A NEVER-ENDING TALE OF POLITICAL NEGLECT

Principals Of All Three Levels Of Government Have Pretended For
Decades That One Stop-Gap Measure Is A Solution

A decade and several elections ago, the three levels of government and
their many and varied agencies agreed that an integrated approach was
the only way to heal the problems of Vancouver's Downtown Eastside.

That was the genesis of the Four Pillars plan and the controversial
decisions to provide free needles, supervised injection sites and,
later this year, free mouthpieces for cocaine pipes.

In their search for solutions, politicians rather neatly neglected to
acknowledge their responsibility for the perfect storm that has
devastated the neighbourhood and left hundreds, if not thousands, of
people dead.

Ottawa stopped funding low-income housing in the 1990s. Today, there's
a housing crisis across Metro Vancouver, the most expensive urban area
in Canada.

To make up for the lack of affordable housing, the B.C. government
changed its rules so that welfare recipients could live in single-room
occupancy hotels. That concentrated the poor in older hotels all
within a very small area near the Carnegie Centre at Main and Hastings
streets.

All of that coincided with closures of mental hospitals. But the
provincial government failed to provide the promised alternative
housing, the group homes and supervised living arrangements on which
the success of de-institutionalization depended. The number of beds
for people with mental health problems plummeted from 5,000 to 800.

The B.C. government closed Pender Detox, the largest residential detox
program for people with alcohol and drug addictions. Other social
service agencies closed in the name of deficit-fighting.

A decade later, we're still trying to make up for what was lost since
1998. And all of that would have been bad enough -- a shortage of
affordable housing, lack of jobs and the ready supply of drugs and
alcohol -- without HIV/AIDS. Combined, those factors resulted in an
AIDS epidemic on a scale seen only in Africa, not in any other
developed or developing countries of the world. By 1998, 40 per cent
of the injection drug users were infected with HIV.

Syphilis and tuberculosis were also at epidemic proportions even as
Vancouver began being recognized as one of the world's most livable
cities (unless you're poor, addicted or mentally ill.)

The folly of governments' containment strategy -- ghettoizing the
poor, the addicted, the sick and the mentally ill in cheap rooms
downtown -- spilled out on to the streets and alleys that quickly
turned into filthy, garbage-strewn shooting galleries, open drug
markets and home to a growing survival sex trade whose workers started
disappearing and nobody seemed to care.

Because of the crisis, local, provincial and federal politicians
embraced the harm-reduction strategy as a stop-gap measure to keep
people alive until housing, detox, treatment and recovery programs
were in place. But the politicians have so heartily embraced the
harm-reduction model, it's virtually all that they talk about or fund.

There's something politically appealing about being a maverick opening
North America's first supervised injection site or promising free
heroin. It gets you on magazine covers, in documentaries. It gets you
invitations to international conferences.

Most of all, it beats the hell out of sitting through long public
hearings with angry residents who don't want addiction treatment
facilities in their neighbourhood whether it's on Hastings, Fraser,
Dunbar or Fir Street. That's especially true if, in the end, the
decision is to ignore the opposition and approve it anyway, because
it's the right thing to do and the only thing that makes a stab at
solving the horrific addiction problems in this city, region and province.

And that's where we find ourselves a decade on. The dramatic stuff,
the headline stuff, the harm-reduction pillar has mostly been done.
The epidemics have subsided. Fewer addicts overdose on the streets.
There's been a reduction in other infectious diseases that require
hospital stays.

All this harm reduction has kept people alive. The question is, for
what? Are there decent places for them to live as they recover? Are
there services available for what is a long road to recovery because
everyone from addictions specialists to the Vancouver Coastal Health
Authority agrees that recovery means leading a substance-free life,
not swapping heroin for methadone, cocaine for marijuana or Ativan for
some other pharmaceutical?

The short answer is no. But there's good news on the housing front
largely because of the B.C. government and Housing Minister Rich
Coleman. Politicians will have plenty sod-turnings and ribbon-cuttings
to attend over the next five years because there are 3,200 units of
social housing on the drawing board for Vancouver.

It's a level of production that hasn't existed since the 1990s. Among
the projects are redevelopment of Woodward's, the provincial
government's renovations of 10 single-room occupancy hotels in the
Downtown Eastside and redevelopment of public housing sites, including
one in Little Mountain.

It's the treatment pillar that lacks a champion. Coleman has talked
about treatment supports being included in some of the new housing
units. But so far, there's no commitment of funds.

Over the past decade, Vancouver Coastal has improved access to detox
and rehabilitation facilities with little or no fanfare. It is the
first city in Canada to have four levels of detox care. But when it
started Canada's only fully supported, home detox program, there
weren't any politicians trumpeting it to journalists.

Vancouver Coastal Health Authority estimates 5,000 people on the
Downtown Eastside need treatment for addictions and mental health
problems. Close to half of them need significant amounts of help and
somewhere between 250 and 500 need significant and long-term
addictions treatment in a residential facility.

To provide that kind of support, Vancouver Coastal recommends that, at
a minimum, Vancouver needs a 30- to 60-bed facility to deal with those
in the greatest need. There needs to be a shorter-term stabilization
facility for 30 to 60 of those who need significant support on the
road to recovery.

And that's just for the Downtown Eastside. It doesn't take into
account the addicts living in other neighbourhoods or cities. Or kids.
Operating money has been promised for the residential youth recovery
centre that's planned for Keremeos. But, so far, there's not enough
money to build it.

There's a civic election in November, a federal election that could
come along any day and a provincial election in the spring of 2009.

It's not enough for the politicians to acknowledge the problems of
addiction and homelessness. It's not enough for them to keep piling on
more harm-reduction programs.

We need solutions. We need strong leaders willing to stand up to the
Not-in-Anybody's-Backyarders and fight not just to keep people alive,
but to help them make a full recovery.