VANCOUVER'S SAFE SITE POPULAR WITH JUNKIES

Injection Facility Tries To Serve 5,000 Addicts. Treatment Programs At
Risk, One Worker Says

VANCOUVER--A woman comes flying down the street and pounds the doorbell at
the city's safe injection site, her hands wringing and covered in scabs.

The door doesn't open; the site is busy and she has to wait, but she can't.
She moans and cries at a dealer for a flap of heroin and races back to the
doorway of the shooting gallery, whips up her pant leg and jams the needle
into her skin.

People can't wait to get their fix, said Doreen Littlejohn, a counsellor at
the Vancouver Native Health Society.

"It's great to have a safe place for people to go, but a lot of our clients
won't walk the half block down the street to use it. They need to use the
drugs the minute they get their hands on them, no matter where they are. So
they're still doing it in the street, in our doorway, in the alley."

That's not to say the safe injection site isn't popular among many of the
estimated 5,000 heroin addicts in Vancouver's gritty Downtown Eastside
neighbourhood. Those who can make it there say they prefer it to the street.

Clients have to register but a tattooed receptionist tells them they can
give initials or a fake name. The waiting room is sterile, except for a
strung-out man frantically trying to brush make-believe bugs off his skin.
A massive injection wound stands out on his arm, red and angry.

When there's space, people are buzzed into a second room where they give
their code name to another staffer, this one heavily pierced. He offers
needles and bands to tie off veins.

The lighting is soft, the music is mellow. Clients take a seat at what
looks like a library cubby.

There's no rush. A nurse, who oversees the room but doesn't intrude, will
help people find a vein if they are having trouble.

A woman who nips out to smoke crack before shooting up confides the nurses
will perform the injection for people if they're too out of it. "It's safe,
man; honestly. Way safer than the street," says the thin woman with lesions
on her face and stringy brown hair.

"Everything is clean, the people are really nice, the cops can't bother
you, you can chill out after. They'll give you coffee and sometimes there's
food."

"You can survive out here if you do it right. It's my 50th birthday today
and I've been using for 35 years," she says.

The site's chillout room isn't exactly the best place to celebrate.

Hot Hot Heat, a punk band from Victoria, plays on the radio while a man
rifles through a garbage can in the middle of the room. With its lineup of
chairs, it resembles a hospital waiting room.

But Canada's first legal supervised injection site is not going to make
much of a difference, said Ann Livingston, a project co-ordinator with the
Vancouver Area Network of Drug Users.

"All the research on different sites anywhere in the world shows that the
idea of having one in a city is not enough," she said. "The Downtown
Eastside needs a minimum of four with staggered hours and each with a
different feel (and) different setting to attract different groups of people."

One facility can't possibly serve the city's 5,000 addicts. "So you may not
see a dent in overdose and disease rates," Livingston said.

So far, the Vancouver Coastal Health Authority says about 25 people who
have overdosed have been taken to hospital and saved.

Meanwhile, another problem grips the city slum.

In the past five years, crack has hit Vancouver streets in a big way.
Smokers' lips are burned and split and they are spreading hepatitis C.

It's estimated about 90 per cent of intravenous drug users in the area are
already infected with hepatitis C and that about 30 per cent are HIV positive.

An inhalation room was built in the federally sanctioned injection facility
and staff are lobbying for an exemption to allow people to smoke crack there.

John Turvey, the founder of the city's first needle exchange, thinks the
facility might be over-emphasizing harm reduction. "They're jumping all
over this (the safe injection site) and forgetting about the treatment
programs that were supposed to go with it. What about abstinence and the 12
steps?"

Counsellors at Vancouver Native Health agree, saying the injection site
just enables addicts. "Some of our clients are working there, getting a $25
stipend for hanging out and giving peer support, and they have been
triggered to use," David Ramsay said.

Ramsay believes it's wrong to fund the injection site while there is a
shortage of detox beds. The waiting list for a junkie who begs him for help
to get clean is at least five days.

"And in that time we lose them," Ramsay's colleague Patti Smith said.

"We need to be able to respond to these people the minute there is a
window. They're taking responsibility and we need to acknowledge it right
away."

The goal of the safe-injection facility is to get people off drugs, though
it's hard to imagine anyone comfortably getting high there would make that
choice. But apparently they do, say those who have worked at the illegal
supervised injection sites that have been operating in the city for years.

Maxine Davis, director of the Dr. Peter Centre, said five users have quit
during the year and a half their centre has offered a supervised injection
service.

The service is part of its day health program, which also includes art and
music therapy, counselling, hot meals, showers and medical services.

About 30 people use the injection site every day. Unlike the sanctioned
safe injection site, users at the Dr. Peter Centre could be charged by police.

"What's most profound is how it has opened up the dialogue. These people
are hard to reach and in this setting they have a much greater engagement
with staff and really open up about their addiction. And we are there to
help them make choices in their lives."