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Sunday, Nov 8, 2009
I do not live in Vancouver but have plenty of friends who have battled heroin use and addiction. I believe had my best friend not been alone shooting up she would still be alive today. While none of these people fit the profile of "street junkie" some went through of the degrading behaviors associated with the procurement and use of drugs. The older I get the sadder I feel about it all. I have spent some time researching both sides of the issue of dealing with the drug problem. It seems to break down into two paradigms which I'll make very black and white.
Classic drug paradigm: tough love,
misery, sin and suffering leads to redemption,
only when negative consequences associated outweigh or are realized by drug user will drug user stop,
users misery and death provides deterrent to people considering drugs.
Harm reduction paradigm: Stop death and disease, and help users find treatment. Awknowledge that only user can make choice to stop but offer steps to better life. Approaching as health problem takes away romantic self destruction myths.
There are strengths and drawbacks to both. But the old school approach it seems has been given more than enough time to be tested and is mostly ineffective alone. Here in the US we have the highest prison population (both raw and per capita) on the planet thanks to our drug war. Jail is a good place to find and use drugs. It is still an enablement of drug use and is very costly to the taxpayer to house and feed the user (or ex-user) for often long periods of time. Violent criminals belong in jail but most drug offenders are not.
Opponents to needle programs fail to see that the motivation is not for the paranelphlia but for the drug. A health program is not an enticing message to prospective users. A needle is still a needle even if it's clean and who likes needles espicially among kids or teens? The corpses on the streets in Vancouver didn't seem to be a very good detterent if there were simply more and more of them. Users have friends and families as well who have to live on both mourning and in shame that drugs deaths produce. HIV is not an quick death sentence anymore neither is Hep C which is good but these facts strengthen the prevention arguement even further since long term treatment is extremely costly. The other story left out is that users can and do spread the diseases to non users. The spread of disease is bad for all of us.
The citizens of Vancouver have the right to their property and their safety. Users need to be accountable for their actions. The money saved from health care costs can be used for law enforcement to protect citizens from theft and assault by users. InSite is not needle park it is a controlled environment with no dealing permitted. Dealing nearyby does complicate the matter, cops turning a blind eye raises problematic issues regarding legalization itself.
It does not address how users can affort their addiction which seems to be responsable for a lot crime in Vancouver. But clean needles and a place to inject are not get out of jail free cards.
Users that come to InSite are taking steps towards being proper citizens. By choosing to go there they are taking partial responsibility for their own health. At the end of the day it is the users decision to stop. Being an addict is a hell often within itself. We choose as a society how we want users to effect the rest of us reducing disease and death is a good start. I hope Vancouver provides a model of success for harm reduction approaches as people are still arrested in the US for destributing clean needles.
While safer injecting sites are one approach to harm reduction among IDUs, there are other approaches which may be more acceptable in the conservative climate of the US. San Francisco's ISIS clinic for soft tissue infections has saved the city a considerable amount of money (over and above the operating costs of the clinic) while providing high quality medical care and referrals to treatment. Narcan distribution programs are showing promise in reducing overdose deaths. It is worth noting that safer injecting sites are not the only way to reduce morbidity and mortality among IDUs. It would have been nice if the article had briefly highlighted some of the other innovative harm reduction measures currently being implemented.
"Thanks Man" that's what he said, dying of an overdose in some obscene flop house. Someone put a blanket on him.
He was 35 years old, the youngest boy in a blended family of step-siblings and adoptees, me the only girl and also the youngest.
The safe house opened the year after he died, would it have saved his life? I don't know, Mike was always on the downward path, wasn't always the smartest about the basic choices in life, always making the wrong call. It doesn't matter, he's gone and I miss him.
As long as the walking wounded try to self-medicate, as long as the thrill seekers get themselves stuck with the needle, until we come up with something better, I applaud Vancouver for trying something different.
Keep it up "lotus-land".
I am a native Vancouverite and I have both lived and worked on the Downtown Eastside at various times in my life. I still visit many friends who have chosen to stay and raise their families near Main and Hastings when they might easily live somewhere else in the city. It is a vibrant community with a lot of good points as well as severe problems, as tough as this is to believe. It is also fairly safe. Sure, if you park on the street, your car probably will get broken into and B&Es are common but chances are you won't get shot during an armed mugging. These are still comparatively rare in Vancouver.
Visitors to Vancouver and even residents are rightly appalled by the rampant open drug use and general chaos of the Downtown Eastside when they see it. But this is kind of the point because it is pretty hard to avoid seeing it. Unlike most North American cities where such problems are tucked away and hidden, Main and Hastings is a major Vancouver intersection and a main transit point for people heading into and out of the city. Both the Main and the Fraser buses, two of the busiest routes in the city, have stops right in front of he Carnegie Centre, site of much dealing activity but also of immaculately clean and safe public washrooms. I wonder if many of the people who have written letters here have bothered to visit them. I have and have taken my children in as well.
The roots of the drug problem in Vancouver are many and complex. The city is not only scenically stunning but is also a tough port city. Drugs have always been readily available. The crackdown by the police over the past few years has moved much of the open dealing and using to other parts of the city. A substantial number of the street drug addicts we see were mentally ill before they became addicted. Vancouver is rapidly becoming a city of the very rich and the very poor. Safe, affordable public housing is almost non-existent. Proper housing, located where people are living as opposed to warehousing in vast no-go areas, does make a difference.
Insite has made a big difference in a very small area of the city. Residents and business people, who once were firmly against such a facility in their neighbourhood, now just as firmly support its continued existence. But one facility really can only do so much. I wonder if the people who are horrified to see open homelessness, mental illness, drug dealing and drug using on their home turf would be willing to support mental health facilities, safe injection sites and housing in their neighbourhoods. If the kurfuffle in my neighbourhood (41st and Fraser) when the Coast Health Authority tried to build a residence for the mentally ill, multiply addicted homeless residents already here is any indication, I very much doubt it. NIMBYism is a major barrier to solving this problem city wide but it is not going to go away unless we spread these facilities city wide.
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Fox News' morning show plays to type, talking about whether Muslims in the Army should face "special debriefings"
The survivor and author is upset about comparisons some on the right are making to genocide
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Salon headlines in your mailbox
