Vancouver appears closer than ever to becoming the first North American city with a working safe injection room, a place where intravenous drug users can inject their drugs in a safe and secure environment as well as receive other services based on harm reduction principles. The governmental machinery of Canada -- the city of Vancouver, the province of British Columbia and the Canadian federal government -- is grinding slowly in that direction, but organized drug users and their supporters in Vancouver's Downtown Eastside will act on their own if no official action comes soon.

The gritty Vancouver neighborhood is home to the continent's most flagrant hard drug scene, with users and dealers creating a constant crowd whose epicenter is the corner of Main and Hastings. Although the city has okayed harm reduction programs, including an active needle exchange program, and is now embarking on a drug court program, the scene continues to thrive, the neighborhood continues to suffer from petty thefts, break-ins, prostitution, and the use of alleyways as shooting galleries and bathrooms. And the junkies continue to fall prey to the police, diseases such as AIDS and Hepatitis C, and overdose.

"We've had a hundred fatal overdoses in Vancouver alone this year," said Dean Wilson of the Vancouver Area Network of Drug Users (http://www.vandu.org). "Not having a safe injection site is criminal," he told DRCNet. "Law

Vancouver appears closer than ever to becoming the first North American city with a working safe injection room, a place where intravenous drug users can inject their drugs in a safe and secure environment as well as receive other services based on harm reduction principles. The governmental machinery of Canada -- the city of Vancouver, the province of British Columbia and the Canadian federal government -- is grinding slowly in that direction, but organized drug users and their supporters in Vancouver's Downtown Eastside will act on their own if no official action comes soon.

The gritty Vancouver neighborhood is home to the continent's most flagrant hard drug scene, with users and dealers creating a constant crowd whose epicenter is the corner of Main and Hastings. Although the city has okayed harm reduction programs, including an active needle exchange program, and is now embarking on a drug court program, the scene continues to thrive, the neighborhood continues to suffer from petty thefts, break-ins, prostitution, and the use of alleyways as shooting galleries and bathrooms. And the junkies continue to fall prey to the police, diseases such as AIDS and Hepatitis C, and overdose.

"We've had a hundred fatal overdoses in Vancouver alone this year," said Dean Wilson of the Vancouver Area Network of Drug Users (http://www.vandu.org). "Not having a safe injection site is criminal," he told DRCNet. "Law enforcement can't do it. The police come in and do a big bust and everyone vanishes for about 24 hours, but then it's business as usual. If the government fails to act, we will do it ourselves before November 1," Wilson vowed.

Provincial prime ministers from across Canada will meet on September 13 to discuss safe injection sites, and Wilson hopes that meeting will prod the British Columbia provincial government to act. "The provincial government is the weak link now," he said. "We've got strong local support with Mayor Philip Owen and we've got good support from the Liberal federal government. Health Minister Alan Rock is open to us."

"We would like to do it with government support and government funding, we would like it to be like Frankfort, with a full range of services," said Wilson, "but if we have to open up in a storefront, we will do it. Right now we have eight people kicking in $150 a month each for a space, and we will open for limited hours with volunteers. We want to reduce the harm to the users and to the community at large," he said. "We'll run a tight ship, there won't be a bunch of drug dealers outside the door even if I have to run them off myself, it will be a place where people can use in a safe and dignified way. We'll have information in front, peer-to-peer counseling. We'd like to do methadone and detox, but we have to get the doors open," he explained.

Even though Wilson anticipates few legal hassles in the event of an unauthorized opening -- "The Vancouver police quietly support us," he claimed -- he emphasized that the planned action was not an official VANDU action, but that of "concerned drug users and non-using friends."

Wilson and other safe injection site advocates got some heavy-gauge ammunition earlier this week when the Canadian Medical Association Journal (http://www.cma.ca/cmaj/), the country's premiere medical publication, published two studies of Vancouver hard drug users calling for the inauguration of the rooms now. The journal's editors also gave a ringing endorsement of the recommendations, calling for serious consideration of safe injecting rooms.

The two studies examined hospital utilization and costs and needle-sharing practices among Vancouver injection drug users, and they found that their subjects fill scarce hospital beds and emergency room space at huge cost, suffer a high number of overdoses, and continue to share needles despite the existence of needle exchange programs.

In the hospital use study, St. Paul's Hospital internal medicine specialist Dr. Anita Palepu tracked 598 injection drug users over three years and found they accounted for 2,763 emergency room visits and 495 actual hospital admissions. Nearly all those visits were medical problems caused by unsafe injection practices, with the most common reasons for admission being abscesses and pneumonia caused by bacteria-bearing needles, the study found.

"Those numbers are very high, especially when you consider most of these people are in their early to mid-30s," Palepu told reporters at a press conference announcing the research results. "There is a segment of society that will always misuse drugs. But they are not necessarily horrible people. It is important to treat them as human beings," she said. "Safe injection sites are an investment to prevent medical problems that we would otherwise end up paying for downstream."

Martin Schechter, head of the University of British Columbia's Department of Health Care and Epidemiology, authored the study of needle-sharing practices among Vancouver drug users. He found that 28% of his subjects had shared needles within the previous six months and that "expansion of the needle exchange program alone will not be sufficient to eliminate" this risky behavior. Schechter identified several factors linked with needle sharing. Being refused access to needles at pharmacies, requiring help to inject drugs, having a mental illness diagnosis, reusing needles, and frequent cocaine or heroin injection were all identified as associated with needle sharing among the 962 injection drug users studied since 1996. (More than 10% of them, 124, have died since the study began.) Schechter also identified problems with police as contributing to needle sharing, as well as other behaviors that raise public order and safety concerns, such as injecting in public or failing to safely dispose of used needles.

"Given the high prevalence of HIV risk behaviors, overdoses, and other health-related concerns that persist in Vancouver, it is crucial to evaluate whether the European experience with safer injection rooms can be replicated in Canada," Schechter concluded.

The Canadian Medical Association Journal editorialists, for their part, went a bit further than Schechter, calling outright for safe injection rooms. The editorial warned that there was no easy solution to severe drug problems within Canada. "But we can make the lives of people with drug addictions a little better and the neighborhoods a little safer," ran the editorial. "Supervised injection rooms are a logical next step, one that combines the merits of realism and compassion."

The studies have provoked extensive press coverage and editorial comment in Canada, most of it favorable toward safe injection rooms. For VANDU's Wilson, it can't come soon enough. "There's always a new batch of kids on the street," he said. "It brings tears to my eyes. But we have a real chance here in Vancouver, because we have educated our users. We have 120 people showing up for our general membership meetings, and they all say working with us is the most incredible experience they've ever had."

Wilson also has his eye on the big picture. "We will have a safe injection site, and Vancouver will be the test case for North America. With our proximity to the border and the United States, the Americans are very scared. If we can do it, then Baltimore will have to do it, Portland will have to do it."

-- END --
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Issue #200, 8/24/01 Editorial: Random Marijuana | More Drug Prisoners Doing More Time in Federal Prison System, According to New Justice Department Report | Colombian Legislators Introduce Legalization, Cultivation Bills, Ask UN to Evaluate Global Anti-Drug Strategies | Jamaican Ganja Commission Calls for Decrim, Battle With US Brewing | Pressure Builds for Safe Injection Rooms in Vancouver as Canadian Medical Association Journal Studies Add Fuel to Fire | NIDA Ecstasy Conference Hears Harm Reduction Call | Aging Behind Bars: New Report from The Sentencing Project Blasts California's Three-Strikes Law | Hutchinson Takes DEA Mantle, Comments Elicit Confusion and Criticism | Hempfest Draws 100,000 in Seattle, Hempstock Draws the Cops in Maine | T-shirts for Victory! Special Offer and Appeal from DRCNet This Month | Action Alerts: Ecstasy Bill, HEA, Mandatory Minimums, Medical Marijuana, John Walters | HEA Campaign Still Seeking Student Victim Cases -- New York Metropolitan Area Especially Urgent | The Reformer's Calendar
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