but if you can get the addicts to willingly connect with health care professionals, you have won a major battle. The next step will be for the Canadian government to provide pure, unadulterated opiates and the like for use in places like Insite. This will drive all the drug dealers out of business and pull the rest of the addicts into places like Insite. Then the process of helping people to leave the addiction can commence.

Sadly, the U.S. 'War on Drugs,' much like our other wars ('The War on Terror,' 'The War on Child Pornography' etc.), is more about bluster and misappropriated morality than about instituting effective policy.

The Swiss developed clean needle exchange programs in the 1980s in response to the HIV epidemic. Injection sites came out of that effort to keep junkies from shooting up in parks and other public areas.

See "Swiss injection rooms lead the way":

http://news.bbc.co.uk/2/hi/europe/5007962.stm

The Drug Czars have had twenty years to learn from this experiment. But they'd rather just say no, preferring to keep pouring money into programs that were doomed from the outset, but keep them handsomely employed.

Junkies and alcoholics are plunked into prison, where they can continue to decline. We'd rather have an overpopulated jails than do *anything* that might actually help a good-fer-nuttin' bloody addict!

... the very end of this very wonderful article. The man was against it, saw the benefits the safe-injection site ended up offering to the neighborhood, and now supports its expansion.

Say something like that in the US, and you're labelled as a "flip-flopper". And God Forbid you ever, ever say you were wrong about something you campagined on.

It is nice, however, to see public health concerns actually triumphing for once. Especially with a population (drug users) that is so easiliy marginalized and written off.

I have a feeling, however, that it was easier to get the site established in Canada because of the Universal Health Care. The populace can understand that the country as a whole will have to swallow the $150,000 treatment of a HIV patient. In the US, it's just as easy to say "they made their bed; they can lie in it".

Unfortunately.

Thanks for your comments, JMiller. I may have overstated the case regarding the impact that Insite has had on public use around Main and Hastings. However, it was clear that it has had a powerful impact. I was told that much of the public use had moved indoors and this was consistent with what I observed in the nearby streets in August, and relative to what I'd observed there three years ago. Over several hours, while I saw dealing take place on the street (as described in the story), I did not observe a single person shooting up.

While there's no question the safe injection site has saved lives, or that most Vancouverites support its existence, this article doesn't reflect the reality of Vancouver's injection drug poblem. The corner of Main and Hastings looks less dramatic today because of repeated police crackdowns that have sent addicts throughout the city. And to say "almost all injection drug use now takes place behind Insite's doors" is laughable. Injection drug use is more widespread and visible in Vancouver today thn it ever has been.

Insite's success has been promising, but not nearly as dramatic as the author claims.

Mark Follman's article is appreciated. There however is a danger to the program he didn't report. The Conservative national government begrudgingly allowed Insite to continue - hoping, most believe, that the next federal election will turn their minority government into a majority, when they can end it. They have bought into the same rhetoric that the Bush Administration uses - playing to their conservative base which wants to believe that addiction is a moral problem (that only born-again Christianity can solve) and not an illness. Only a concerted effort by people and politicians in Vancouver saved the site this time. Nationally, we're not all that enlightened in Canada, as Follman suggests.

The attitude represented by Insite, compared to the attitude of the War Against Some Drugs, reminds me of speeders on the freeway. Some people tailgate instead of changing lanes and going around, others simply go around well before they reach you. They are the ones in a hurry, places to go, things to do, and Insite reminds me of them. There is a problem, and they want to fix it. The tailgaters remind me of the War On Some Drugs, where the appearance of being in a hurry, of pretending to want to do something, is what's important to the control freak within. They are not really in a hurry, they don't really want to do anything, but they want to present the appearance of doing something, so they tailgate and flash their lights when there is a perfectly open path right there for the taking -- if they were truly in the hurry they claim to be.

And no, I don't drive down the fast lane at the speed limit. I am talking about empty save for me and the speeder, where there is no excuse for tailgating for those who truly do have places to go and things to do. It is only the impatient with nothing else to do who tailgate.

I appreciate Mark Follman's very optimistic article about Insite in my home city of Vancouver. I am very much in favor of the site despite what I am going to say next.

It is now a regualar occurance to see one or two addicts shooting up in the back alley of my apartment. I live in the fairly well-off neighborhood of Kitsilano, several miles from the Downtown Eastside that houses Insite. It's likely that these same people are the ones breaking into our apartment's garage and vandalizing cars every couple of months. Petty crime in Vancouver is on the rise, and drug use is spreading to all parts of the city (I don't know if numbers are up, but many are no longer staying in the Downtown Eastside).

It's easy to find crime statistics here: http://www.city.vancouver.bc.ca/police/Planning/Reports/District.html

Mark mentioned in his article about the 4 pillars that targets prevention, treatment, and crime (and something else that I can't remember). This was great rhetoric for its time, but the only thing that is funded properly is Insite. The police force is vastly underfunded. When we report a break-in to our apartment building, the police don't even show up---just an automated service to report your crime.

My point is that Vancouver has gone too far with its carrot approach and it is affecting the non-drug-addled citizens. I do not want to see Insite go away, but I do want to see fewer criminals on the street.