TEN YEARS OF FOUR PILLARS IN VANCOUVER

Prevention, treatment, harm reduction and enforcement.

It's been 10 years since the Four Pillars drug strategy has been
official policy in Vancouver -- and although the comprehensive model
of dealing with the city's drug epidemic has worked, it hasn't been
on the scale the policy's author envisioned in 2001.

"We're getting there slowly, but scale is the one thing that's been
really difficult for me and still bogs (the strategy) down," Donald
MacPherson admits. "When I wrote the policy, I really thought this
could elicit a bigger response."

The prime example of MacPherson's frustration is the Four Pillars'
poster child: the Insite supervised injection site.

When the Downtown Eastside facility opened in 2003, MacPherson says
it was long overdue.

And despite all research pointing to the benefits of the site, the
federal government's staunch opposition to it (until they were
finally shot down by the Supreme Court of Canada last week) has
limited Insite's impact and stopped offshoots from sprouting up.

"If your building is on fire, you don't go through a long, drawn-out
public process," MacPherson says. "The DTES was on fire. It's been
eight years and we still don't have another one."

The policy expert says there's a need for more supervised injection
sites, but they don't have to be as large as Insite. Clinics,
shelters and other facilities could easily incorporate harm-reduction
practices, he said.

Despite the frustration MacPherson feels at times, it's not all doom
and gloom. Vancouver has made great inroads in shelter, housing,
cutting down on bloodborne infection rates and overdose deaths in the
10 years since the Four Pillars were set in stone.

The policy works and MacPherson hopes that the strategy can kick into
second gear now that Insite's legal battle is over.

"If you walk anywhere in Vancouver, it's still a big issue," he said.
"Let's really take a good look at the need and address the problems."