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 Clay
Adams works for the Vancouver Coastal Health Authority that operates Insite, in Vancouver, B.C., North America's only
safe injection site. Clay Adams works on the service delivery side,
while today the government policy debate rages about Insite, which is located in the Downtown East
Side (DES) of Vancouver. This area is a place with a long history of
being 'the wrong side of the tracks'.
At first the Hastings area of Vancouver drew people who came
to work on docks or disappear onto the briny aboard ships. Draft
Dodgers from the Vietnam War showed up in the 1960s and 1970s with an
intense drug culture that escalated to alarming heights and stayed
ever since.
INSITE safe injection
site in Vancouver is a controversial action taken by a community that
has run out of options dealing with rampant drug abuse, and the
facility runs for only a few months at a time before the Federal
Government conducts a review.
On May 5 08 (the week of) another such review was underway.
The Insite proponents made a number of
statements in the media supporting the program. The federal
government replied that the program hardly touches the magnitude of
the problem and possibly acts as a mask of the reality. The
proponents reply, indeed, and expanding safe injection policy would
be a good idea, to which the government sings, No No No .
"People either support it or they don't since it began
three years ago," said Adams, "The debate continues, but
clearly since (the opening) we have seen support increase."
Studies are being conducted into the effectiveness of the safe
injection site at the federal level and with the Vancouver-based
Centre for Excellence for HIV/AIDS at St Paul's Hospital.
Adams said, "We are located at 137 East Hastings Street,
just West of Main and Hastings," in the heart of the DES. The
location borders Vancouver's Chinatown, "a very active
area," of the city. The DES is home to a variety of store front
retail outlets, poverty action groups, walk-in health clinics, food
shops, porn shops, inexpensive hotels filled with disenchanted
humanity. East Hastings itself is a throughfare
that turns into the TransCanada Highway.
"Our clientele is not necessarily from the DES. It comes
from right across the province and from out of province. There are no
residency requirements," said Adams, "We are seeing 700
clients a day." The site is used by prople
whose identification is confirmed by assigned password. The Insite Safe Injection Site is open "18 hours
a day, 10 A.M. to 4 A.M., seven days a
week."
Adams said, "We are about at capacity. We don't run 24
hours a day because we cannot afford it." Drug addicts bring in
their own 'stuff', "The drugs used are usually heroin and
cocaine, but other drugs are used, including methamphetimines
and others. "The 'stash' is their own,
and they bring in enough for one sitting, one injection, and there
are no assisting persons," to accompany the drug user.
Insite staff provide medical supervision and monitoring,
and many staff members are Registered Nurses, as well as professional
non-clinical counsellors. They have a 12-person staff. The place is
set-up with open area injection booths, not private at all.
"That is the point, the activity is supervised."
Popularity of Insite is undeniable,
"the numbers speak for themselves," said Adams, "The
number of users per day is telling us it is useful. The site is very well
supported by the Vancouver Police. It takes injection activity,"
something that is an all-too-common occurrence in the Vancouver DES,
"out of the street. We get people off the street to provide safe
injections under supervision, prevent communicable disease
transmission, and prevent death or disability due to overdose. We
have cleaner streets."
Adams said other police departments in Canada are less
enthralled about Insite. "They have
indicated concerns that harm reduction should not supercede
enforcement of the law." Police forces require clear-cut rules
of engagement to deal with crime. Safe injection sites tend to muddy
the waters of human behaviour, what is acceptable and what is not,
but what is illegal remains the same.
On the other hand, certain diseases like HIV/AIDS and
hepatitis 'C' can turn into epidemics. "We are seeing some signs
that communicable disease rates will drop. We have suffered no
overdose fatalities in three years of operation," said Adams,
"although it is too early to judge our progress on the disease
side." The federal government had announced an extension to Insite, permitting it to operate until December
2007. As the month of May rolled into the double digits the debate
about the Insite service raged in Ottawa.
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