Ottawa's way of dealing with the health effects of drug addiction may have to change, the mayor said at a meeting attended by many residents opposed to giving out clean crack pipes and needles to drug users.

At a public discussion Monday night, Mayor Larry O'Brien spoke with a crowd of more than 100 residents on how to combat the city's problem with street drugs. The meeting was held at City Hall at the invitation of the Ottawa Police Services Board.

'It [needle exchange] may have to be conditional with treatment and it may have to be done in a controlled environment.'— Mayor Larry O'Brien

O'Brien said he agrees with the concept of "harm reduction," where the city tries to curb the spread of disease among addicts by distributing free, clean needles to discourage needle sharing. The city's public health department has been asked to review its needle exchange program to determine whether it should require addicts to turn in a dirty needle instead of distributing clean needles and collecting dirty ones separately.

However, O'Brien thinks even that might not be enough of a change to the program.

"It may have to be conditional with treatment and it may have to be done in a controlled environment," he said, adding that he is still working to get the province to open a drug treatment centre for youth in Ottawa.

O'Brien said he understands the concerns of many people in the crowd, who greeted his comments with a roar of cheers and applause when he recalled that in July, city council cancelled funding for a program that provides free crack pipes to addicts. The province has since agreed to provide the funding to continue the program.

Once the public was invited to speak, some residents such as Shirley Mosely said they don't like harm reduction.

"All the health-care workers in this city are so concerned about drug addicts, crackheads, bums, homeless people, but in my ward, last November, these innocent little children were pricked by a needle," said Mosely, who said distributing clean crack pipes and syringes ends up affecting everyone.

Aileen Leo, chair of the Somerset West Community Health Centre, warned that killing harm reduction programs won't solve the city's drug problems and will likely boost Ottawa's HIV and hepatitis C infection rates, which are already among the highest in the country.

She said the city needs to take an approach that includes harm reduction alongside enforcement, prevention and treatment.

"Yes, there are problems with discarded drug paraphernalia," she said, "but you won't solve those problems by trying to curb or kill harm reduction programs."