solution here to this problem."

He thinks the city should boost the number of needle disposal containers in the city to make it easier for drug users to get rid of their used syringes, and should ramp up its needle hunter programs, which send people out to hunt for and dispose of dirty needles in the streets.

He added that restricting access to clean needles will boost the HIV and hepatitis C rates among Ottawa drug users to among the highest in the country, when they are already far higher than rates in Toronto.

Explanation rejected

Meanwhile, a man whose community activism helped prompt the Shepherds of Good Hope's needle exchange audit said he doesn't buy the explanation that the city's crack problem is responsible for the number of dirty needles littering the ground.

Chris Grinham, who lives in the Lowertown neighbourhood, helped organize the collection of 1,000 discarded needles across four blocks in six weeks last year.

"I've spoken to addictions experts. I've spoken to treatment experts, I've spoken to addicts themselves, and I've never heard that type of comment before. I think that's absolutely false," he said.

"I think it has to do with the implementation of the program and the lack of regard that Public Health has for these citizens in the communities of Ottawa."

He added that he thinks health officials are trying to deflect criticism away from the needle exchange program.

The City of Ottawa has run a needle exchange program since 1991. The official policy states that needles are to be exchanged on a one-for-one basis, drug users will be encouraged to bring used needles back when they receive new ones and they will be told about other locations where needles can be returned or exchanged.

Other major cities that have similar programs include Vancouver, Montreal and Toronto.