THE KERRISDALE FIX

In Nettie Wild's documentary Fix, an East Side businessman claims that if
Kerrisdale had his neighbourhood's problems, they would have been solved in
a fraction of the time it's taken in the Downtown Eastside.

When COPE mayoral candidate Larry Campbell suggested a safe injection site
in that affluent community, the intake of breath across the West Side was
practically audible. NPA opponent Jennifer Clarke accused Campbell of being
inflammatory-though she later agreed safe injection sites should go where
they're needed.

The implication of the reaction is clear: the notion of a drug problem, with
brazen dealers, flailing addicts fixing in lanes and attendant crime, is
inconceivable in well-heeled Kerrisdale. Many West Siders would like to
believe there is no drug problem, hidden or otherwise.

The facts, however, tell a different tale. For every hour it's open,
Kerrisdale's needle exchange distributes 15 clean syringes to local users.

Ten days before the election, From Grief to Action, a support group for West
Side parents of drug addicts, hosted a candidates' forum on drug issues at
St. Mary's Anglican church in Kerrisdale. Founding member Nichola Hall was
concerned coverage of the drug issue had been saturated. "I was worried no
one was going to show up." Instead, the Nov. 6 meeting was the best
attended, and arguably one of the liveliest, of the campaign.

"Three years ago when we first met," says Hall, "the idea that 300 people
would come to Kerrisdale to talk about the drug problem was unfathomable."

This weekend, the city will have a new mayor-decided after the Courier's
deadline-and Kerrisdale is pondering what that will mean for its staunchly
middle-class image and not-so-hidden drug problem.

Hall, a mother of two sons currently in Methadone treatment for addictions
to heroin and injected cocaine, has a vision of better times she hopes the
election will usher in.

Most of what she sees is centred on a low-rise brown concrete building at
the corner of West Boulevard and West 43rd Avenue.

Pacific Spirit Community Health Centre is an unremarkable building. Outside,
there's a red awning over double doors. Inside, to your right, is a long
formica reception desk, modular couches, a worn carpet and old magazines.
Someone has trained a hanging plant to grow across the top of the picture
window. In the waiting room are pensioners and a father with a mischievous
two-year-old. The staff seem to know most people by name. Nichola Hall wants
to put a safe injection site in the middle of it.

The thing is, the needle exchange has been operating from the formica
reception desk for four years. Every week day between 3:30 and 4:30, a brisk
business occurs in brown paper bags. Used needles slide over the counter and
are replaced with clean ones. The bags could easily be from the bakery or
card shop.

Kerrisdale residents who have seen the Downtown Eastside TV pictures of
broken and desperate addicts sticking needles in their arms worry that a
safe injection site in Kerrisdale will somehow draw those people out of the
East Side onto West 41st Avenue.

"Obviously, we don't want druggies lying around," says 74-year-old Isobel
Fulton, a five-year resident of Kerrisdale. She later qualifies her stance:
"If things like that are going on all around, the treatment needs to be all
around. It's only fair."

Ross Hill, proprietor of Hill's of Kerrisdale, an upmarket men's and women's
fashion store, shares Fulton's sense of civic duty. He's been to see Fix
and, as a citizen, thinks it's hypocritical to tell the East Side a safe
injection site is "not fair in my backyard, but it's just fine in yours."

But as a past president of the Kerrisdale Business Association, and a man
with a store to run he has doubts. He sees Kerrisdale potentially paying a
price for its sense of duty if there's only one suburban injection site and
it happens to be on his doorstep. "If they were as common as bus stops, no
problem, but not just one."

Hill sees the Oakridge shopping centre as an equally central and convenient
location for an injection site, but where Kerrisdale is a neighbourhood, a
mall is private property. In Hill's view, the city can lean on neighbourhood
business associations to be civic-minded, but a private facility like
Oakridge isn't held to the same standards.

Though he admits he knows little about injection sites, Hill points out the
Kerrisdale Business Association's mandate is to promote a prosperous and
safe business environment for its members. He suspects customers will be
driven away by the unknown quantity.

The fear that a safe injection site would be a massive honey pot luring
drugs users from the East Side-or anywhere else-into the waiting room at
Pacific Spirit is unfounded, argues Thomas Kerr, a University of Victoria
research psychologist.

Kerr, who was hired to write Canada's first proposal for a safe injection
site, visited 19 such sites in Europe and Australia with his team. Data
collected showed that 95 per cent of heroin users venture no more than a
kilometre from the point of purchase to the point of consumption.

Now working at St. Paul's Hospital, where a limited form of supervised drug
consumption has been available for 25 signed-up patients at the Dr. Peter
Centre since last spring, Kerr says there's no evidence anywhere in the
world that addicts will travel any significant distance to use their drugs.

The argument is backed up by Vancouver Police data. VPD studies in both the
Downtown Eastside and suburbs show that IV drug users travel fewer than 200
metres between purchasing and fixing. "These people are addicted to drugs,
not safe injection sites," says Kerr.

Most people aren't that easily reassured that an open drug scene won't
develop in Kerrisdale if a site is opened, however.

The users may blend into the passing crowd, they argue, but the dealers who
sell to them will be loitering on the street corners. The worst-case
scenario features drug dealers on street corners down the boulevard towards
Point Grey Secondary School.

It's a scenario that flies in the face of all available data, says Inspector
Kash Heed, a member of the Vancouver Police Department's vice squad. Citing
several studies of European and Australian injection sites, Heed says there
has never been a case where more addicts or dealers have gravitated to the
area around a site.

In Australia, the Sydney Police Department has been tracking the notorious
downtown King's Cross neighbourhood since an injection site opened late last
year. According to its monthly reports, there has been no observable
increase in crime-including drug-related crime-or the number of drug users
entering the area.

Other cities' experiences tell Heed and Kerr that if a neighbourhood doesn't
already have open drug dealing or use, an injection site won't change that.
Kerrisdale addicts will continue to buy from the dealers they've always
used-the kind who drive in and deliver. It's a program the vice squad and
the users call "Dial a Dope."

Lisl, a Kerrisdale mother who did not want her name used for fear of
identifying her daughter, who is in methadone treatment, didn't know you
could order drugs like pizza. She and her husband were aware of phone calls
coming in late at night, and that their daughter would slip out for a couple
of minutes after hanging up, but they never connected the dots. Assuming
ordinary teenage secretiveness, they never imagined she was going straight
to the bathroom to shoot up when she got back.

After learning the same lessons, Nichola Hall found herself chasing a shiny
late model sedan down the lane behind her house to get its license number.
The car's driver had just sold heroin to her son outside the garage.

Though the two Kerrisdale kids may have paid a few extra dollars for the
luxury of having their heroin delivered, the quantity and quality of cocaine
or heroin is no different from what you can purchase in the Downtown
Eastside, says Heed. "It's the same stuff from the same dealers, with the
same chances of impurities or overdose."

Even if the dealers aren't standing out on the boulevard, some parents worry
about the effect an injection site at Pacific Spirit would have on their
children. Joanne Yen, a Kerrisdale mother with two children in grades 8 and
9, is worried the site's presence might encourage kids to experiment with
drugs, or see them as cool. In response, Hall asks rhetorically how many
teens think going to the doctor's office is cool. For Hall, injection sites
are part of a health care approach to addiction, just like clinics for
anorexics. "No one sees an anorexia clinic as encouraging eating disorders,"
she says.

Kerr points out that the average age of an IV drug user in Frankfurt has
increased since the introduction of safe injection sites as part of a larger
harm-reduction program. The German theory is that the local kids no longer
see injection drug use as part of a wild, fun, party lifestyle. In the kids'
eyes, "the addicts have become people who are not well," says Kerr, "people
who are on their way to the doctor to get help. Not party animals."

But why does the neighbourhood need a safe injection site at all, if there's
no visible problem to correct? For Hall the site and services around it
represent a leap forward in dealing with the problem of addiction in a
community fixated on social stigma rather than solutions.

If there had been a site when her sons started using drugs at age 15, the
family would have had somewhere to go, says Hall. "The family doctor didn't
know where to go; the school counsellor didn't know where to go. As parents
we had to strike out on our own to find help." The time wasted tracking down
resources that would be easily available at the new site might make the
difference in an addict's life, she says. "If we'd caught [our sons' drug
habits] early enough, maybe we could have nipped it in the bud."

For Kerr, slowing the spread of disease is also a very real public health
benefit to be derived from even a small installation. He's not suggesting a
massive 20-seat shooting gallery for Pacific Spirit. If a site is opened, he
says, it would be on a very small scale-eight by eight feet, with two seats
and a table. Its primary purpose would be to offer education on safe
injection practices for addicts who generally shoot up at home in the
bathroom. Most users don't know that a needle has an up and a down side.
Used one way, it protects the skin and veins. Used the other way, it tears
and rips, increasing the risk of contracting and spreading diseases such as
hepatitis and HIV.

For both Kerr and Hall, the most important thing about the imagined
injection site is that it be "embedded" in a larger set of addiction
services. Hall pictures a revamped Pacific Spirit capable of drawing in
addicts and turning them into patients. They may come for the supervised
injection site, but they're never more than a couple of doors away from
counselling, a detox bed, or a doctor. Proximity to these advanced services
means an addict can capitalize on the fleeting moment when they feel like
they want to quit.

In Hall's centre, the addict walks in, exchanges needles, passes his heroin
to a street nurse, who tests it for purity, and takes up a chair in the
injection room. Before or after shooting up, counselling is available. Two
doors down on the left is detox-on-demand-a half dozen beds and a place to
straighten out before entering treatment. At the same formica counter where
the needles were exchanged, a methadone dispensary fills prescriptions
written by the health centre doctor as part of treatment. Once a week, a bus
drops by Pacific Spirit on its way to a treatment centre outside Vancouver,
a place away from the old habits, the old triggers.

It seems like a grand, expensive plan, but Hall insists the savings on
ambulance calls, hospital admissions and overhead associated with the
revolving courtroom door for drug addicts will easily cover the cost. Better
still, the result will be recovering addicts, people who can work and pay
taxes.

Though she acknowledges most West Side addicts already do have jobs, or are
financially secure, Hall says that's all the more reason to get them into
treatment.

According to Insp. Heed, the average Kerrisdale heroin user has paced out
his or her habit and functions fairly normally. While on the Downtown
Eastside, a crack cocaine addict may get high every 25 or 30 minutes, in the
suburbs, where the mellower fix and longer effects of heroin are the drug of
choice, an addict may have a once or twice-a-day habit.

The problem comes as the amount used increases. Add in the stress of exams,
or a break up, or even a really big party and suddenly the paced addict
needs to score much more often. The more they need, the more likely they are
to gravitate towards an open air market, says Heed. Enter the Kerrisdale
treatment centre; a place to shoot up, a place where counselling is closer
than the next dealer.

To give some idea of how many people a safe injection site at Pacific Spirit
would actually serve, Mark Haden, director of addiction services, points out
that over the last five years, the waiting list for one-on-one addictions
counselling at Pacific Spirit has ranged from a month to six months,
although that's for all forms of addiction. At times, it's been the longest
list in the city, despite the fact that up to seven counsellors are
available.

Since responsibility for addiction services shifted from the Health Ministry
to the health authority six weeks ago, Haden has proposed that the needle
exchange come under his department's control. If the proposal goes through,
he hopes to extend its operating hours beyond a single hour a day. If he
succeeds, it's not the kind of move he's interested in making a splash with.
"It's all about discretion, for the neighbourhood and for the users," he
says.

While Haden takes small steps forward, Hall's grand vision stands tall in
the distance. Other communities have had similar visions-and similar fears.
When safe injection sites were first proposed in Frankfurt, Germany, more
than 1,000 protesters turned up, says Kerr. Six weeks into the pilot
project, fewer than 100 showed up for a protest. The point for Kerr is that
an injection site doesn't radically alter a neighbourhood-even Kerrisdale.

For him, and Hall, supervised injection is only a start. "They're a small
part of a larger strategy," says Kerr. "They will not solve the drug
problem."