OUR STREET, MONDAY MORNING

An insider's view from Vancouver's Downtown Eastside -- the so-called "eye
of the storm" in Canada's War on Drugs.

Drug prohibition doesn't work. One does not have to be a expert in
addictions to realize this fact.

One only has to walk through the streets of the Downtown Eastside with open
eyes and an open mind to see the sum total of the war on drugs. The recent
articles in The Vancouver Sun discuss this very thing -- the cycle of
despair that the criminalization of illegal drugs creates.

The argument should be made that more damage is done, directly and
indirectly by the contributions of prohibition, than by the drugs
themselves. Drug enforcement in North America has become a folly of
oppression. The criminalization of addiction is absurd, and costly to say
the least -- and there really is no easy singular "silver bullet" solution.
But there are many initiatives that could be developed to reduce risk for
certain parties and maintain quality-of-life issues for others across B.C.

The much-needed discussion around what to do regarding the impact of drug
use and abuse encounters barriers right from the start. The largest lobby
group in North America for continued, or increased, prohibition is U.S. law
enforcement and corrections personnel. This is reflected in certain
provinces in Canada.

The "left" leaning political parties seem to have embraced, with some
exceptions, the concept of "harm reduction," which is designed to reduce
risk during addiction.

Leadership regarding substance abuse is scarce, entrenched and often biased.
Political leadership usually reflects "moral high ground" positions, and we
all know that this kind of "moral" posturing is very costly, and usually
counter productive.

In the City of Vancouver, Mayor Philip Owen, a recent convert to a practical
harm reduction initiative, has been struggling with the ongoing dynamics of
a federally funded initiative called the Vancouver Agreement. But little
will happen until both the province and the federal government put money on
the table to develop overdue resources.

So people still wait for detox and treatment, some get sicker, some will
die, and the drug profiteers get wealthier, and quality of life, both for
"users" and the rest of society, suffers. At the community level agencies,
organizations and citizens are involved in a complimentary initiative in the
Downtown Eastside, "Community Directions." We are struggling to achieve
consensus in what proposed course of action to follow or support.

To achieve a collective, rational approach, we need information regarding
drug use in our community. Often "hard" research or data is not readily
available, but let's not fool ourselves. There are already numerous studies
and documents that are deserving of attention.

People should understand that research indicates drug users in the Downtown
Eastside represent most communities in B.C. and major cities throughout
Canada.

Provincial coordination of the scarce substance-abuse-related dollars and
health resources is needed to secure the best "bang for the buck." In one
six-month period, the addicts observed and engaged by the Vancouver
Injection Drug User Study, VIDUS, indicated over 60 per cent of their target
group had moved in and out of the Lower Mainland. Many of the solutions for
the Downtown Eastside lie in other regions and communities throughout B.C.

This coordination was former chief coroner Vince Cain's first recommendation
in his 1993/94 Overdose Task Force Report. But most recommendations from
that report are yet to be addressed, or implemented.

Provincial coordination cannot be emphasized too much as we look at the
dynamics of hepatitis C, and

HIV/AIDS in the addict population.

It is most likely that the outbreak of HIV/AIDS in the Downtown Eastside is
the "eye of the storm" of a potential similar outbreak throughout B.C.'s
addict population.

The later report from the national "Injection Drug Use & HIV/AIDS" working
group recommended heroin trials in Montreal, Toronto and Vancouver. These
trials were to be tightly controlled, and research-based to see if the move
toward heroin maintenance was feasible. Unfortunately, the trials were never
implemented.

The graduated move toward the decriminalization of drug use is a fact of
life. The removal of "drug profits" from the addiction cycle is a must if
the community is to achieve successes in its struggles with the realities of
drug addiction.

The community must understand addiction for what it is, a disease, and deal
with the addiction dynamics in an appropriate fashion. This would help
remove much of the status that surrounds drug use and dealing, thus
thwarting some of the recruitment of young people into the drug trade. One
of the more alarming facts is that roughly 25 per cent of addicts in the
Downtown Eastside have clinical mental health problems.

To do nothing, or just to maintain the status quo, is not an option. If we
do that, more individuals will enter into addiction, exit services will
become oven more congested, drug profiteers will get wealthier and gain even
more power in the community. We do know that treatment works for some folks,
some of the time. Drug substitution also works, and needs to be developed
further.

But coordination is a must at all levels. Youth, and other groups with
specific needs, have to be engaged and educated, and options offered to
offset entry into addiction.

Law enforcement should be targetted towards those who break laws and the
drug profiteers, not the street addict who is only guilty of drug
possession. The carnage on the streets and in the community due to drugs is
massive -- no one is immune to it. The question is do we care enough to do
something rational to effectively deal with this situation?

I am not talking about just putting more resources into the Downtown
Eastside, although more are needed. All regions in the province need to be
assisted in developing the capacities to deal effectively with the dynamics
of addiction. Treatment is but a portion of the cost of incarceration. It
will cost hundreds of thousands of dollars for every HIV positive conversion
that takes place within the addict community. The saying goes, "pay now, or
really pay later."

In the Downtown Eastside, people die about 10 years earlier than the norm.
They are sicker, and they are more likely victims of violent crimes. An
aboriginal person has an even shorter life expectancy. The homeless are more
at risk to contract a serious illness or disease.

Data suggests between 400 and 500 addicts will die in the province this year
from drug overdoses alone. About 50 per cent will be in Vancouver, and about
half of those from the Downtown Eastside. More than 50 per cent will also
involve alcohol in combination with drugs. About 85 per cent have Hepatitis
C, and 28 per cent will test positive for HIV.

Many street people have a very difficult time following drug regimens for
medication, and often do not complete antibiotic prescriptions, leading to
more serious infections at a later date.

People who enter street-level sex trade activities are at very high risk,
both from diseases and violence. Prostitutes go missing all the time. Our
agency publishes a newsletter that identifies possible predators, and those
who would hurt, maim, abduct, rob or even kill these people.

To salve the pain of this lifestyle, and often previous unresolved trauma
such as sexual abuse, illegal drugs work effectively, but relief is for such
a short time. As the need for drugs increases, people take greater risks,
and often reduce their price for sexual services -- sometimes "undercutting"
others, which places them in an even more vulnerable position.

As the dynamic of addiction increases, the toll on the individual is
radical. Diet suffers, ability to care for one's self often is no longer a
personal priority. Drug access is the paramount factor in that person's
life.

But there is hope.

I recall one adolescent girl, sores over her body from poor injection
protocol and habits, who went from being attractive and bright to a tragic
36-kilogram isolated, insular, hostile, drug-obsessed person in a matter of
months. She was dumped by her "pimp," as she was no longer a money-maker,
and she was on her own.

As she said, "it's her and her pipe." Five-dollar acts of oral sex is what
she offered and there was no shortage of disgusting pedophile opportunists
willing to avail themselves of this act of child abuse. Agencies, police and
community members all worried she would be dead soon. She would not bond
with anyone, and wouldn't accept help.

Police tried to arrest her for any offence just to get her off the street
and off the "pipe" long enough for someone to help her. She was often seen
smoking her crack squatting over street drains, so that if the police
appeared she could dispose of her drugs down the drain thus avoiding arrest.

But months later, photos arrived. She was fat and sassy, in care, thanking
all, specifically the police for not giving up on her. Despite overwhelming
odds, miracles do happen in this community.

However, for those in recovery -- all those heroines and heroes who struggle
daily with the dynamics of addictions and their personal demons -- it often
is a hard road to travel.

Leaving the street can be a major challenge for addicted individuals. Often
the supportive community needed for their recovery is not out there, so
relapse and subsequent return to the street happens frequently.

Relapse has the potential to stifle personal optimism effectively. People in
recovery need all the help they can get. Because the street experience for
an addicted person has often been totally traumatic, those of us outside of
this reality have to assist them.

Addiction is a tragic reality that strikes individuals, families and affects
communities. Society is not exempt.

But solutions are there. They often are not easy or simple, for either
individuals or the community.

To continue to persecute, isolate and alienate these folks like
"21st-century lepers" is neither cost-effective nor morally acceptable.

John Turvey is the executive director of the non-profit Downtown Eastside
Youth Activities Society, which runs programs for street-involved people. A
former heroin addict, Turvey has been active in developing programs in the
Downtown Eastside for the past 20 years.