GETTING JUNKIES OFF STREET, INTO CLINIC - TO SHOOT UP

VANCOUVER, British Columbia - Her fingers travel up and down her arm,
feeling for a good vein. Lori-Kim Veenstra opens a $7 bag of
methamphetamine and pours some of the crystals onto a clean spoon. She
opens a tiny blue bottle of sterile water and fills the spoon, waiting for
the chemical to dissolve. Sometimes junkies use water from puddles to break
down their drugs, sometimes soda pop or toilet water. Sometimes they use
their own blood.

Not here. Veenstra, 40, is in a clinic at the Dr. Peter Centre, where
junkies who test positive for HIV can shoot up safely under supervision.
This is one of the first of what are called "safe-injection sites" in North
America. Soon to be sanctioned by the provincial and federal governments,
it is an example of a new policy in Canada, called harm reduction, to
address a pervasive drug problem plaguing Vancouver and other major cities.

In the last year, Canada has drastically shifted its approach to drug
users, going from punishing them to instituting the policy of harm
reduction. This program makes sure junkies are safe while they are shooting
up instead of jailing them.

"Before I knew about this room, I used to go outside and shoot in the back
alleys," Veenstra says. She ties a blue rubber tube around her left arm and
pulls it tight with her teeth. She takes a clean syringe and draws up the
liquefied drug, sucking it through sterile cotton, hoping the cotton will
capture the impurities in the addictive stimulant, made of substances she
is unsure of - her crystal meth could be cut with drain cleaner, baby
laxatives or asbestos.

The syringe is full now. She steadies the needle and points it at her best
vein.

"The only thing I ask of you," she says, looking up, "is don't talk to me
and don't ask me if I'm OK. OK?"

The needle punches her vein, and there is a slight hissing sound. She drops
the needle. But there is no hurry. She is not on the street. There is no
fear that another junkie might attack and stab her, then run off with her
drugs. There is no concern of an overdose.

All the time, a registered nurse is watching, guiding her, making sure that
she uses sterile water and cotton and a clean needle, and that she inserts
the needle correctly, following instructions.

"Go flush with the skin," a nurse, Patti Zettel, says. "Then up. Once in
the vein, release the tourniquet. Look, she has good blood flow."

Throughout Canada, officials are considering radical changes in the
country's approach to drugs, rejecting the tendency in the United States to
push for law-enforcement solutions.

In so doing, officials are taking up the stance of several other countries,
including Germany, the Netherlands, Switzerland and Australia, which have
various programs for decriminalization, clean needles, and free methadone
clinics.

The Vancouver-based Harm Reduction Action Society, which advocates changes
in drug laws, reported that drug overdoses in Frankfurt, Germany, decreased
from 147 in 1991 to 26 in 1997 with the creation of safe-injection sites.
In Switzerland, it said, overdoses also declined, and there was a marked
increase in the number of people registering for methadone and other
treatment programs.

U.S. officials have angrily criticized the Canadian policy of harm reduction.

"The very name is a lie," John Walters, the White House drug-policy
director, said in a telephone interview. "There are no safe-injection
sites." He said the United States would continue to treat drug abuse as a
"deadly disease that shortens lives."

"It is reprehensible to allow people and encourage people to continue
suffering," he said.

Canada also faced criticism from the United States in May when it proposed
decriminalizing possession of small amounts of marijuana.

Canadian officials said their approach was intended to combat HIV, rampant
among drug users, and to decrease overdoses. Officials in Toronto, Montreal
and Vancouver are also debating whether supplying heroin to addicts would
save lives and combat criminal behavior.

The Dr. Peter Centre does not yet have legal sanction to run its
safe-injection program, but officials are allowing it to operate without
interference. The provincial government has approved a three-year, $1.1
million pilot program, to be run by the Vancouver Coastal Health Authority,
for a safe-injection clinic in the drug-ridden Downtown Eastside district.
This includes exemption from prosecution under the Controlled Drugs and
Substances Act.

Part of the pilot program involves gathering information on whether addicts
will be more likely to seek treatment, and whether the number of drug
overdoses and cases of infectious diseases decrease.

"Somebody said, 'Why are we helping addicts?' " said Viviana Zanocco, a
spokeswoman for the health authority. "... Why shouldn't we? Are we only
supposed to help heart patients?"

The program also makes good economic sense, Zanocco said. "When we get
somebody with HIV, it costs $150,000 Canadian [about $107,000 U.S.] to
treat over a lifetime," she said. "... If we can prevent 10 people from
contracting HIV, the safe-injection site pays for itself."