Drug addicts should only be allowed to receive a clean needle from Ottawa's needle exchange programs if they turn in a dirty one, so dirty needles won't litter the streets by the hundreds as they do now, says a group of Ottawa councillors.

The city's medical officer of health, David Salisbury, is to review the city's needle exchange program thoroughly as a possible first step toward tightening the rules, following a request made Thursday by the city's community and protective services committee.

The review will take place despite Salisbury's own insistence that the current system of giving away free clean needles and collecting dirty ones separately is the best method for reducing the spread of HIV and hepatitis C, as the program is intended to do.

Coun. Shad Qadri said the current system results in dirty syringes littering city parks and sidewalks.

"We're concerned about protecting HIV-positive people or hep C spread through drug users, but we're not giving any concerns to the residents of the community," said Qadri, who brought forward Thursday's motion, with councillors Bob Monette and Eli El-Chantiry, calling for the review.

The motion asks Salisbury to provide evidence that the current system is more effective than a one-for-one exchange at reducing the spread of disease.

It also asks him to:

• Show evidence that adverse effects might result if the city requires a one-for-one exchange of dirty and clean needles.
• Outline the risks of changing the system to a one-for-one exchange.
• Determine whether the program would cost more, less or the same amount if it required one-for-one exchange.
• Compare Ottawa's program to practices of needle-exchange programs in other Canadian cities.
• Provide medical evidence that the program meets health objectives set by the Ontario Ministry of Health.
• Give a detailed history of past reports on the program.

Qadri said he was particularly concerned after a highly publicized case last year in which two little girls had to take drugs to prevent HIV infection as a precaution after they were pricked with a dirty needle while playing outside.

"I don't want that kind of thing happening to innocent people in the community," he said.

1-for-1 exchange would boost HIV: Salisbury

Salisbury said he is opposed to a one-for-one exchange because he knows what will happen.

"It will increase the HIV rates in this city," he said.

However, council is entitled to ask him any questions they want, he added.

"I will come back with the evidence base that supports the decisions that I have made professionally over the last four years."

Meanwhile, Ottawa police Chief Vern White said he supports the push for one-for-one needle exchange.

In March, one of the city's main homeless shelters, the Shepherds of Good Hope, brought in a new policy to provide clean needles only to people who turn in dirty ones. The move came after the shelter conducted an audit of its needle-exchange program and found it gave away four clean needles for every dirty needle it collected over a 25-day period. The audit was prompted by Byward Market-area residents who collected more than 1,000 discarded needles from the streets.

This is not the first time Salisbury has faced off against councillors over the city's harm-reduction programs. Last July, council cancelled a city program that provided addicts with free crack pipes, even though Salisbury said the program reduced the transmission of HIV and hepatitis C among drug addicts.