Winnipeg Free Press - PRINT EDITION

Insite offers second chance to addicts

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Richard Chenery, in 2011, injects heroin he bought on the street at the Insite safe-injection clinic  in Vancouver, North America's first and only legal injection site.

DARRYL DYCK / THE CANADIAN PRESS ARCHIVES Enlarge Image

Richard Chenery, in 2011, injects heroin he bought on the street at the Insite safe-injection clinic in Vancouver, North America's first and only legal injection site.

VANCOUVER -- The 100 block of East Hastings is, by any definition, a societal nightmare, the kind of chaotic place most Canadians would mistakenly think was a movie set.

Wrecked and emaciated people lie on the sidewalk, throngs of discarded, disadvantaged and dirty street people roam about, jaywalking, running, limping, yelling past pools of vomit, streams of urine and trash everywhere. Pushing overflowing shopping carts, they navigate along the filthy concrete with small treasures in refundable cans and bottles.

There is a near-constant sense of pain, fear, hunger, abandonment and need. It is not the sort of destination most people would choose to go to in daylight, let alone during the darkest hours, when the ugliness level gets ramped up exponentially.

But it is also here, at Ground Zero in Vancouver's sometimes searingly depressing Downtown Eastside, an area often referred to as Canada's poorest postal code, a miracle has occurred every day for more than 10 years.

Here, at the Insite supervised-injection site, people intent on shooting heroin and other dubious toxins into their bloodstream are given a temporary, and caring, respite from the dangerous streets and alleys outside.

Once inside, addicts are greeted in a friendly and professional manner, allowed to wash up, offered clean needles, and, armed with their own drugs, go to one of the 12 injection booths to shoot their poison.

Nurses and supervisors are in attendance to offer free advice and make sure there is immediate medical help if an overdose occurs. After they have injected their drugs, there is another room where addicts can relax, drink coffee and, if they feel they are ready, begin thinking or talking about the possibility of using the detox facilities upstairs.

'I really think our society will eventually look back with great shame on how we've treated addicts'

Although not for the squeamish, this miracle, despite the federal government's tough-on-crime and war-on-drugs rhetoric, is an overwhelming success.

Statistics gathered at Insite tell the tale. Since it opened more than a decade ago, as the only legally sanctioned drug-injection site in North America, there have been 2,943 overdose events but not a single fatality.

That is simply amazing in a city that has since its inception 137 years ago always had to deal with the scourge of addiction and drug-addled people dying alone behind putrid garbage cans or in cheap, stinking rooming houses.

At Insite, people get a second chance, if not to kick their addiction, then at least not to succumb to it.

Program manager Darwin Fisher describes Insite as a wonderful place to work and interact with the people using the facility.

"The most basic aspect of health care at Insite is observation," Fisher notes. "Staff and nurses are watching and checking on people's health and are responding immediately if there's an issue like an overdose. We've had thousands of people die (elsewhere) in this province because they injected drugs alone."

Fisher adds that many people using Insite exhibit "such amazing strength and creativity and generosity in the face of terrible trauma and privation."

With an average of 529 injection-room visits per day last year and a provincial operational budget of $2.8 million, Insite has a Health Canada exemption from the Controlled Drugs and Substances Act.

Operated by Vancouver Coastal Health and the Portland Hotel Society (PHS) Community Services Society, the facility has been warmly supported by civic leaders who over the years became sickened by the high number of addicts dying on the streets.

People on the front lines of providing severe addiction services, such as Fisher, credit local politicians for supporting the Insite model of getting drug users out of filthy alleys and into a facility with free, clean equipment, running water and non-judgmental assistance.

But the federal government was not as supportive, as a tangled web of court decisions makes clear.

Originally operating as a temporary science and research experiment, the PHS and others asked the B.C. Supreme Court in 2007 to declare Insite the exclusive jurisdiction of the province and for Ottawa to no longer be involved in its future activities.

When the B.C. Supreme Court awarded Insite a permanent constitutional exemption a year later, that decision was appealed by the attorney general of Canada. That appeal was dismissed by the B.C. Court of Appeal in 2010. The following year, the Supreme Court of Canada denied the appeal by the attorney general of Canada, authorizing Insite to continue operations.

Fisher and others in Vancouver are, rightly, flabbergasted by Ottawa's position, considering the success of Insite.

"Their opposition to the site has never been articulated beyond a level of weak sound bites," Fisher says. "This became very apparent in the Supreme Court hearing."

He adds that North American culture, with its "war-on-drugs mentality," demonizes and criminalizes addicts without lessening addiction or the ready supply of street drugs.

"We're well due, as a culture, to move past this 'paradigm,' but culture changes slowly. I really think our society will eventually look back with great shame on how we've treated addicts."

What Fisher doesn't say is politicians from all levels of government need to climb out of their 20th-century bunkers and look at addiction a new way by treating it medically and socially.

Spending astronomical amounts of taxpayers' money on jailing drug addicts, or letting them die beside a Dumpster as some sort of tough-guy punishment, no longer works.

The compassion-based Insite miracle has shown us what does. Here's hoping Canada's policy-makers have the courage to do what is right on an issue that clearly is not going to go away.

 

Chris Rose is the Winnipeg Free Press West Coast correspondent.

Republished from the Winnipeg Free Press print edition October 29, 2013 A11

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