Safe place for users cleaned up Vancouver slum, free drugs may make it safer

Amy Carmichael
Canadian Press

Saturday, February 12, 2005

VANCOUVER (CP) - It's a daily grind for the thousands of junkies living in the city's eastside slum.

Waking up dope sick, the body screaming for a fix. Stumbling to the street to turn a $10-dollar trick and shooting every penny directly into the bloodstream.

Chuck Parker, a heroin addict, stands outside Vancouver's supervised injection site, Thursday with a poster that has been distributed throughout the Vancouver's eastside calling for volunteers to take part in a radical study. (CP PHOTO/Chuck Stoody) 

Many of those junkies are fighting for a chance to be part of a study that will give them heroin for free.

Crazy? Many people thought the opening of Canada's first supervised injection site a year and a half ago was as sick as the 4,000 addicts spreading HIV and hepatitis in an eight-block neighbourhood, sometimes called Canada's Third World.

Chuck Parker, an addict living above the controversial injection site known as InSite, said the radical project has cleaned up the streets, literally. He thinks free heroin might make them safer.

"We no longer have rigs laying around on our streets, in our alleys and our doorsteps. We no longer have people shooting up in alleys, we no longer have people using water out of a puddle to inject with. They're in here using safe supplies," he said, gesturing to the door of the supervised injection site behind him.

Eight hundred people go to this safe place, subdued with green plants and shaded windows, to get fixed every day.

A huge improvement but it's not a perfect system, Parker acknowledged as a young woman threw herself on the sidewalk beside him and frantically split open her crack case.

Needles and other gear rattled in the tin case as she shakily cooked a bowl of crack.

A bare-chested man in a leather vest and cowboy party hat lurked beside her. A pimp, a john, somebody to do drugs with until they ran out and have to come up with a way to get more.

"It's ridiculous," muttered the long-haired Parker behind his mirrored glasses.

"For some poor girl to have to go out and prostitute herself for $10 in the mornings and again in the evenings. She may be HIV positive, spreading this in society. She's having to lower herself to this position, so vulnerable she could be one of these missing girls on the Downtown Eastside."

More than 60 women, mostly drug-addicted sex-trade workers, have disappeared from the area in the past 20 years. Robert William Pickton, a former Port Coquitlam, B.C., pig farmer, has been charged with 15 counts of first-degree murder in the disappearances.

"How many people end up in alleys being robbed down here, or beaten," Parker said.

"Girls, even the guys who have to prostitute themselves. This is not just a female problem.

"The theft involved in cars being broke into. . . . This could certainly be solved if heroin was free."

Phone lines opened Thursday for people to call and volunteer to be part of the free heroin study, which has spots for 156 addicts.

Similar programs will start in Montreal and Toronto in the spring.

The federal government was quick to agree with the idea and decided it was important to try, said Dr. Martin Schechter, principal investigator on the North American Opiate Medication Initiative (NAOMI) project.

"They looked at the outcomes of similar programs in Switzerland involving 1,100 people. After the first year and a half they noted marked decreases in criminal activity, improved income and increase in physical health, employment," he said.

"And when the costs of free heroin were compared against the savings for the system when these people are functioning better, it was found that overall far more money was saved."

The support gives Parker hope.

"It's not going to solve all our problems, but it shows that Canada is willing to do whatever it takes. This is a real bold step forward, meeting the hardest to reach people on their terms and seeing what we can do together."

Parker has been able to straighten himself out enough to work under a somewhat similar program. He is on a methadone prescription and receiving a free, stable dose has elevated him to place where he can hold down a job.

Parker, a past president of the Vancouver Area Network of Drug Users, does consulting work for various health agencies and acts a liaison for the drug user community.

He's part of a small group who have been able to stay on methadone without going back to heroin.

Methadone has a bad reputation on the street. It's believed to have a worse withdrawal period than heroin and the constant doctor visits users have to make are too much for people who live their lives with no control.

"With NAOMI, people will go through those hoops when they apply and that's it," Parker said. "You can't expect many addicts to sit and fill out a form when they want their fix. It's not going to happen."

Instead, 156 people chosen for NAOMI will go to its Downtown Eastside office, pick up clean needles, rigs and their prescription and immediately inject under the supervision of registered nurses.

Of that group, 80 will be given pharmaceutical grade heroin. The rest will get methadone. Schechter wants to see which is most effective in helping people improve their lives.

It's possible they will find they have time to think about why they need drugs. Participants who want to will be hooked up with counselling services. Some might even be stabilized enough to work.

Nurses will be on the lookout for people who are topping up their dose with street heroin, so people don't overdose.

"People wouldn't want to do that. That's not the nature of addiction," Schechter said.

"We will be testing for other illicit drugs and doses will be adjusted accordingly. If a person comes into the site and it's evident to nurses that they've used on their own they wouldn't be allowed to get their dose for that session."

Just like everybody else, addicts want to be engaged and make their lives as good as they can be, said Mark Townsend, a worker with the Portland Hotel Society, which helps find housing for the hookers and drug users landlords won't take a risk on.

"Everyone thinks they know the best way for people to beat an addiction. If there was such a thing, people would be doing it. The problem is so complicated that we need an equally deep array of treatment methods. One more approach might save one more person, so it's worth trying."

Free heroin will be allowed to flow under the study for 12 months. When that time is up, people who are getting it will go through a three-month transition to a methadone program.

The $8.1-million cost of running the program for a year will be compared to possible savings it might create for the health and justice systems. That might determine whether it will ever make it beyond the study stage, to a pilot project or permanent programs like those operating in Germany, Switzerland and Spain.

"Maybe then we can start thinking about what we really need down here," said Townsend.

"Free counselling."

 The Canadian Press 2005



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