VERDICT STILL OUT ON SAFE HAVEN FOR ADDICTS

Supporters Say Vancouver Injection Site Saves Lives; Detractors Say It
Legitimizes Drugs, Jane Armstrong Writes

VANCOUVER -- Robert Simmons's morning routine is the same every day: He
showers and shaves, then hops on a commuter train to Vancouver to feed his
heroin habit.

Mr. Simmons's destination is the Downtown Eastside, a fitting endpoint for
a man who equates his morning heroin fix to a jolt of caffeine. These 10
square blocks are the drug mecca of Canada, where the sight of hollow-eyed
addicts is as much a part of the city landscape as the mountains and ocean.

Mr. Simmons, 56, heads for Vancouver's safe-injection site, North America's
only legal place to shoot heroin, now nearly one year old. Once inside, the
former welder scribbles his initials and is handed a stainless-steel basin
of sterilized utensils with which he'll cook his powdered narcotic into a
liquid to inject into his arm.

Most days, he'll use the clinic twice before he catches the Skytrain home
to suburban New Westminster.

Mr. Simmons, whose family life was smashed by his nine-year heroin habit,
said the supervised injection clinic has improved his life and restored
dignity to his daily routine.

"I was always looking over my shoulder," he said during an interview last
week in a coffee shop near the site.

Before the clinic opened, he spent his days scouting deserted locales in
which to shoot up, such as gas station bathrooms or parks, a process that
left him drained and shamed. "Now, I can relax a bit, out of the rain. It
was embarrassing. I still had some pride."

Mr. Simmons isn't the worst of the addicts; he's not homeless or penniless.
Until last year, he maintained a pretense of a stable suburban life; a
comfortable house, a wife and two teenaged children. His hair is combed and
his clothes are clean, but he has the tired eyes of a hardcore addict.

He is a living, breathing poster boy for the safe-injection site, which
opened in September of 2003 after years of lobbying from activists. Like
thousands of clinic users, Mr. Simmons has no immediate plans to stop heroin.

Today, nearly a year after it opened, the supervised site has won
international praise as a pragmatic and humanitarian response to
Vancouver's highly visible drug problem. Locally, it has been embraced by
politicians and health professionals who say it has improved the lives of
addicts.

But not everyone is celebrating the clinic's first milestone. Critics say
the site has done little to change Vancouver's most troubled neighbourhood.
Prostitution, open drug dealing and thieving are still rife along Hastings
Street, the neighbourhood's main corridor.

Overdose death rates haven't dropped as promised, critics add. And addicts
are still shooting up in streets and alleys. Others think Vancouver is
pandering to drug users and say a cottage industry of services for addicts
has sprung up in the Downtown Eastside, undermining attempts to reduce drug
use.

"I think we're doing these people a terrible injustice," said Vancouver
Police Constable Dave Dickson, who has worked the Downtown Eastside beat
for 25 years and is on a first-name basis with many inhabitants. "That
money could be put to better use."

Constable Dickson said the clinic acts as a magnet for addicts. While it's
indeed clean and safe, the injection site, by its very premise, does
nothing to really change addicts' lives. "I have issues with it morally,"
he said. "I guess if you're an addict, it's a good place to go." Addicts,
he said, need treatment -- not safe havens.

But Mr. Simmons has a different take. Ten years into his heroin addiction,
the onetime businessman said he can't quit. He's tried and failed. He hopes
one day to stop and repair his fractured family, but in the meantime he
wants to stay alive. Hence his decision to use the injection site daily.

Mr. Simmons started using drugs in 1991 after he was injured in an
explosion at a pulp mill in Gold River, B.C., where he worked as a welder.
He came home from the hospital addicted to morphine and later switched to
heroin. He hates life as an addict, but the clinic has provided safety and
peace of mind.

Thousands of other addicts agree. If numbers alone were a measure of the
clinic's success, it would be considered a blockbuster. Each day, more than
800 visits are made to the storefront clinic. It has a regular client
roster of about 2,000.

Staff and supporters say it has saved lives and helped clean up the
Downtown Eastside's notorious alleys, where addicts congregate in clumps to
shoot drugs. There are about 4,700 drug addicts living in the neighbourhood
and most are afflicted with drug-related conditions, such as HIV or
hepatitis, that can be caused by using dirty needles and water. An
estimated 65 per cent of Vancouver addicts have some form of hepatitis.

The clinic's supporters take exception to complaints that it doesn't do
enough to stop drug use.

That's not its mandate, said Mark Townsend, an activist who heads an agency
that helps run the injection site. The clinic's sole purpose is to keep
addicts alive.

"Somewhere in their subconscious, they don't want to die," Mr. Townsend
said. "From our perspective, if they can live another day, then we've been
a success."

But critics say there's no evidence the site has saved lives. One of the
repeated rationales for setting up the clinic was to reduce overdose
deaths. But the rate hasn't dropped.

In 2003, 52 people died of drug overdoses in Vancouver. In 2004, there were
15 in the first three months, the latest figures available. If that rate
continues, there could be more overdose deaths this year than last.

Some skeptics even suggest the clinic has caused more harm than good. They
say it condones drug use and speeds the downward spiral of addicts. The
clinic is a three-year, $3.7-million pilot project funded by Health Canada
and the B.C. government.

"You have to ask yourself, what else could have been done with the money
that is being used for this," said Peter Vamos, who runs a drug treatment
centre in Montreal.

Even former drug addicts interviewed have reservations about the clinic.

Sharon Baptiste, 41, and Sherry Vranna, 39, are recovering addicts. Between
them, they have 42 years of experience with heroin addiction.

Ms. Baptiste, who lives in a recovery house in Abbotsford, a two-hour drive
east of the Downtown Eastside, said she used the injection site twice
during a relapse in the spring, although safe was last thing she felt. Both
times she went in she was the only woman. The cubicles were filled with
men. "So, you walk in and you have a bunch of men eyeing you," she said in
an interview at the recovery house. "Then you walk out and all those guys
know you're wasted. That ain't safe."

Ms. Vranna sees the site as yet another service for addicts. In her years
in the Downtown Eastside, she said, she never once bought groceries. When
she was hungry, there was a soup kitchen. When she got her welfare cheque
she went on a binge. Ms. Vranna has been clean two years. She said that if
the clinic had been there while she was using, she would still be addicted
to drugs.

"It was quite a party."

Mr. Simmons disagrees. Heroin addiction, he said, is no party. And the
clinic, for all its physical comfort and caring staff, doesn't lessen the
desolation of addiction.

Last year, his wife of 31 years kicked him out and asked for a divorce.
"She was my best friend for 37 years. She could not understand how I could
choose heroin over her and the children."