CANADA FIGHTING AIDS WITH SAFE HEROIN GALLERY

IN A LEGAL VEIN: The safe injection site, where marijuana and crack
are prohibited, is aimed at helping users avoid infection, but critics
have called it state-sponsored suicide

David Lands enters an upscale office building, checks in with the
receptionist and goes inside to shoot heroin and cocaine into his veins.

The frail, long-haired addict is one of the first to use North
America's only government-sponsored safe injection site -- called
Insite -- which opened last month as a trial project in a seamy
downtown neighborhood known for junkies and prostitutes.

"They should have more places like this," Lands said afterward,
holding two peanut butter and jelly sandwiches provided by Insite
clinic staff as he recovered from his heroin and cocaine speedball.
"You'd find less people that have overdosed in the alleys."

Critics disagree, saying that providing a legal place for addicts to
shoot up only enables more drug use. US drug chief John P. Walters has
called the Insite clinic "state-sponsored suicide," but those who use
it believe the opposite.

Lands, 32 and a heroin addict since 1997, said junkies can end up
injured or dead from robbers or overdosing when injecting in alleys of
the Downtown Eastside, a 15-block area frequented by 5,000 drug addicts.

The Insite clinic means an addict can feed his habit without worrying
about getting attacked while lying comatose after injecting.

"If you overdose, they help you here," he said. "Not in the alleys.
There they don't care."

Lands and another longtime addict, who would give his name only as
Joe, outlined the Insite procedures. Users bring their own drugs, and
clinic staff provide a kidney-shaped bowl containing a needle, a
"cooker" and matches to heat up the goods and an antiseptic swab.

Joe, a 39-year-old construction worker wearing a bandanna on his
shaved head, agreed the clinic was safer than the streets.

"I was in an alley shooting up and two guys stuck a knife in my
throat," he said, describing a robbery of his stash. "They would have
killed me if I hadn't given it up."

At Insite, the junkies have their backs to nurses when shooting up,
but are monitored by mirrors in the 12 injection booths, according to
Joe and Lands. Nurses show those who ask how to inject safely, but
otherwise have no direct role in the process.

Vivianna Zanocco of the Vancouver Coastal Health Authority, which runs
the clinic with a local advocacy group, said 153 addicts came during
the first two 18-hour days the site was open. Total pre-registration
for the clinic was 600 people, she said.

After injecting, users are monitored in a "chill-out room" -- where
Lands got his sandwiches -- before leaving. They also can get help if
they want to kick their habits.

The WHO and the UN have singled out Vancouver for high HIV infection
rates in a wealthy, western city. According to the British Colombia
Center for Disease Control, more than 30 percent of addicts in the
area have HIV or full-blown AIDS. The city already hands out needles
to addicts under anti-infection programs. The Insite clinic is exempt
from Canadian drug laws, allowing the addicts to posses heroin and
cocaine inside. Such an exemption can be made for medical or
scientific reasons, or if it is in the public interest.

Zanocco said smoking marijuana or crack cocaine is prohibited, and
initial fears that drug dealers would congregate around the site have
proven unfounded, so far.

Police officers maintain a low profile outside, permitting addicts to
enter the clinic with their drugs.

"It is not the police intention to intervene or interfere with anyone
entering the site, unless there is a lawful reason to do so," Police
Chief Jamie Graham said. However, the police presence presumably
scares off dealers

Mayor Larry Campbell, a former police officer and coroner, was elected
last year after pledging to establish safe injection sites as part of
a "four pillar" drug policy involving treatment, prevention, harm
reduction and enforcement.

He called the Insite clinic a vital part of a plan to reduce overdose
deaths and the spread of AIDS and hepatitis C, and to provide primary
health care to drug users. So far this year, 37 people have died of
drug overdoses in Vancouver.

Two blocks away, users inject at an illegal shooting gallery that
opened in April due to impatience over waiting for the opening of the
government-sponsored clinic. Police are letting it operate for now,
but say they are keeping a close watch.

Joanne Csete, a spokesman for the international group Human Rights
Watch, praised the opening of the Insite clinic as essential to
helping users avoid overdose and infection while exposing them to help
toward kicking the habit.