A PLACE TO SHOOT UP

Vancouver's Addicts Await Word On Their Safe Injection Site

THREE years ago, Vancouver became the first city in North America to have a
legal, supervised site where addicts could inject illicit drugs.

The safe injection site opened after the federal government granted it an
exemption from Sec. 56 of the Controlled Drugs and Substances Act, ensuring
that staff and users would not be charged with offences such as the
possession of drugs like heroin and cocaine.

But the trial ends Sept. 12 and both here and at the recent World AIDS
Conference in Toronto Stephen Harper's minority Conservative government has
been under heavy pressure to renew that exemption.

The issue has become so highly charged that what's being neglected is that
the $2-million-a-year facility has not solved the city's substantial drug
problems, nor was it intended to.

Vancouver's drug policy co-ordinator Donald MacPherson has always said the
safe injection site was only a small piece of a comprehensive plan of harm
reduction, treatment, enforcement and education -- the so-called Four
Pillars plan.

Taken together, that plan was supposed to solve Vancouver's drug addiction
problems and possibly provide a model for other Canadian cities. But all
the time the safe injection site has operated, the Four Pillars plan has
teetered precariously, possibly fatally, on harm reduction and enforcement
alone. Which is not to suggest that the safe injection site --called InSite
- -- has been a failure.

In fact, it has accomplished much of what it was supposed to do.

Researchers from the B.C. Centre for Excellence in HIV/AIDS have credited
it with a significant reduction in the number of intravenous drug users
injecting in public, a reduction in discarded syringes and other
injection-related paraphernalia and less sharing of needles. They have yet
to determine whether the provision of clean needles through the site has
reduced HIV and hepatitis infection rates, but a separate study released
Friday found that HIV rates had come down in the Downtown Eastside since
InSite opened.

The researchers from the Centre for Excellence also found that InSite has
reduced the number of overdose deaths as well as the need for victims
requiring hospitalization and paramedic assistance.

Other good news, if you can call it that, is that InSite hasn't resulted in
an increase in addicts, which some people predicted when the city made it
easier for people to safely inject their drugs. But there has been no
decrease in the number of addicts, either.

As a recent RCMP-funded study said, "There were disappointingly few
referrals to detoxification services largely because clients usually did
not meet the strict conditions required to access those services."

Over a 12-month period that spanned most of 2004 and the first three months
of 2005, 37 per cent of InSite's users were referred to addiction
counselling. Only 3.7 per cent went into methadone maintenance treatment or
longer term abstinence-based housing.

When Vancouver approved its Four Pillars plan five years ago, it had
overwhelming support. The safe injection site, however, has always been
controversial. A 2002, city-commissioned survey found that one in five
residents opposed even considering it as an option. No official measurement
of public support has been taken since InSite opened.

But what has happened is when enforcement was at its peak, the open drug
market in Vancouver's Downtown Eastside largely disappeared and addicts
were pushed out into other parts of the city. Now, the addicts and sellers
remain in those neighbourhoods even though the drug mat is once again open
for business at its old location. Streets and alleys in the Downtown
Eastside may no longer be used as shooting galleries, but aggressive
beggars desperate for a fix are frightening away tourists.

Addicts may have a safe place to inject drugs, but Vancouver still has the
third highest property crime rate in Canada after Abbotsford, B.C. and Regina.

And as keen as Vancouverites are to regain some sense of normalcy, few want
any part of the solution in their neighbourhoods.

More than 3,000 people wrote to city council or signed petitions in 2004
opposing a 39-unit transition home for mentally ill, recovering addicts.
Council went ahead anyway, describing the facility as "an essential
component of the four pillars strategy."

Six more treatment facilities are planned at undisclosed locations and a
group called Not in Anyone's Backyard has formed to protest construction in
virtually every one of the city's residential neighbourhoods.

So the question is: What now?

Even at $2 million a year, InSite serves only a third of the addicts in
Vancouver -- 6,000 people. To serve them all would cost a minimum of $6
million a year. But that won't make a dent in the problem without funds for
treatment and education. And five years ago, the price tag for the total
program was estimated at $30 million annually.

When he was campaigning to be prime minister, Harper said his government
would never spend public money on illegal drugs. More recently, he said
Health Minister Tony Clement will evaluate InSite based on the facts. What
Harper and Clement must calculate is the price of a human life -- an
addict's life.

Through their political prism, they must balance the cost of saving lives
of heroin and cocaine addicts (who aren't likely to vote for them in any
event) against the needs and desires of those who might vote for them --
homeowners who across the city have homes worth a minimum of a half-million
dollars, seniors who need housing and home care, baby boomers' calls for
more money for knee and hip replacements, parents' pleas for expanded
child-care services and even Vancouver Olympic organizers' cries for an
extra $55 million.

And in the end, don't bet on them choosing addicts.