Pubdate: Sun, 26 Aug 2001
Source: St. Paul Pioneer Press (MN)
Copyright: 2001 St. Paul Pioneer Press
Contact:  http://www.pioneerplanet.com/
Details: http://www.mapinc.org/media/379
Author: Deneen L. Brown, Washington Post

'INJECTION CENTERS' SOUGHT FOR VANCOUVER ADDICTS

VANCOUVER, B.C. -- A woman squats on a stoop in an alley. She holds an 
orange syringe in her right hand. With her left, she is squeezing the air 
as if trying to catch an insect that is not there. Half of the dose of 
heroin she had been injecting is still in her needle. She is in junkie limbo.

"She has done a hit of heroin. She hasn't even finished it, it's so good," 
explains Mel Hennan, who is patrolling this city's back alleys.

Next to the woman is a girl with pale skin and braids who looks as if she 
could be the cashier at a fast food restaurant. Yet she's scraping the 
alley with her black fingernails, looking for rocks of cocaine, holding her 
syringe between her teeth like a toothpick.

This is heroin alley in Vancouver's Downtown Eastside, near the corner of 
Main and West Hastings streets, the underworld scene of what police call 
North America's largest open-air drug market. Here, some of the purest and 
cheapest heroin and cocaine on the continent are bought and sold openly 
along streets where tourists are warned to watch out for random needle 
stickings. City officials call Vancouver's drug problem an epidemic as 
incidents of overdoses soar and addicts crowd some street corners.

Last spring, Mayor Philip Owen proposed a radical plan to set up "safe 
injection centers," where addicts could get clean syringes and inject their 
drugs under the watch of trained health workers.

"These legally sanctioned facilities could provide a safe, secure 
environment where drug users could inject under the care of health 
professionals trained in safe injection techniques and overdose response 
and away from the dirt and dangers of the street," Owen said.

Vancouver, a major seaport, is a point of entry for heroin and cocaine. 
Since the 1980s, the drug market in Vancouver's Eastside has exploded as a 
result of concentrated poverty, lack of adequate housing, high unemployment 
and easy access to inexpensive heroin and cocaine in almost pure form. An 
estimated 12,000 intravenous drug users roam the streets.

Since 1993, Vancouver has averaged 147 illegal drug overdose deaths 
annually. As the death rate increases, so have cases of HIV and hepatitis C.

"In 1997, we had escalating HIV and AIDS cases among IV drug users," said 
Heather Hay, regional network director for addiction services with the 
health board for the Vancouver-Richmond area. "The Board of Health declared 
a public health emergency. The health board's position is safe injection 
sites are a tool to prevent drug overdose deaths."

The plan has drawn praise, but also strong opposition from business groups 
that say more should be done to enforce drug laws and that such sites will 
only lure more addicts into the area and harm legitimate businesses.

While U.S. cities fight drugs principally with tougher law enforcement, 
Canadian officials are using a different weapon. They call it harm 
reduction, an approach that treats addiction as a disease rather than a 
crime and attempts to keep as many users as possible alive and healthy.

"In Canada, the drug trade has the potential to generate criminal proceeds 
in excess of $4 billion (Canadian) at the wholesale level and of $18 
billion at the street level," Owen said in a report. "Expectations that 
extra officers at the street level can significantly alter a problem of 
this scale and complexity are unrealistic."

Putting more officers on the streets only displaces dealers and forces them 
to develop more sophisticated marketing strategies, Owen said. One that 
emerged recently was called "dial-a-dope." Owen's report quoted a 
middle-class cocaine user as saying: "You order a pizza. I'll order 
cocaine. We'll see which one gets here quickest."

Other Canadian cities, such as Montreal, have considered providing safe 
injection centers. Canada's top drug enforcement officer, Chief 
Superintendent Robert Lesser of the Royal Canadian Mounted Police, has said 
such centers could stop the spread of HIV and hepatitis C. "I think it's 
something we have to look at," Lesser said.

German and Swiss cities set up injection sites several years ago. The 
clinics provide clean needles, distilled water, filters and spoons, and 
often allow addicts 30 minutes to inject and feel the effects of their 
dope. Such cities as Sydney and Madrid have opened sites more recently; 
officials say they've helped reduce crime and disease dramatically.

Safe injection centers would bring dignity to addicts, said Ann Livingston, 
project coordinator of the Vancouver Area Network of Drug Users, an 
advocacy group made up of intravenous drug users and former users.
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