HASTINGS NEVER RESTS

Exploring The Reality Of IV Drug Use

It's like one of those cheap horror flicks where zombies come out of the fog.

The sun sets on East Hastings and everything turns to a dull, greyish
colour. Vibrant murals are all but drowned out by graffiti and the
once-living faces of the people that trudge past it. But like the walls,
the faces are disguised by warped, drugged-up masks--people aimlessly
wandering, prodded skin and sunken eyes.

Once you enter East Hastings, you've stepped into something you can't quite
call life. The people aren't dead yet, but they're not alive either.
Needles decorate the curbs. Piles of what looks like rubbish turns out to
be someone's home for the night. The alleys smell like outhouses with a
hint of rotten food, marijuana or vomit . . . it's hard to tell which one.
The volume seems to be muted except for the random bursts of profanity.
Everything is hazy. Everything is monotone. You may as well be colourblind.

This is East Hastings Street. Downtown Vancouver. Friday night at 11 p.m.

"It's almost sexy and glamorous because it's so horrific," says Steve
McDougall, a recovered drug addict who spent years on and off heroin. "I've
never seen anything like it in North America."

Maybe that's because he's used to Victoria, our little tourist city on the
island, beautiful and quaint. Or maybe it's just quieter, hushed to
"beautify" the city, to attract the tourists. We don't have an East
Hastings to see or smell, but have you seen the Open Door, the Needle
Exchange or "Crack Corner" on Pandora and Douglas? Victoria has 2,000
intravenous drug addicts--the same amount, per capita, as Vancouver. We're
just not allowed to notice.

The provincial government is spending $10 million on a Vancouver site that
will provide free, legal heroin for addicts. It will open in January. Even
more than that is spent on enforcement options. Yet Victoria hasn't
received funding to create one recovery house. A year after Vancouver set
up its experimental safe injection site, Victoria is now looking to open
one. According to the Vancouver Island Health Authority, the site is almost
a guarantee. McDougall says this shows the city is making an effort to come
to grips with these issues.

There are 5,000 intravenous drug users on the Downtown Eastside in
Vancouver--the highest concentration in Canada. Insite, Vancouver's safe
injection site, oversees about 500 users and up to 800 injections per day.
Ninety per cent of its patients are infected with hepatitis C and 30 per
cent are HIV positive. According to McDougall, though roughly one in every
five families are affected by addiction in some way, the majority of the
public refuses to care.

"We're trying to change the perspective on drug addiction from a criminal
issue to a health issue," says Jeff West, the co-ordinator at Insite. "It
takes the buzz out of doing drugs because this place is very clinical. The
folks that use the site are not people who are in the party mode."

The immaculate site resembles a Radio City Music Hall dressing room: 12
booths lined up, each equipped with full-length mirrors to allow the user
to see his or her vein while nurses observe the injection. The mirrors were
also installed, however, to force patients to look at what they have become.

Insite is a clean, safe environment where supervised injections occur with
self-provided drugs. The site provides sterile needles, medical care and
counselling for its patients. It is a type of harm reduction, a division of
Vancouver's Four Pillar Drug Strategy, along with prevention, enforcement
and treatment. According to West, this is harm reduction for both the user
and the community. Police and local businesses have less drug-related
trouble to deal with, and curbs are not strewn with used needles anymore.

"The businesses have dealt with the problem for so long, their compassion
started to slip away," says West. "But I think it's coming back now."

The clinic focuses on building trusting relationships with the users and
connecting them with detox centres, referring between five and 10 patients
every day. Insite has just received approval to build a low-threshold detox
centre on the second floor of the building that will house 20 to 28 beds,
adding to the 48 beds in the two existing detox centres.

According to Sgt. Al Arsenault, a Vancouver police officer, harm reduction
isn't necessarily the right approach. He believes that it undermines the
other three pillars for drug strategy because it is the only division that
doesn't condemn drug use.

"What does the harm is the relation between the addict and the drug," says
Arsenault. "Don't blame it on the needle."

In 1987, a needle exchange was established in Vancouver, and 127,000
needles were given out. Instead of improving the situation, the problem
worsened because desperate cocaine addicts used the needles to pump
coke-infected blood into their systems.

"On the fourth day of coke runs, [the addicts] would take the clean needles
to flush blood residue off the walls in case it had a trace of coke in it,"
says Arsenault. "There are all of these frailties of the human character
that no needle exchange can account for."

Last year, Vancouver's needle exchange gave out over three million needles,
and the hepatitis C rate among users skyrocketed to 90 per cent.

"These drugs are poison, and we're saying, 'let's do it,' and calling it
safe," says Arsenault. "When a dog gets into poison, we take it to the vet
and take the poison away. I wouldn't treat a dog like we're treating these
people."

Arsenault admits that a positive aspect of Insite is the immediate
assistance someone receives in case of an overdose.

"The act of overdosing won't go down," says Arsenault. "Death from
overdosing [might]."

This is what the provincial government has labelled as success. A pulse
equals victory. So, in that sense, we have improved--maybe not the quality
of life but the fact of life.

"The threshold that we're accepting at which drug use is tolerable is
death," says Arsenault. "There's got to be something more than just a pulse."

Victoria's site has yet to be established. In the meantime, citizens,
churchgoers and patrons have created a few areas of refuge for drug users.
One is the Open Door on Pembroke Street, providing shelter, food, Internet
and a place to socialize.

Addicts sprawl on the steps outside, either over-intoxicated or yearning to
be. But inside, everyone reads the paper, plays pool, drinks coffee and
socializes with Reverend Alan Tysick, known to everyone as "Al."

"The people here aren't throwaways," says Dennis, a drug addict who asked
that his last name not be used. "They just look like it. It's not fair."

The Open Door is Victoria's safe haven for those who don't have one, a
place to keep track of the street people without homes. "Otherwise, they
just fade away, and you're sent a list saying who has died," says Dennis.
Three memorials were held here last week.

Kerrie Scott, a social worker for the Open Door who graduated from the
University of Victoria in June, thinks this is a great step for Victoria's
drug scene. "It doesn't make any sense denying what's happening," she says.
"People are dying."

One of the most difficult challenges users face when combatting their drug
addiction is the stigma that it has in society. "You feel like such a piece
of junk anyway," says McDougall. "You might as well keep using because you
don't deserve to live."

Most addicts isolate themselves from society because they are too ashamed
to let the public see their pain. By doing so, they feed their addiction
because no one discourages them from using. "I thought all drug addicts
were a waste of human skin," admits Daniel MacDonald. "That is, until I
started associating with them."

MacDonald, who has never used intravenous drugs, found himself forming his
own needle exchange after he witnessed a young girl playing beside a used
needle on the street.

Now, he is a member of the Society of Living Intravenous Drug Users
(SOLID), the most active user group in Victoria that deals with harm
reduction and needle exchange. It is the only group that does not promote
abstinence.

At the weekly meeting at the Capital Regional District health building, a
few of its 150 members gather, surrounded by the smell of marijuana, to
discuss drug-related issues. Last week's meeting included a 31-year-old
grandmother, a master's graduate, a certified first aid trainee and a woman
who had nothing but her 1998 chequebook to verify the date of a November
2004 meeting. Every member at the meeting suffered from hepatitis C. Two
were also HIV-positive.

They are tired of the government's lack of funding for drug relief services
and impatiently wait for the talk of Victoria's safe injection site to
become more than just a hot conversation topic. One of these members is Dennis.

"In the meantime, we're trying to teach [drug addicts] that what they're
doing is killing themselves," says the 48-year-old member of SOLID.

But time is constantly running out for users. "You can't save the dead,"
says McDougall. And he would know. He was a musician and a writer, an
intelligent, cultured man who had travelled the world. He used to perform
in a band called The South Side Allstars and owned a prosperous record
store, Mezzrow's Records, in Victoria. In his words, "creativity symbolized
the point of being alive." He was a community support worker who worked
with children with autism and Down syndrome.

He was also a drug addict--a drug addict who relapsed three times and
recovered three times, who lost three marriages and left three children
without a dad. All because he couldn't get off heroin.

In the 1980s and early '90s, McDougall suffered from two life-threatening
drug relapses. Both times he tried rehabilitation treatment. Both treatment
facilities experimented with potential cures to heroin by substituting the
addiction with methadone and morphine. By the time McDougall relapsed for a
third time in 2000, what he was left with barely constituted a life.

He couldn't read, write or even talk. His body was confined to a
wheelchair, while his mind was confined to whatever drug he could get his
hands on. He was so filthy that his little girl asked him not to tuck her
in anymore.

"I tried to pull away as much as I could out of shame," says McDougall. His
ex-wife informed his family in Portland, Ore., of his decrepit condition.
He hadn't contacted them for a decade, but when they heard of his state,
his two younger brothers immediately came to Victoria to convince him to
attend rehab.

His only long-term treatment option in Southern Vancouver Island was
Edgewood, a treatment centre located in Nanaimo. As with all treatment
facilities in British Columbia, the only glitch was the expense: $10,000
for eight weeks.

His family paid for the entire thing, as well as an extended program for
those who require more time before re-entering society after the eight-week
in-patient cycle. On top of the $10,000, the extension cost $1,500 per month.

"My family came and saved my life," says McDougall. "I was basically dead."

His self-proclaimed "clean date" was Dec. 18, 2002, when he began his
four-month stay at Edgewood.

At first, McDougall couldn't even focus enough to read two lines. He was
hostile and self-loathing. For the first five or six weeks, he refused
anyone's advice. The turning point was when he decided to "shut up and
listen." He began to see that he deserved to live--that he was worth it.
And through that, he dug up the essence of his life: writing and playing music.

"I thought I had lost those forever," he says. "Choosing to resume my life
was choosing to embrace creativity."

He feared returning to Victoria after he finally recovered. He didn't want
to see his "ghosts from the past," the places he had broken into, the
people he had hurt. But this time, he didn't relapse. Instead, he felt that
he had the strength to help others suffering from drug addiction.

Though a lot of people told him that re-integrating with users would harm
his recovery, McDougall disagreed. "Almost immediately, my reaction was
horror," he says. "There was no fucking way I'd choose this again."

He is now actively involved in Narcotics Anonymous service work and speaks
at Victoria's detox centres. In two weeks, McDougall will celebrate his
second anniversary of being clean.

He is one of the lucky few that got a second chance to learn of a life
without drugs, with motivation and a sense of personality. Users often lose
these qualities to the greed and ego of a drug addict who just needs his or
her fix.

When someone is on their last breath, says Sgt. Arsenault, an addict will
steal the boots off their feet instead of calling an ambulance.

This province's funding for treatment facilities is miniscule considering
the number of addicts in Victoria and Vancouver. It is also far less than
the amount of funding invested into the other three drug strategy pillars.
There are less than 100 detox beds in British Columbia for the 10,000 to
15,000 intravenous drug addicts who live in the province. Victoria has only
seven.

Currently, treatment is too expensive for the average addict to afford. The
only options are the standard 28-day treatment sessions that are far too
short to be effective for heavy addicts.

"The adjustment [at rehab] was major," says McDougall. "If it was only 28
days, I wouldn't have had a chance . . . Treatment is so horribly
under-funded."

Though Victoria used to have safe houses, the government has now shut down
almost all of them. One of the only remaining safe houses is the Foundation
Recovery House that carries a 12-step program. There are also two other
small safe houses on the island, each housing less than 10 people at any
given time. They are difficult to stabilize and rarely have 24-hour staff.

"There needs to be a place for people to go if they do decide to change
their lives," says McDougall.

Though murmurings about drug abuse issues are gradually changing to voices
confronting the unavoidable issue, harm reduction is only one step in the
war on drugs. The drug addiction rate will continue to rise unless we
receive funding for treatment to build more residential treatment
facilities and recovery houses. The question is not why drug users don't
choose to stop, it's where they would go.

On East Hastings at midnight, a 32-year-old woman doesn't even run from the
police as she snorts her coke. Before she tried it at a party over a decade
ago, she had a college degree and a planned future. She looks unusually
strong in her fragile situation. Snot drips from her nose onto the ground
because it is so cold. She doesn't notice. Or she doesn't care.

"I lived right there in those apartments growing up," she says, pointing to
an old building flanking the worst alley on Hastings. "My view was this
alley, and I thought it was disgusting. I hated it.

"Now I'm one of these people."