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An addict uses the sign for the Portland Hotel Societies mobile needle exchange program to block the wind as he tries to smoke a rock of crack in a alley in Abbotsford, B.C. on Thursday, July 5, 2012.JONATHAN HAYWARD/The Canadian Press

Once a week, Jamie MacDonald walks down a quiet alley in this sprawling community in British Columbia's Fraser Valley, finds a familiar black SUV and picks up a package of clean needles, alcohol swabs and other supplies for injecting heroin.

MacDonald doesn't need the needles himself – although he's addicted to heroin, he smokes the drug – but he has friends who do.

He takes a paper bag containing about 20 or so needles, meets with friends and chats with an outreach worker from Vancouver's Portland Hotel Society, who visits Abbotsford every Thursday with syringes, crack pipes and other supplies designed to make the lives of drug addicts safer.

"I grab needles and pipes and I give them to people – I just like to do my part to make sure somebody doesn't catch a disease," says MacDonald, 34, who started smoking heroin as a teenager growing up in Vancouver's Downtown Eastside, where he was born and raised.

"For me, it's a no-brainer. It helps people."

In Abbotsford, this transaction has actually been illegal since 2005, when city council passed a zoning bylaw that effectively bans any form of "harm reduction," including needle exchanges and safe-injection sites, within the city limits.

But the bylaw is now up for review, as the local health authority pushes for a government-run needle exchange program, and community groups that have been quietly contravening the law for years argue it's time for the city to embrace the concept of harm reduction.

The debate has revealed that some in this city, located in an area often referred to as the province's Bible Belt, are still uncomfortable with the idea of giving addicts free needles to inject their drugs, despite the insistence of health officials that such programs save lives, reduce health-care costs and connect addicts with treatment.

The harm-reduction bylaw was introduced seven years ago as politicians looked to ensure the blight of addiction in Vancouver's Downtown Eastside didn't replicate itself in Abbotsford. At the time, Vancouver's controversial safe-injection site had been making headlines for more than a year, and city councillors argued allowing any form of harm reduction would merely condone drug use.

The Fraser Health Authority recently asked city council to reconsider the bylaw, pointing to statistics that show Abbotsford, where several hundred people are believed to use injection drugs, has some of the province's highest rates of overdoses and infections of HIV and hepatitis C.

The health authority presented a proposal to council last month that would see a needle exchange program phased in over several years, beginning with distribution through community organizations and then eventually introducing mobile and fixed-site needle exchange services.

Municipal staff have been asked to study the proposal before the city decides what to do with the bylaw, but some councillors have revived the same concerns that prompted the bylaw in the first place.

David Portesi, the Fraser Health Authority's public health director, says city council made a mistake when it passed the bylaw, but now he sees an opportunity to change that.

"I think in 2005, they made a decision, if not uninformed, certainly weighted toward the wrong information," Mr. Portesi said.

"I think back then, council was certainly more hostile [toward harm reduction]. I think what you're seeing now is a change in public perception and an actual discussion."

Mr. Portesi notes several organizations already pass out harm-reduction supplies in Abbotsford, and the city doesn't appear to be using the bylaw to stop them. The Fraser Health Authority is also looking into whether the city can legally enforce a bylaw that restricts a health-care service.

Still, he said the bylaw has severely limited services available in Abbotsford.

"At the very least, it puts a cool down on the community," he said.

"We tend not get many partners who are willing to partner with us. And quite frankly, if you're working with a community that's hostile to harm reduction, the services are not as effective as they could be. We recognize it's best to work with the community."

Councillor Simon Gibson has been at city hall for more than two decades and he was among the councillors who supported the bylaw in 2005.

Mr. Gibson hasn't changed his mind.He describes harm reduction as "largely cosmetic" and says it fails to focus on getting addicts off drugs. "I'm satisfied with the bylaw, because it represents what is in the best interests of the overall social fabric of Abbotsford," Mr. Gibson said.

"They [harm reduction advocates] may be putting the interests of the addicts over and above the interests of our community. Our citizens want to see addicts turn their lives around and contribute to society, but I believe that our citizens don't want to see that rehabilitation done at the expense of the social fabric of our community."

Mayor Bruce Banman said council remains divided on the issue. Mr. Banman says he's convinced a needle exchange program would save lives and money by preventing addicts from contracting diseases such as HIV. However, he says his support is contingent on Fraser Health also promising to increase detox services in the community – something he complains isn't part of the current proposal.

"If you can prevent one case of AIDS and a couple of cases of hepatitis C, it would most likely pay for the entire needle exchange program, so, financially, to me it just makes sense," Mr. Banman said.

"Having said that, I will demand that detox be part of the solution. That is non-negotiable for me. I think to just hand out needles without detox is just solving half the problem."

Fraser Health says it's open to talking about expanding detox services. Currently, the health authority provides mobile, in-home detox services, and Abbotsford residents who need to enter a treatment centre are referred to a facility in Surrey.

Back at the Portland Hotel Society's needle exchange truck, Kimberley Ann Quinn walks over from a women's drop-in centre around the corner.

Quinn, 40, who is addicted to crack cocaine and alcohol, picks up a couple of crack pipes before jumping at the chance to talk about the harm-reduction bylaw.

She doesn't think the city hall politicians realize what life is like for Abbotsford's poor and drug addicted.

"It makes me sick when they say no to harm reduction – we really need it," said Ms. Quinn, who has lived in Abbotsford since she was a child.

"Abbotsford society always comes down on everybody. If they just leave that office and step in our shoes for a day, then they would really understand how it is."

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