DRUGS: SYMPTOM OR CAUSE?

Over the past 10 years a lot of things have gone wrong on the Downtown
Eastside, and not everyone agrees where drugs fit in.

Rubbies, 1968: Different drug, similar problems. Gastown, 1973: Gentrifying
hippies sent drunks packing.

It's easy enough to see that drugs are the major problem on Vancouver's
Downtown Eastside. Easy enough, but overly simplistic, if not in fact wrong.

"We used to say there were 15,000 addicts across the province, and we're
still using that number," says Larry Campbell, the former provincial
coroner who, during the 1990s, saw the tragic results of misguided public
policy on the autopsy table. Campbell adds that it's impossible to know how
many hard drug users there are. Still, he and many others agree the current
situation is not so much a result of a rapid increase in the number of drug
users as one of changes in the nature of drug use and, more importantly,
the intense concentration of poverty in the Downtown Eastside.

When you set out to trace the neighbourhood's downfall, you quickly amass a
litany of explanations: The federal government's retreat from social
housing. The arrival of cheap cocaine. The curtailment of institutionalized
mental health care. Low welfare rates. The collapse of Vancouver's stock of
cheap housing. The failure of federal and provincial policies toward First
Nations. And Expo 86. Especially Expo 86.

"No question about it," says Campbell. "That's when it all changed."

The world's fair didn't just introduce Vancouver to the international jet
set, he says, it also introduced the city's fast-life attractions to the
rest of the province and country. Prince George, come on down. Prince
Albert, here we are.

In anticipation of the well-heeled incoming multitudes, cheap hotels and
rooming houses across the city were renovated into tourist traps and local
residents turfed. The poor had only one place to go: the Downtown Eastside,
the last bastion of the flop house and the slumlord.

At the same time, social vices such as prostitution and street-level drug
dealing were pushed into the area by the gentrification, and by police
responding to the political will of the day. The best estimates put the
number of drug-dependent downtown residents at between 3,000 and 5,000
people, he explains. Thousands more are believed to come in every day on
SkyTrain looking to score.

Almost as if they had set out to create a cauldron of misery, governments
at every level concentrated services for the poor and sought to contain
street crime to the inner city neighbourhoods with little clout at city hall.

In the 1970s and 1980s, people mostly used heroin, which made them want to
nod off and zone out. In the early 1990s, however, an influx of cheap
cocaine changed the drug culture. A stimulant rather than a depressant,
cocaine ramps up its users and can be a catalyst for sex and violence. The
altered drug culture changed the mood and the street scene.

The difficulty, Campbell says, is that everybody points the other way.
"It's nobody's problem. Allan Rock, when he was minister of justice, said
it was a health problem. When he's health minister, it's a legal problem.
The province talks a great tale, tells a great story. Nothing. The city --
actually the city has done more than anybody else ... to at least bring it
to the public fore. But solutions? Arrests ain't going to do it. More
police ain't going to do it. Can't do it. Impossible."

The Downtown Eastside isn't just drugs, Campbell adds passionately: "It has
been a dumping ground for all of society's problems and most of it is
simply poverty driven."

The area surrounding Main and Hastings has been called Skid Road for as
long as most people can remember. For half a century, it has been the
catchment area for society's undesirables: alcoholics, natives dazzled by
the bright lights who've ended in the ditch, people suffering from mental
illness and the proverbial one percenters -- those who'll never fit in,
those who don't want a nine-to-five job, a wife, 2.5 kids and a mortgage.

From its days as a ghetto for Chinese immigrants until it became the
post-war tenderloin and saloon district favoured by transients and the
working poor, this is where the unwanted, the disenfranchised and the
alienated gravitated. But it also attracted families struggling to make
ends meet and own a home.

Few families would choose the Downtown Eastside today. But it is simplistic
to attribute all the problems to drugs. "Some people would have us believe
that as recently as 10 years ago, life in the neighbourhood was a slice of
life, a little edgy but nothing more than that," Jeff Sommers, a member of
the Carnegie Community Association who is working on a doctoral thesis
about the area, told a recent meeting of downtown business people.

Sommers and others believe the debate is fraught with misinformation. In
the last decade, Vancouver's crime rate has fallen to 146 from 187 criminal
code offences per 1,000 people. Even the crimes associated with drug
addiction (robbery, break and enter and motor vehicle theft) have dropped.
Yet the perception persists that the city has become more lawless and there
is a need for more law enforcement.

Sommers points to other factors. Throughout the 1970s and 1980s, cheap
accommodation disappeared in Vancouver as landlords redeveloped rooming
houses in Kitsilano, Fairview Slopes, Mount Pleasant, Grandview, Downtown
and the West End. By the late 1980s, the only significant stock of single
rooms was in the Downtown Eastside. Not only were the poor from elsewhere
in the city forced down there for accommodation, they found themselves
competing for scarce rooms with mental patients released from Riverview
Hospital and elsewhere as institutional health services were replaced by
inadequate community care programs.

At the same time, shame-the-johns campaigns (backed up by injunctions from
the Supreme Court of B.C. and a tough-talking attorney general) drove the
street-oriented sex trade from Davie, Granville and West Georgia Streets
into the Downtown Eastside.

Dr. Perry Kendall, the provincial medical officer of health, says B.C., in
many ways, is reaping the bitter harvest sowed by misguided public policies
adopted by the three levels of government.

"From one perspective, what has clearly happened is a concentration and
shrinking of the lower-income area that started with Expo and the
subsequent gentrification around the region," he explains.

"You've had a loss of affordable housing, a shrinkage of affordable
housing, a shrinkage of the low-income area. You've also seen a change in
that area from alcohol (which is still there), but we've seen a
concentration of injection drug users and people with multiple social,
psychiatric and physical health problems concentrating in that area. And,
starting in the early 1990s, explosive epidemics of HIV and Hepatitis C and
overdose deaths among that community."

By 1997, one in four of the drug-dependent population concentrated in the
area was HIV-positive, and the transmission rate for the syndrome was a
sky-high 18.6 per cent. The incidence of hepatitis and other diseases
prodded the Vancouver/Richmond Health Board into declaring a public health
emergency.

Kendall says policies that have opposed treatment facilities elsewhere
while allowing an open drug market in the Downtown Eastside have
exacerbated the existing neighbourhood woes.

For a variety of reasons, he says, "a really comprehensive, determined,
multi-sector action by all levels of government" to address the growing
public health danger was never adopted.

Some of the issues were contentious, Kendall concedes, and there were
jurisdictional squabbles among the three levels of government and within
each layer of public administration.

Addiction services, for instance, were booted between provincial ministries
and now reside within the Ministry of Children and Families, rather than
the Health Ministry. At the same time, antagonistic community groups in the
area proposed different policies and solutions. "It's hard if you can't get
a political consensus, it's hard to move forward in a coherent fashion," he
laments.

Witness, for example, the debate currently raging over such harm-reduction
elements as safe-injection sites. To begin, there are some who oppose any
action that legitimizes drug use. But a much more significant rift pits
those who seek to improve the Downtown Eastside by flooding it with help
against others who believe expanded services would only lure more drug
users and the problems they bring.

Jon Stovell is general manager of Reliance Holdings Ltd. and president of
the Gastown Business Improvement Society. He and others in the area have
formed a new group, the Community Alliance, which is lobbying for tougher
law-enforcement and a ban on further social services in the area.

"In part, the changes are a result of changes in drug culture itself, the
change from heroin to crack," Stovell acknowledges. "But equally to blame
is how we've responded to that and how we've just reinforced that behaviour
as acceptable in this neighbourhood and as a city sought to contain it down
here. It's a process of containment, ghetto-ization and creating a social
services-industrial complex that feeds off the unfortunate. It's a proven
mistake."

Cindy Chan Piper, a Strathcona resident and an organizer of the Alliance,
expresses it in more colourful fashion. "Basically this area is being
treated as the toilet," she says. "Because there was a containment policy,
the problem has grown exponentially."

Stovell adds that the neighbourhood already has too many social services,
drug treatment facilities and methadone dispensaries. "We are just saying
you can't put any more; it's reached the point where you have to start to
distribute it and treat these community problems equitably throughout the
region. The traditions of containment here are so strong that people who
complain about these things are viewed as insensitive and heartless."

"Residents are feeling like they're being run out of the community," adds Chan.

"We feel we are being labelled bad people because we want our children to
play in our yards, because we want to walk down the street and feel safe,
because we don't want our seniors barricading themselves and locking
themselves indoors."

There have been wild rumours of drug users stockpiling hand grenades and of
plans to fire-bomb the Woodwards building if development is approved
without social housing. Closed since 1993, the vacant landmark building and
the adjacent dead commercial space are testament to the area's decay.

"Aggressive lawlessness," concludes local architect and Alliance member
Bryce Rositch, "that's what it is. In the last year it's become
particularly intense and it's turned mean. We've also noticed a growing
animosity and attitude of social service providers toward regular people --
shop owners, residents, middle-class people, we're bad. Well, if Kerrisdale
allows people to inject on the street corner, we'll accept it here. It's
real simple."

Each person compiles their own private list of what went wrong on the
Downtown Eastside in a slightly different way. Ann Livingston, who was
instrumental in creating the city's first brazen safe-fixing site and is
spearheading another at 213 Dunlevy, is convinced land developers are one
of the factors behind the continuing chaos.

"They want the people of Vancouver to get so fed up that we will let them
zone this land any way; we'll give them money to do anything," she
complains. "The land developers are going to make a bundle on this. If they
can keep this chaos they benefit."

To her, governments have exacerbated the historic despair of the
neighbourhood by adding more than 1,000 mentally handicapped residents
along with the bulk of the city's prostitution and drug crime.

"I think the drop of the welfare rate was the most devastating thing," she
says. "That really hurt the drug users. It's just utter mayhem now."

At 12th and Cambie, Non-Partisan Association Councillor Jennifer Clarke
echoes much of what Livingston says, but has little sympathy with her
evil-land-developer analysis or attempts to impose a city-funded solution.

"It's fairly obvious the situation has become worse over 10 years -- and
probably for a number of reasons," says Clarke.

But she does not see city hall as primarily responsible for the urban
blight -- she blames Victoria for mishandling mental health services and
senior governments for the large number of aboriginal people in the area.

"Two-thirds of the first nations people in the province are not on
reserve," she said. "They're non-reserve natives, and many are finding
themselves in our urban cores."

The treaty-making process and the country's aboriginal policies appear to
have failed, she says, and there is also an inadequate level of detox
services and treatment throughout the region. "If you had not had the
downsizing of Riverview and the proliferation of cheap cocaine and heroin
and other factors," she adds, "I don't think you would have seen the
phenomenon at such a critical mass."

Dr. John Blatherwick, the city's medical officer of health, offers the most
optimistic note. The Downtown Eastside, he says, has "deteriorated
extensively" over the last decade, but has recently taken a turn for the
better: Overdose deaths are down, methadone treatment has been doubled,
there are significant decreases in infection rates, and Victoria has
delegated responsibility for addiction services to the local health board,
which is better able to manage it.

Urban despair is not the result of a single government decision or a single
identifiably stupid policy, Blatherwick says. Yet, he emphasizes, the
collapse of public health in the Downtown Eastside can be directly linked
to the erosion of low-cost housing stock. And, yes, he says, that started
with the gentrification unleashed across the city by Expo 86. "The housing
in the Downtown Eastside was allowed to deteriorate to an extent that
despair and feelings of worthlessness set in within that community and the
drug problem overcame the whole area."

Still, Blatherwick adds that in many ways the problem is simply a
reflection of society's larger inequities and gene-pool anomalies. In a
word, the Downtown Eastside is an inner-city slum because of endemic
poverty. "That's really where you have to attack the long-term problem," he
says. "Everything else is a Band-Aid that helps a little bit, but unless
you solve the root cause, it's going to continue."

Governments, he says, used the neighbourhood as a dumping ground, "whether
it was intentional or just convenient to do it," and it's time to stop.

He shakes his head. "I think it's all very sad," he said. "It's just sad.
After the Second World War, look at Germany and Japan -- they got together
and rebuilt their entire country. We can't do one part of a city. One
neighbourhood? It says there's something dramatically wrong."

Tomorrow: Drugs across the Lower Mainland