PROGRESS MADE IN DRUG POLICY

I was reminded how far we have come when I attended a conference last week
to mark four years since Vancouver formally adopted its Four Pillar drug
strategy.

The kernel of the idea started long before that. In 1989 with a load of
lobbying from Downtown Eastside activist John Turvey and support from
then-Vancouver mayor Gordon Campbell, council voted to create a needle
exchange program in the city. They were motivated by the devastating spread
of disease caused by shared needles. In spite of critics wailing that
public money was encouraging illegal acts, for the first time politicians
accepted a connection between injection drug use and health problems
suffered by the addicts. If for no other reason, needle exchanges made
sense on economic grounds; sick and dying junkies were a burden on the
health care system.

Four years later B.C.'s Chief Coroner Vince Cain noted the epidemic in
heroin overdoses in Vancouver-then over 200 a year-and called for a safe
injection site. That wouldn't come for another decade.

But in 1994 Cain produced what is considered a landmark report in the
evolution of this country's drug policy. His Illicit Narcotic Overdose
Deaths report is seen as the beginning of the harm reduction movement. He
not only repeated his call for a safe injection site, but wanted all drugs,
hard and soft, to be decriminalized.

In 1996 the Vancouver Richmond Health Board declared an HIV epidemic in
Vancouver. The primary causes were a combination of sexual activity and
intravenous drug use.

By the next year and with the continued lobbying of Bud Osborne, another
Downtown Eastside activist, the health board declared a public health
emergency. To help quell the impact of that emergency, Vancouver had a well
established street nurse program funded by the health board. It was running
a mobile clinic, exchanging needles and handing out condoms on city
streets. The goal was to reduce the overwhelming spread of AIDS and
sexually transmitted diseases that were killing people and sapping health
care resources. Overdose deaths had dropped to about 150 a year and
continued to fall.

Donald MacPherson moved from his position as director of the Carnegie
Centre to city hall where he became the first co-coordinator of drug
policy. He gave shape to what would become known as the Four Pillars.

It was that policy that Vancouver Mayor Philip Owen embraced with
increasing passion over the years, coincidentally alienating himself from
his party and most of his NPA colleagues on council.

Throughout this period business types in Gastown and Chinatown were
increasingly twitchy about official support for a drug activity they
claimed was ruining their economic prospects.

Near the end of 1999, when the street nurse program began to work out of
the Chinese Cultural Centre, there was an explosion of resistance from
Chinatown merchants. They would eventually join Bryce Rositch and others
from Gastown to form the Community Alliance. Together they vigorously
opposed plans for four centres to deal with drug addicts in the Downtown
Eastside. They lost.

In May of 2001 the city adopted the Four Pillars as Vancouver's official
drug strategy. Two years later in September 2003, the first safe injection
site in North America opened in Vancouver. It was virtually unopposed. Drug
overdoses had leveled out to about 50 a year.

On Monday, I'm told, the first clients received free heroin in another
facility, at Hastings at Abbott, as part of the North American Opiate
Medication Initiative. On Friday the British medical journal, The Lancet,
will have an article noting the progress made at Vancouver's safe injection
site in reducing the spread of disease.