Wednesday, September 27, 2006

Vancouver's drug policy

Salon reports on Vancouver's harm-minimization program for drug users. Three years ago, infectious disease was rampant amoung Vancouver's addicts, with diseases like hepatitis and AIDS at risk to spread to the wider population. The streets were littered with discarded needles and trash, and sometimes corpses: an average of three people died in the streets from overdoses every week.

But since Vancouver started the Insite legal injecting room program, things have turned around radically. The streets are cleaner, disease is under control, people are no longer dying, drug use in the streets is reduced and the number of addicts seeking help and entering rehabilitation programs has increased.

A banker by trade, Allen was helping run a community campaign to secure Insite's future. "Just seeing the renewed optimism of the neighborhood has been amazing," he told me. "It's been a dramatic change over the last three years. I remember a person dying almost every day out here. One of your neighbors was always in mourning."


Rising support for the policy north of the border agitated Washington. Shortly after Insite gained Canadian federal approval, President Bush's drug czar, John P. Walters, slammed the program as immoral. "There are no safe injection sites," he declared, calling Vancouver's policy "a lie" and "state-sponsored personal suicide."

Since Insite opened, there has not been a single death inside or connected to the facility among the more than 7,200 individuals who have used it -- including at least 453 people who have overdosed.

Unlike American conservatives, who often act as if it is their personal mission from God to see to it that as many people die from drug abuse as possible, many of the initially skeptical Canadian conservatives have been won over by the success of the programme. Even the police like it, as it helps keep the streets safe and frees them from harrassing two-bit junkies, giving them more time to go after the major dealers.

"I guess you see what you see," [the officer] said. I mentioned how different the area appeared to be since my prior visit, which elicited a sliver of a polite smile. "It's a lot better out here now," he said.

"I think the police often feel like they're shoveling water in terms of street-level dealers," said West, the Insite coordinator. He suggested the police were more interested in focusing on bigger drug traffickers operating in the city. In the neighborhood around Main and Hastings, more critical to the police department's role in the harm-reduction strategy is maintaining public order and safety. "They're really quite supportive of the site," West added. "They know it's another tool that helps them do their job."

"If somebody's dealing drugs right in front of an officer, I can assure you they'd be dealt with," said Constable Howard Chow, speaking by phone from the public affairs office of the Vancouver P.D. He noted that the squad assigned to the Downtown Eastside, one of the city's most volatile sectors, regularly conducts surveillance and sweeps to bust dealers. But he acknowledged there were priorities. "Is simple possession as harshly looked upon as trafficking, for example? No. Those officers are often inundated with calls down there. We use the resources where they're most needed." He added, "We support the site in terms of the medical research, and helping see that through for its potential benefits. We don't comment on the right or wrong of it -- that's not up to us."

Nor has the programme lead to an increase in robberies and other crimes, as conservatives initially feared. Instead, many property crimes decreased.

Another major plus is the savings to the healthcare system. Preventing just twelve addicts from contracting AIDS will pay for the programme's operating expenses for a year.

Despite all the scientific evidence that safe injecting rooms reduce the harm of drug abuse, people still worry about "the message" it sends.

There are other, less tangible considerations that can stand in the way of opening a safe injection site. "Plenty of people are going to feel like it sends the wrong message about a neighborhood," said Mark Kleiman, a former policy director in the U.S. Department of Justice who now heads the Drug Policy Analysis Program at UCLA. "Would you want one of these next door to you?"

Still, Kleiman says the potential benefits are undeniable. "Nobody's going to start using heroin because you've opened a safe injection site. Assuming you can keep crime in control, I don't see much downside," he said. "But there is a big upside in terms of public health and public order -- I'm not surprised this has worked well in Vancouver. So is it a good idea for us to try this? Certainly."


The Bush administration has often spoken of a "compassionate conservative" approach to social crises, but has emphasized only so-called faith-based and abstinence programs. Might they look at the results in Vancouver and consider exemption from federal drug laws for city governments under siege from drug-related disease and urban blight?

"Don't be ridiculous," Kleiman said flatly. "They're completely unserious about drug policy. It's an issue that's all about liberal-bashing to them, and playing to their base. I haven't seen them do anything counter to their own prejudices just because the science says they should."

Despite multiple calls seeking comment on Insite's results and legal status, Walters and the White House Office of National Drug Control Policy did not provide any response.

Community leader George Chow, now a city councilor, initially opposed the programme, running as an independent on a campaign of opposition to the injecting site.

Three years later, Chow has changed his mind:

"It was a fear of the unknown -- people were afraid such a facility would bring in more chaos," Chow said, speaking by phone from his office at City Hall. "After three years that has not happened, even with an increase in the homeless. Without this facility the drug problem would have been far more out of control. There would be an even bigger problem with HIV transmission and other issues."

Chow spoke with measured but unambiguous praise of the program. Insite has had a huge impact on the neighborhood, he said, though it certainly hasn't solved all its problems. "There is no easy solution," he said. "I think a lot of people still look at this as a moral issue, and it's challenging -- but as a councilor, I believe we have to do all we can to deal with these health and social issues. This is most important, to work toward practical solutions."

And what of other drug hubs such as Toronto and Montreal? "I would advocate for a national plan, with more facilities like this in other cities," Chow said. "Not just an injection site, but also including treatment and education programs. This, of course, requires more money and resources."

1 comment:

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