Pubdate: Wed, 12 Nov 2003 Source: National Post (Canada) Copyright: 2003 Southam Inc. Contact: http://www.nationalpost.com/ Details: http://www.mapinc.org/media/286 Author: Brian Hutchinson ACTIVISTS FIND HOPE IN PUBLIC OVERDOSES Addicts Resuscitated At Safe Injection Site VANCOUVER - Here on Vancouver's Downtown Eastside, victories are rare and achievement is measured in increments so tiny as to seem perverse. News that 25 people have experienced drug overdoses while shooting up inside the neighbourhood's first offical supervised injection site is, for example, considered cause for hope. Insite, North America's first government-sanctioned and funded shooting gallery, opened amid much publicity two months ago. Critics worried it would be a magnet for every drug addict on the continent. Vancouver's Mayor, Larry Campbell, defended the $3.7-million centre as a "vital part of a harm-reduction plan to reduce overdose and overdose deaths." Even under the gaze of Insite's registered nurses and other staffers, addicts are still overloading on bad dope and either passing out or freaking out, which often means tearing off their clothes and clawing at their exposed skin, until they receive medical assistance. But in this teeming drug market, even a marginal success rate is considered laudable. As Chuck Parker says, "at least no one has died." A recovering heroin addict and local advocate for the Downtown Eastside's thousands of drug users, Mr. Parker is also an occasional user of crack cocaine. He is on welfare. He is HIV positive and has hepatitis C. Things could be worse, he shrugs. "I could be dead." A parched-looking man in his 40s, Mr. Parker is volunteer president of the Vancouver Network of Drug Users, a gritty streetfront operation that seeks to make life better for the thousands of addicts living and using in the Downtown Eastside. It is not surprising that he feels the new injection site is working; his group, after all, was one of many that campaigned long and hard for it. The notion of a public shooting gallery was contentious from the start; Phillip Owen, the previous mayor, was essentially expelled from office last year after pledging his support. He too has reacted positively to the fact that while overdoses inside the clinic have occurred, and are actually increasing week to week, no fatalities have resulted. But death continues to haunt these six or so city blocks in the shadow of downtown Vancouver. According to the B.C. Coroners Service, there were 37 overdose fatalities in the city in the first eight months this year; last year, in the same period, there were 39. Officials with Insite say their facility has prevented at least five more deaths. Overdoses, they say, are simply inevitable. "We don't test the drugs that people bring to the site," says Insite spokeswoman Viviana Zanocco. "That's not our job as health care providers. People have to take some responsibility for what they are using." It's a realistic position, and hopeless. Insite staffers can't possibly know what any single user has in his system when he enters the site, and no one really has a clue what he is shoving into his arm. Word around the street is that dealers are now cutting their product with gyprock. Addicts are not interested in testing their $10 hits to determine purity. They want to fix quickly. Many are choosing to do it at Insite because it is a handy, uncompromising shelter stocked with free needles and clean water, used to cook their smack and to turn their cocaine powder into liquid. Early concerns that Insite would be rejected by wary drug users have evaporated. Its visitor count has steadily increased since it opened in September, from a few dozen a day to more than 500. Insite's maximum capacity is approximately 650 visitors. Funded with grants from the provincial and federal governments, the facility sits in the Downtown Eastside's epicentre, on East Hastings, a street synonymous with heavy drug use, trafficking, prostitution, theft and violence. Users turn up at a non-descript building and enter through a steel door, where they mark their initials on an arrival form. Handed a sterile, unused needle, a vial of water, a cooking spoon and a tourniquet, they are shown into a large, austere room with 12 separate stainless steel shooting booths, illuminated overhead with bright lighting. They inject themselves with their drugs, and then proceed to a post-injection "chill" room, where they are asked to sit and linger for a few minutes while their body absorbs whatever substance has been introduced into the blood stream. Counselors are on hand to discuss safe shooting practices and treatment options. Such a place did not exist when Mr. Parker landed in the Downtown Eastside. A native of Calgary, he moved to Vancouver 11 years ago, and says he was making $1,600 a week as a skilled tradesman before he began using cocaine. "I tried to get off it by shooting heroin," he says, as we walk down East Hastings, in a cold rain. "Biggest mistake I ever made." We pause for a few minutes on the corner of East Hastings and Carrall. "She's having an overdose," Mr. Parker says, gesturing toward a woman lying on the sidewalk in front of us. She is shrieking and tearing at her clothes. Her face is bright orange; it looks as if she has been attacked with paint. "She's been injecting cocaine," explains Mr. Parker, "and now her brain is telling her that she's overheating." Another woman approaches us, walking crab-like, her body bent and twisted. She hits up Mr. Parker for $6. Later, I see the same woman buying drugs from a man on the street. She skips into the safe injection site with a smile on her face. Mr. Parker spent years on these streets, mixing dope with gutter water and injecting himself with dirty needles. Had he been able to fix in a place such as Insite, he figures he could have at least avoided contracting hepatitis C and HIV. Patsy Thorpe wishes Insite had been around last year, when her 21-year-old daughter Alexandra scurried into a neighbourhood flophouse, shot herself full of heroin, and overdosed. Her two companions tried to revive her, in vain. Alexandra died in hospital a week later. Earlier this year, Ms. Thorpe helped establish Vancouver's first supervised injection site. It was less formal and lacked government approval. It operated only a few weeks before the "legal" site opened. "Our whole goal was to force the issue and get Insite up and running," she explains. "We wanted to do something while people debated the need for a clean injection site." For some, it came too early; Randy White, a local Canadian Alliance MP, has said he thinks the idea of a government-funded injection facility is counter-productive, that it will attract more addicts to the Downtown Eastside. Insite's future is not secure; it has not received any funding commitments beyond April, 2004. Millions of dollars have already been spent on social services in the Downtown Eastside, establishing a sense of permanence, even purpose, in the neighbourhood. Aside from new housing, addicts have access to innumerable services especially for them: shelters, clinics, schools, art workshops, an Internet cafe, a radio station. Mr. Parker has mixed feelings about the services that have appeared in the last few years. "On one hand, people will come here because they can score and fix and find food. But they will live in shit, literally. It's a vicious circle. All we can down here is try to help keep them from dying." The question, still unresolved, is how much value the rest of us are prepared to assign to what's left of a junkie's life. - --- MAP posted-by: Keith Brilhart