ACTIVISTS FIND HOPE IN PUBLIC OVERDOSES

Addicts Resuscitated At Safe Injection Site

VANCOUVER - Here on Vancouver's Downtown Eastside, victories are rare and
achievement is measured in increments so tiny as to seem perverse. News
that 25 people have experienced drug overdoses while shooting up inside the
neighbourhood's first offical supervised injection site is, for example,
considered cause for hope.

Insite, North America's first government-sanctioned and funded shooting
gallery, opened amid much publicity two months ago. Critics worried it
would be a magnet for every drug addict on the continent. Vancouver's
Mayor, Larry Campbell, defended the $3.7-million centre as a "vital part of
a harm-reduction plan to reduce overdose and overdose deaths."

Even under the gaze of Insite's registered nurses and other staffers,
addicts are still overloading on bad dope and either passing out or
freaking out, which often means tearing off their clothes and clawing at
their exposed skin, until they receive medical assistance.

But in this teeming drug market, even a marginal success rate is considered
laudable. As Chuck Parker says, "at least no one has died." A recovering
heroin addict and local advocate for the Downtown Eastside's thousands of
drug users, Mr. Parker is also an occasional user of crack cocaine. He is
on welfare. He is HIV positive and has hepatitis C. Things could be worse,
he shrugs. "I could be dead."

A parched-looking man in his 40s, Mr. Parker is volunteer president of the
Vancouver Network of Drug Users, a gritty streetfront operation that seeks
to make life better for the thousands of addicts living and using in the
Downtown Eastside. It is not surprising that he feels the new injection
site is working; his group, after all, was one of many that campaigned long
and hard for it.

The notion of a public shooting gallery was contentious from the start;
Phillip Owen, the previous mayor, was essentially expelled from office last
year after pledging his support. He too has reacted positively to the fact
that while overdoses inside the clinic have occurred, and are actually
increasing week to week, no fatalities have resulted.

But death continues to haunt these six or so city blocks in the shadow of
downtown Vancouver. According to the B.C. Coroners Service, there were 37
overdose fatalities in the city in the first eight months this year; last
year, in the same period, there were 39.

Officials with Insite say their facility has prevented at least five more
deaths. Overdoses, they say, are simply inevitable. "We don't test the
drugs that people bring to the site," says Insite spokeswoman Viviana
Zanocco. "That's not our job as health care providers. People have to take
some responsibility for what they are using."

It's a realistic position, and hopeless. Insite staffers can't possibly
know what any single user has in his system when he enters the site, and no
one really has a clue what he is shoving into his arm. Word around the
street is that dealers are now cutting their product with gyprock.

Addicts are not interested in testing their $10 hits to determine purity.
They want to fix quickly. Many are choosing to do it at Insite because it
is a handy, uncompromising shelter stocked with free needles and clean
water, used to cook their smack and to turn their cocaine powder into liquid.

Early concerns that Insite would be rejected by wary drug users have
evaporated. Its visitor count has steadily increased since it opened in
September, from a few dozen a day to more than 500. Insite's maximum
capacity is approximately 650 visitors.

Funded with grants from the provincial and federal governments, the
facility sits in the Downtown Eastside's epicentre, on East Hastings, a
street synonymous with heavy drug use, trafficking, prostitution, theft and
violence. Users turn up at a non-descript building and enter through a
steel door, where they mark their initials on an arrival form. Handed a
sterile, unused needle, a vial of water, a cooking spoon and a tourniquet,
they are shown into a large, austere room with 12 separate stainless steel
shooting booths, illuminated overhead with bright lighting.

They inject themselves with their drugs, and then proceed to a
post-injection "chill" room, where they are asked to sit and linger for a
few minutes while their body absorbs whatever substance has been introduced
into the blood stream. Counselors are on hand to discuss safe shooting
practices and treatment options.

Such a place did not exist when Mr. Parker landed in the Downtown Eastside.
A native of Calgary, he moved to Vancouver 11 years ago, and says he was
making $1,600 a week as a skilled tradesman before he began using cocaine.

"I tried to get off it by shooting heroin," he says, as we walk down East
Hastings, in a cold rain. "Biggest mistake I ever made."

We pause for a few minutes on the corner of East Hastings and Carrall.
"She's having an overdose," Mr. Parker says, gesturing toward a woman lying
on the sidewalk in front of us. She is shrieking and tearing at her
clothes. Her face is bright orange; it looks as if she has been attacked
with paint.

"She's been injecting cocaine," explains Mr. Parker, "and now her brain is
telling her that she's overheating."

Another woman approaches us, walking crab-like, her body bent and twisted.
She hits up Mr. Parker for $6. Later, I see the same woman buying drugs
from a man on the street. She skips into the safe injection site with a
smile on her face.

Mr. Parker spent years on these streets, mixing dope with gutter water and
injecting himself with dirty needles. Had he been able to fix in a place
such as Insite, he figures he could have at least avoided contracting
hepatitis C and HIV.

Patsy Thorpe wishes Insite had been around last year, when her 21-year-old
daughter Alexandra scurried into a neighbourhood flophouse, shot herself
full of heroin, and overdosed. Her two companions tried to revive her, in
vain. Alexandra died in hospital a week later.

Earlier this year, Ms. Thorpe helped establish Vancouver's first supervised
injection site. It was less formal and lacked government approval. It
operated only a few weeks before the "legal" site opened. "Our whole goal
was to force the issue and get Insite up and running," she explains. "We
wanted to do something while people debated the need for a clean injection
site."

For some, it came too early; Randy White, a local Canadian Alliance MP, has
said he thinks the idea of a government-funded injection facility is
counter-productive, that it will attract more addicts to the Downtown
Eastside. Insite's future is not secure; it has not received any funding
commitments beyond April, 2004.

Millions of dollars have already been spent on social services in the
Downtown Eastside, establishing a sense of permanence, even purpose, in the
neighbourhood. Aside from new housing, addicts have access to innumerable
services especially for them: shelters, clinics, schools, art workshops, an
Internet cafe, a radio station.

Mr. Parker has mixed feelings about the services that have appeared in the
last few years. "On one hand, people will come here because they can score
and fix and find food. But they will live in shit, literally. It's a
vicious circle. All we can down here is try to help keep them from dying."

The question, still unresolved, is how much value the rest of us are
prepared to assign to what's left of a junkie's life.