Pubdate: Sun, 16 Nov 2003 Source: Philadelphia Inquirer, The (PA) Copyright: 2003 Philadelphia Newspapers Inc Contact: http://www.philly.com/mld/inquirer/ Details: http://www.mapinc.org/media/340 Author: Jeremy Hainsworth DRUG ADDICTS HAIL LEGAL INJECTION SITE VANCOUVER, British Columbia - David Lands walked into the upscale office building, checked in with the receptionist and headed inside - to shoot heroin and cocaine into his veins. The frail Lands was one of the first addicts to use North America's only government-sponsored safe injection site, which opened in September as a trial project in a downtown neighborhood known for junkies and prostitutes. "They should have more places like this," Lands said, holding two peanut butter and jelly sandwiches provided by the staff at the Insite clinic as he recovered from his heroin and cocaine speedball. "You'd find less people in the alleys that have overdosed." Critics disagree, predicting that the provision of a legal place for addicts to shoot up will only lead to more drug use. John P. Walters, chief of the U.S. antidrug effort, called Insite "state-sponsored suicide." Those who use the clinic believe the opposite. Lands, 32, who has been addicted to heroin since 1997, said junkies can end up injured or dead from robbers or overdosing when they use drugs in alleys and other out-of-the-way spots. "If you overdose, they help you here," he said. "Not in the alleys. They don't care." A 39-year-old construction worker, who would identify himself only as Joe, agreed that Insite was safer. "I was in an alley shooting up and two guys stuck a knife in my throat," he said, describing a robbery of his drugs. "They would have killed me if I hadn't given it up." Similar clinics operate in Zurich, Switzerland; Frankfurt, Germany; and Sydney, Australia. Canada's federal government has committed $1.2 million for research during the one-year pilot project at Insite, while British Columbia is paying $2.4 million in costs. Mayor Larry Campbell, a former police officer and coroner, won election last year pledging to establish safe injection sites in Vancouver as part of a "four-pillar" drug policy involving treatment, prevention, harm reduction and enforcement. He says Insite is a vital part of efforts to reduce overdose deaths and the spread of AIDS and hepatitis C, and to provide health care to drug users. The World Health Organization has singled out Vancouver for a high HIV infection rate in a wealthy, Western city. According to the British Columbia Center for Disease Control, more than 30 percent of the area's addicts are infected with HIV or have AIDS. The city already was handing out needles to addicts in an anti-infection program. Joanne Csete, a spokeswoman for Human Rights Watch, praised the opening of Insite as essential to helping users avoid overdoses and infection while exposing them to help toward overcoming the addiction. "It's certainly a step forward," she said. "We hope they will continue to respect this as a part of essential humane services for drug users." The clinic is exempt from Canadian drug laws, allowing the addicts to possess heroin and cocaine inside. Such an exemption can be made for medical or scientific reasons, or if in the public interest. Lands and Joe said Insite required addicts to bring their own drugs. The clinic provides a bowl containing a needle, a "cooker," and matches to heat the drugs, and an antiseptic swab. Junkies using Insite's facilities have their backs to nurses when shooting up, but they are monitored by mirrors in the 12 injection booths, the two men said. Nurses show those who ask how to inject safely, but otherwise have no direct role in the process, they said. After injecting, users are monitored in a "chill-out room" - where Lands got his sandwiches - before leaving. They also can get help if they want help in overcoming their addictions. Vivianna Zanocco of the Vancouver Coastal Health Authority, which runs the clinic with a local advocacy group, said smoking marijuana or crack cocaine inside is prohibited. She said that worries about drug dealers congregating around the site had proved unfounded. Police officers maintain a low profile outside, permitting addicts to enter the clinic with their drugs. "It is not the police intention to intervene or interfere with anyone entering the site, unless there is a lawful reason to do so," Police Chief Jamie Graham said. - --- MAP posted-by: Larry Stevens