Pubdate: October 6, 1997 Source: Toronto Star Contact: William Walker, Toronto Star Ottawa Bureau Chief Deadly drug epidemic brings death to downtown Vancouver VANCOUVER Day after day here on the grimy downtown east side streets, Lou Demerais counts another AIDS or overdose death from what has become the worst drug epidemic of any city in the developed world. ``On average, we're hearing of one new HIV positive diagnosis per day and,'' Demerais says, pausing to control his emotions, ``for the last week, on average we're losing one person per day.'' In the thick of this drug plague, Demerais is executive director of the Vancouver Native Health Society, a dropin centre for addicts. As he meets with a reporter, his assistant arrives looking alarmed. ``You've got to call Judy. Now. She's on the edge,'' the assistant warns. It's only noon. A few minutes earlier, a young woman came through the front door, her face contorted and her body twitching with spasms. She urgently tried to explain herself, but the words came out as garble. Her eyes rolled back and it looked as if she may collapse. ``Sit down. Okay. It's all right. Sit down. We'll get you some help,'' Demerais soothed as other social workers came to assist. It's just another day at the office. In the shadow of glitzy GM Place, home to hockey's Vancouver Canucks and just blocks from luxury highrise condos and fivestar downtown hotels, lies a world unknown to most Canadians. But the people here could be known to any Canadians. They've come from across the country to live on these streets and take advantage of Vancouver's moderate winters and plentiful, cheap drugs. ``I see who walks through our doors,'' said John Turvey, executive director of a needle exchange centre in the drug area. ``When (Alberta Premier Ralph) Klein made his cuts, we had 200 people a week through the door from Alberta. When (Ontario Premier Mike) Harris made his cuts, we had another 200 a week from Ontario through the door.'' Dr. Steffanie Strathdee, a doctor in epidemiology from the University of Toronto, has researched the HIV plague for the B.C. Centre for Excellence in HIV/AIDS. ``It's like Dundas and Sherbourne Sts. times 10 down here,'' she said in an interview. ``Our studies are showing this is the highest rate of HIV infection among drug users in the developed world.'' For many who arrive in Vancouver's downtown east side, it's the last stop in a downward spiral of life. Almost half the 10,000 drug addicts and prostitutes who huddle outside the doors of rundown hotels and beer joints are already HIV positive. ``I would consider it catastrophic. We have an epidemic,'' said Liz Whynot of the Vancouver and Richmond Board of Health, which last week declared the first health emergency in Vancouver's history. It seems unbelievable, but some addicts are so desperate for food and shelter that they're deliberately borrowing used needles from known HIVinfected drug users, in order to get infected. Why? Because they'll receive higher benefits from the provincial government. ``For many of these people, (selfinfliction) is an alternative to criminal activity,'' Demerais says. ``It speaks to the lack of resources available to these people. People are willing to infect themselves just to get an extra $200 a month in benefits. It doesn't say much,'' remarked Judy McGuire, manager of the Deyas Needle Exchange. At McGuire's cramped storefront office, there are 100,000 clean needles stacked up in cardboard boxes to the ceiling, free to anyone who will walk in off the street. Many heroin users take advantage of the program. But increasingly, addicts are shooting up cheap cocaine, up to 50 times a day on binges. Sometimes they just want the fix and can't be bothered to arrange for clean needles, even though 2.5 million syringes are distributed free here each year. McGuire said cocaine users get to a point during a ``run'' street lingo for a drug binge where they no longer care if the needle is used. ____________________________________________ `It's already too late for the people of the downtown' ____________________________________________ Another reason HIV is spreading so rapidly here is that some who share needles don't even know that they're infected. Not to mention that Strathdee's studies show 40 per cent of people who know they're HIV infected are sharing needles with others. A walk through the druginfested streets of the east side immediately illustrates the desperation in this community. ``Rock. Big rock. Rock man. You want the rock? Big rock. Rock. Rock,'' barks the jittery, waferthin man standing in a doorway on East Hastings St., in the notorious 100 block, where police say they're powerless to stop drug dealing out in the open. Two doors down, in a large doorway beside a seedy pool hall, half a dozen young men are shooting up in broad daylight, oblivious to passing motorists. Inspector Gary Greer of the Vancouver Police Department said at $10 a hit for cocaine ($5 when dealers are desperate) even the most povertystricken users can usually fix. That's why Vancouver also has the highest rate of property crime in North America. Users break into a car or a house, cash out at a neighbourhood pawn shop and buy drugs. But the cocaine high is much shorter than the heroin high most heroin addicts will fix four or five times a day so soon the cocaine addict needs more and commits another crime, Greer said. ``Nobody can be kept in custody, not for simple possession, so they're back out on the street,'' said Greer. As Demerais surveys the East Hastings St. drug culture, he remarks that it's a slow day by this neighbourhood's standards. The last Wednesday of every month is known as ``Mardi Gras.'' That's when the welfare cheques go out. It's a party for the addicts. Emergency workers can barely keep up with the overdoses.'' Demerais calls the east side ``the eye of the storm.'' Social workers in the area say federal and provincial politicians, and most Vancouver residents, think the HIV plague will remain within the east side, but they're dead wrong. ``They think these are just disposable people in the community. They think the virus is contained to that community. It's just nuts,'' Turvey said. When addicts learn they're infected, they usually go on a drug binge, he said. That requires more money. Prostitutes often turn more tricks. They get paid more if they perform unprotected sex. ``We have these men going through our community buying sex from the women and children, so God knows where it's spreading into the suburban communities,'' Turvey said. There are several prescriptions to try to tackle the problem. Greer said the police feel Ottawa needs to legislate longer prison sentences, since the only way to treat some habitual drug users is to get them off the streets and into jail. ``Besides, that's cheaper in the long run compared to the healthcare costs down the road,'' Greer said. The health board's Whynot said Ottawa should examine perhaps through a pilot project Switzerland's model of prescribing drugs such as heroin for longterm users to gain control of the situation. Needle exchange director Turvey said if Ottawa is concerned about a similar epidemic breaking out in Toronto or Montreal, it should immediately call a major inquiry the likes of the Krever inquiry into the tainted blood scandal. ``It's already too late for the people of the downtown east side,'' Strathdee said, ``but if we don't act it's going to spread to outlying communities and the heterosexual population more rapidly. Back at the Native Health Centre, Demerais is pounding out a letter to Finance Minister Paul Martin, who will be in Vancouver Oct. 15 to issue his fiscal update. He wants to know if Martin ``has the guts'' to tour the druginfested streets with him to witness the problem.