WILL FREE DRUGS TURN TIDE?

Vancouver Program Could Hit Montreal, Toronto

IT'S A DAILY grind for the thousands of junkies living in Vancouver's
east-side slum. Waking up dope sick, the body screaming for a fix.
Stumbling to the street to turn a $10 trick and shooting every penny
directly into the bloodstream.

Many of those junkies are fighting for a chance to be part of a study
that will give them heroin for free.

Crazy? Many people thought the opening of Canada's first supervised
injection site a year and a half ago was as sick as the 4,000 addicts
spreading HIV and hepatitis in an 8-block neighbourhood sometimes
called Canada's Third World.

Chuck Parker, an addict living above the controversial injection site
known as InSite, said the radical project has cleaned up the streets,
literally. He thinks free heroin might make them safer.

"We no longer have rigs laying around on our streets, in our alleys
and our doorsteps. We no longer have people shooting up in alleys, we
no longer have people using water out of a puddle to inject with.
They're in here using safe supplies," he said, gesturing to the door
of the supervised injection site behind him.

Eight hundred people a day go to this safe place to get
fixed.

A huge improvement but it's not a perfect system, Parker acknowledged
as a young woman threw herself on the sidewalk beside him and
frantically split open her crack case. Needles and other gear rattled
in the tin case as she shakily cooked a bowl of crack.

A man in a leather vest and cowboy party hat lurked beside her. A
pimp, a john, somebody to do drugs with until they run out and have to
come up with a way to get more.

"It's ridiculous," muttered the long-haired Parker behind his mirrored
glasses.

"For some poor girl to have to go out and prostitute herself for $10
in the mornings and again in the evenings. She may be HIV-positive,
spreading this in society. She's having to lower herself to this
position, so vulnerable she could be one of these missing girls ...
."

More than 60 women, mostly drug-addicted sex-trade workers, have
disappeared from the area in the past 20 years. Robert William
Pickton, a former pig farmer in Port Coquitlam, B.C., has been charged
with 15 counts of first-degree murder in the disappearances.

"How many people end up in alleys being robbed down here, or beaten,"
Parker said. "Girls, even the guys who have to prostitute themselves.
This is not just a female problem.

"The theft involved in cars being broke into ... This could certainly
be solved if heroin was free."

Phone lines opened Thursday for people to call and volunteer to be
part of the free heroin study, which has spots for 156 addicts.

Similar programs will start in Montreal and Toronto in the
spring.

Ottawa was quick to agree with the idea and decided it was important
to try, said Dr. Martin Schechter, principal investigator on the North
American Opiate Medication Initiative (NAOMI) project.

"They looked at the outcomes of similar programs in Switzerland
involving 1,100 people. ... they noted marked decreases in criminal
activity, improved income and increase in physical health,
employment," he said.

"And when the costs of free heroin were compared against the savings
for the system when these people are functioning better, it was found
that overall far more money was saved."

It gives Parker hope.

"It's not going to solve all our problems, but it shows that Canada is
willing to do whatever it takes. This is a real bold step forward,
meeting the hardest to reach people on their terms and seeing what we
can do together," he said.

Parker has been able to straighten himself out enough to work under a
somewhat similar program. He is on a methadone prescription and
receiving a free, stable dose has elevated him so he can hold down a
job.

Parker, a past president of the Vancouver Area Network of Drug Users,
does consulting work for various health agencies and acts as a liaison
for the drug user community.

He's part of a small group who have been able to stay on methadone
without going back to heroin.

Methadone has a bad reputation on the street. It's believed to have a
worse withdrawal period than heroin and the constant doctor visits
that users have to make are too much for people with no control.

"With NAOMI, people will go through those hoops when they apply and
that's it," Parker said. "You can't expect many addicts to sit and
fill out a form when they want their fix. It's not going to happen."

Instead 156 people chosen for NAOMI will go to its office, pick up
clean needles, rigs and their prescription and immediately inject
under the supervision of registered nurses.

Of that group, 80 will be given pharmaceutical grade heroin. The rest
will get methadone. Schechter wants to see which is most effective in
helping people improve their lives.

It's possible they will find they have time to think about why they
need drugs. Participants who want to will be hooked up with
counselling services. Some might even be stabilized enough to work.

Nurses will be on the lookout for people who are topping up their dose
with street heroin, so people don't overdose.

Just like everybody else, addicts want to be engaged and make their
lives as good as they can be, said Mark Townsend, a worker with the
Portland Hotel Society, which helps find housing for the hookers and
drug users landlords won't take a risk on. Free heroin will be allowed
to flow under the study for 12 months. When that time is up, people
who are getting it will go through a three-month transition to a
methadone program.

The $8.1-million cost of running the program for a year will be
compared to possible savings it might create for the health and
justice systems.

That might determine whether it will ever make it beyond the study
stage, to a pilot project or permanent programs like those operating
in Germany, Switzerland and Spain.

"Maybe then we can start thinking about what we really need down
here," said Townsend. "Free counselling."