Published in the February 23 edition of Street Roots courtesy of Megaphone, our sister paper in Vancouver, B.C.
The city is quiet on a Tuesday morning just after Christmas, but Insite, Vancouver, B.C.’s safe-injection facility, is already busy: music plays as people sit at open booths to inject heroin or cocaine, while others chat and joke with the nurses as they wait for a booth, or head to the chill-out room to lounge and drink coffee.
Clean needles and condoms are available to users who bring their own drugs to inject in a supervised room. They can relax afterwards in the lounge as needed, and staff are available to help them with other needs, like housing applications.
Modelled on similar clinics that first opened in Switzerland in the 1980s and then spread to other European countries and Australia, Insite remains North America’s only safe-injection site. Like its counterparts, this brand of harm reduction has proven to be a tremendous success here in Vancouver.
“For us, it’s a very basic thing: Insite saves lives,” says Mark Townsend, executive director of the PHS Community Services Society, which operates the safe-injection site in partnership with the provincial government’s Vancouver Coastal Health (VCH). “We’re able to reach the people that would have been dying in their hotel rooms if Insite wasn’t here. Now we can get them the necessary help and get them into detox and treatment.”
Before Insite, the Downtown Eastside saw overdose deaths and infectious diseases reach calamitous heights. Overdose deaths in Vancouver spiked to a high of 201 in 1993 and, according to a United Nations report, the Downtown Eastside has an HIV rate of 30 percent, while Canada as a whole has a rate of only 0.2 percent.
A mass mobilization led by drug users and the creation of illegal injection sites in the neighbourhood finally helped secure the political will needed to create Insite, which has witnessed hundreds of overdoses, but as yet no deaths. And since it opened, overdose deaths across the city have declined — reaching a low of 34 in 2008.
The health crisis has also subsided. There were just 30 new HIV cases in the Downtown Eastside in 2006, compared to 2,100 a decade before. According to a 2008 Canadian Medical Association Journal study, Insite could prevent 1,517 HIV infections in 10 years, saving the Canadian health system $14 million in costly treatments.
As Insite helps keep addicts alive, just a few steps upstairs are the 12 detox and 18 transition beds at Onsite. Also run by PHS and VCH, Onsite is a drug recovery facility working at getting users sober.
Together, the facilities have led to a 30 percent increase in enrollment in detox programs, according to a 2007 study published in the Society for the Study of Addiction.
Onsite and Insite are the first steps to engaging the Downtown Eastside’s 5,000 homeless and impoverished addicts — people who generally feel isolated from the rest of society.
Addicted to heroin for more than 30 years, 49-year-old Brad Taylor began using Insite in 2003 while homeless. He wanted to be safe, and the site’s clean needles and nurses kept him so. Six months ago he moved up to Onsite to try and overcome his addiction.
Since beginning the program, Taylor has relapsed three times, the last occurrence on Christmas Eve when he was alone in his house. But he said the clean spells between relapses have increased the longer he stays in the program.
“Being around people who are actively trying to get clean motivates me,” he says, as does the “honest compassion of the staff.”
What is most important for Taylor is the chance to come back. It is a rarity among recovery and rehab facilities to allow a relapsed patient back into treatment. For Onsite, the hope for a second chance is essential.
Despite its accomplishments, Insite has found itself fighting for its survival. Originally approved by a federal Liberal government, Canada’s Conservative government is opposed to the site and has attempted to shut it down.
“We think (safe-injection facilities) are inherently harmful to health,” said Pamela Stephens, press secretary for the Minister of Justice. “They deepen and prolong addictions.”
Prime Minister Stephen Harper initially planned to shut down Insite after its Criminal Code exemption ran out in June 2008.
“It would be catastrophic,” says Townsend of a Vancouver without Insite. “People will die because of it and there will be more HIV and Hepatitis C. It would be a step backwards and a much more oppressive way to treat those that are suffering from addiction.”
However, on Jan. 15, the B.C. Court of Appeals upheld a successful court challenge by PHS and the Vancouver Area Network of Drug Users (VANDU), which allowed Insite to remain open and operating with provincial funding. Nearly 50 supporters of the clinic who filled the room and waited outside applauded after Chief Justice John Finch read the court’s ruling. Advocates insisted that if Insite had been forced to close, hundreds would die as a result.
The ruling also raises proponents’ hopes that similar facilities will now open in other cities, and aid more addicts across the country. Addicts like “Razor,” who was homeless and sold drugs a corner for seven years, but has been clean for the past 16 months and lives in social housing in East Vancouver. A user of both Insite and Onsite, he says the facilities helped him realize that he never wants to be addicted again.
“I don’t want to be homeless,” he says. “I don’t want to puke and shit myself, I don’t want to be dope sick, I don’t want to rob people, I don’t want to go to jail.”
By Daniel Guillemette, Street News Service
Reprinted from Megaphone, Vancouver, B.C. © Street News Service: www.street-papers.org