WORKERS OFFER INSIGHT INTO INSITE

When People Ask Where They Work, The Answer Might Be 'Retail'

For some workers at North America's only supervised injection site,
one of the trickiest things about the job is explaining it.

How do you describe the job of helping addicts safely use drugs that
are deemed illegal?

"You know you're in for an hour-long conversation," said Allison
Laing, a 35-year-old dayshift co-ordinator at Insite.

"From now on, at any parties at my dad's house, I am in retail."

Beside her in a booth at the Ovaltine Cafe on East Hastings, about a
block east of the Insite safe-injection facility, program worker
Paulo Ribeiro recalled a function at the house of his girlfriend's stepfather.

Ribeiro, 32, was among business types and accountants in their
mid-50s and older. "When they asked me, 'Where do I work?' and I said
where I worked, it was kind of like this uncomfortable conversation
stopper, so I realized, 'The next time they ask me . . ."

"Retail," interjected Laing.

"Social worker," continued Ribeiro, though he added that most people
are supportive.

"Or they're very curious," said Laing.

Insite -- which opened in September 2003 as an experiment to try to
prevent overdose deaths and the spread of blood-borne diseases -- is
still controversial to some.

To its employees, it is also a job.

Three of them -- Laing, Ribeiro, and Darwin Fisher, 40 -- agreed to
sit down with The Province to provide an insight into Insite.

Each came to Insite over the past three years from other jobs in the
Downtown Eastside.

There are others at Insite, including nurses from Vancouver Coastal
Health and peer workers. In all, 16 people a day work at the
facility, funded by the B.C. government to the tune of $1.5 million
to $1.8 million a year.

They work in two shifts of about nine hours each. The average hourly
wage for the program workers interviewed by The Province is $16.75 an
hour. There is a night-shift differential. Nurses earn more.

Fisher drew a sketch of the storefront facility. It showed the front
door and waiting room where clients arrive between operating hours of
10 a.m. and 3:45 a.m.

By the time the doors open, staff have cleaned up and stocked
stations for injecting with syringes, water, alcohol swabs and rubber
ties to be affixed to arms so veins are easy to find.

As users arrive, they give their names, usually code names so staff
can call up records for relevant information.

"They pick a handle or a nickname that they will be identified by,
which is to protect everyone's privacy," said Ribeiro.

Then they proceed to the Injection Room -- a.k.a. the "Hair Salon" --
to inject their drugs under medical supervision.

Nurses are on hand to assist. They deal with specific health needs
like hygiene, abscesses, handing out information and helping users
find their veins. "There's a whole roster of injection information
that even a lot of people who have been using for a long time don't
know," said Fisher.

Some female users linger to do their makeup in the Injection Room,
taking advantage of mirrors at a station where they shoot up. Staff
gently try to move people along so there is no traffic jam.

"There are people who get bogged down for a variety of reasons," said
Fisher. "It can be absolute hell finding a vein for some of the
users, and it can take hours of work with a nurse and program staff
and anybody else."

Sometimes there are overdoses, sparking a protocol that includes
nurses applying oxygen and calling 911, if required.

There was one the night before this interview. The woman, using
heroin, survived. "She was on oxygen for a bit, sat there, her heart
rate went back to normal," said Laing. "When she felt OK, she talked
to the nurse some more, and they were like, 'OK, you can go.' "

Fisher's map showed a route from the Injection Room to the "Chill
Lounge" where there is coffee and orange juice, and users can relax
for a moment before leaving.

There, users are given information on housing, detox programs and
other services.

"It's a great time to talk to people, get to know them," said Fisher.

Not all of the users are downtrodden. There are some working people.

"Even white-collar working people," Ribeiro noted. "In three-piece
suits," added Laing.

Why? "For safety," said Laing: They fear overdosing if not supervised.

Christmas is a complication. "People are ruminating a lot about their
personal history and past and want to talk to other people," said Ribeiro.

"There's a lot of pain associated with [Christmas]," said Laing.

For staff like Laing, Ribeiro and Fisher, it can be a challenging way
to earn a living.

They came to Insite for the challenge, to try something different, or
because they knew someone involved in the project, whose primary
partners are Vancouver Coastal Health and the Portland Hotel
Community Services Society.

"I enjoyed the notion that we're providing some service that's not
being provided anywhere else," said Ribeiro. And the work "never gets boring."

Insite faced the prospect of being closed this year. An exemption
under the Controlled Drugs and Substances Act that allows it to
operate was due to expire Sept. 12 after three years.

In September, federal Health Minister Tony Clement said Insite could
continue to operate until his department makes a decision on its fate
by the end of 2007.

Meanwhile, studies are to be conducted into the impact of supervised
injection sites on crime prevention and treatment.

"[We're] happy to still be open," said Fisher. "Hopefully, this
window of opportunity will allow for some real discussion. If it's
dealt with in terms of the facts, we'll stay open."

Asked where they'll be in a few years, Laing quipped, "We'll be
looking at the other Insite that has opened across the street."