Where Carla and Wayne Shoot Up
Inside the world of the Insite safe injection clinic.
Carla and Wayne in front of Carnegie Centre. Photo Elaine Brière.
Two years ago, when Vancouver became the first city in North America to open a safe injection site where people can use narcotics in a medically supervised setting, a storm of controversy ensued. Critics claimed that the facility, called Insite, would increase drug use and make taking drugs easier -- that addicts from all over the country would move to Vancouver.
These days it's clear that by providing a benign environment for injection drug users, Insite (located on the infamous 100 block of East Hastings) has, if anything, reduced the harm and severity of the drug problem in the Downtown Eastside. "Given how new Insite is, the results are amazing," says Dr. Thomas Kerr, a research scientist with the B.C. Centre for Excellence in HIV/AIDS, which is overseeing the evaluation of Insite. "There has been a substantial reduction of people injecting in public, less discarded syringes on the streets, reductions in needle sharing and elevated rates of entry into detoxification services."
Kerr's claims and the data backing him up haven't convinced the Conservative government to green-light the clinic permanently, however. "Given the need for more facts," said Health Minister Tony Clement on September 1, "I am unable to approve the current request to extend the Vancouver site for another three-and-a-half years."
A pilot project funded by the Vancouver Coastal Health Authority, Insite also provides a point of contact for education, counselling and treatment. Its approach to street drug addiction is part of a philosophy and practice known as harm reduction. The central concept is to help people, without making judgments about their addiction or requiring them to stop using before receiving help. As Kerr says, "We have to invest in strategies that keep people alive and as healthy as possible until they get to that place where they quit on their own or their use stabilizes so they can manage their lives better.'' Many say this is an approach whose time has come for North America.
'Best thing in my life'
At Insite, staff initially worried that people might be slow to use the facility, says co-ordinator Sarah Evans. "But after four months we were running at maximum capacity." With 12 booths open 18 hours a day, Insite can handle up to 800 visits -- just a fraction of the number of injections happening daily in Vancouver. But many users, like Wayne and Carla, are willing to wait their turn for the measure of safety and security the site offers.
Both are injection drug users who travel from their apartment in Kitsilano to use the facilities at Insite. Because both are HIV and hepatitis C positive, infections and abscesses from unclean needles and paraphernalia could prove fatal for them. About 17 per cent of users at the facility are HIV positive.
Carla is an attractive, articulate woman in her early fifties. She grew up in a small town near Montreal where her parents owned a hotel. "I was well taken care of," she says. "I had everything I wanted. We had money. We lived by a lake. I skated. I skied. But I was a very high-strung kid, nervous and scared all the time. My mother didn't know what was wrong with me. I was afraid of airplanes. It was the time of the assassination of John F. Kennedy and they were saying scary things on television...I took it as being real. I had to tape down the blinds in my bedroom at night and tack the drapes to the wall. "
When Carla was 11 her mother took her to a pediatrician who put her on Librium. Ever since, Carla has been taking drugs in the benzodiazepine family for anxiety and panic attacks. During the '70s she experimented with hard drugs off and on but never became addicted until 1983, when her first husband died in a head-on collision in Montreal. She was working in the film industry at the time. "When I lost my husband, I started going out with a bisexual guy and fixing coke with him...anything to take away the reality."
Her present husband, Wayne, is 38, but seems older. "Wayne is the best thing in my life," Carla says. "I don't know what I would do without him...my biggest fear is being alone and dying...with Wayne I can share my fears, someone to be honest with who sees every side of you and still accepts and loves you." Lean and stoic, he looks like a sailor straight off the deck of a WWII merchant ship. His heavily tattooed right arm is lifeless from the elbow down after he accidentally injected a nerve two years ago, and he has a steel bar from his left knee to his ankle from an assault in 1999 during a botched robbery attempt he was involved in.
Wayne first injected LSD at a party when he was 14. "To be honest," he says, " I was petrified of needles. There was a big party. I was coerced into it. I had very low self-esteem. I wanted to be cool. I come from a small town just outside of Winnipeg. All my family were big drinkers.'' That same year Wayne's life in prison also began.
'Can conquer anything'
"My first conviction, for robbery, was when I was 14 years old," Wayne says. "I got nine months in juvenile detention. From there it was nothing but prison. I matured very quickly in prison. The worst part was the loneliness, being locked down and nobody there. I've been in the prison system most of my life. I was in the penitentiary twice, once in Winnipeg, and once in Drumheller. I started with property crime -- business, not residential -- then it escalated. I have eight years' experience as an industrial spray painter, which I learned in jail, but I can't work now because of my health."
Carla was diagnosed HIV positive in l998 and began to take HIV medications to fight the virus. At first she had a strong negative reaction. "A nurse came every day to my hotel to make sure I took it. I had nausea, headaches -- like the flu -- right away. But my numbers were great. Undetectable. It was like the operation was a success but the patient died. So I went off the meds and I got better. The ones I'm now on are great. I don't get sick at all."
Both Wayne and Carla take daily methadone, an oral synthetic opiate administered by a pharmacist. It has a long-lasting effect that stabilizes the nervous system but without the euphoric effect of heroin. Many people on methadone, which is a depressant, still use stimulants like cocaine and heroin to get high and overcome the slowing-down effect of the methadone. Wayne is not on antiretrovirals right now because they conflict with his methadone treatment -- to find a solution for this problem, he is having blood work done.
Before the safe injection site opened, Wayne and Carla injected in the alleys on the Downtown Eastside. "I had a rat run over my feet when I had a needle in my arm," Carla tells me. "That's the power of addiction. I was more concerned with my injection than the rat. This is not me at all. I still think about it and quiver. It just blows me away that I didn't stop immediately and scream."
"When you take that drug,'' Wayne says, ''whether you're smoking it or injecting it or snorting it, you get this euphoric feeling of 'nothing matters.' You could have a cable bill you haven't paid in three months, your life could be a total mess, a total disaster. You don't have a nickel in your pocket. You're at your wit's end and then you take the drug and none of these things bother you anymore. You have energy, you feel that you can conquer anything."
European import
Using opiates continually over the long term creates opiate dependency -- the drug is needed to generate an endorphin-like high. Bill Nelles, founder and director of the Methadone Alliance, a user-led group of activists and professionals in the United Kingdom (U.K.), talks about the long-term effect of opiate use on the brain. After six months or so of continual use, dependency takes place. "Opiates, unlike alcohol, are easy on the body," he says, "but what does happen is that the brain shuts down the whole endorphin system...In many, if not most users, these changes may not be reversible."
The Alliance, which is funded by the British government, does educational work and lobbies for better treatment and services for addicts, such as safe injection sites, inhalation rooms, prescription narcotics and detox. The first harm reduction initiatives, Nelles says, were taken in the early '80s by Amsterdam drug users who were worried about the spread of HIV and hepatitis C. "We took the Dutch work and brought it to the notice of the English-speaking world.''
A former opiate addict now on methadone, Nelles became addicted while he was a student nurse involved in a relationship with a doctor who easily obtained the drugs. No methadone program existed in eastern Canada in l977, although there was one in Vancouver. Because he had a British passport, Nelles chose to go to the U.K. to get into methadone treatment.
"All of the people I started doing opiates with in Ottawa are dead now," Nelles says. "We have this lovely idea that people who are addicted can come off the drugs if they want to...that they are making a choice to stay addicted."
Local experts
It's the users themselves, Nelles says, who are the experts on drug use. He credits the work of the Vancouver Area Network of Drug Users (VANDU) and its feisty director, Ann Livingston, for taking the lead in pushing for a safe injection site in Vancouver. In 2003, in response to a large-scale police crackdown and government inaction, VANDU, along with other like-minded organizations, opened an unsanctioned user-led safe injection site that operated for 181 days and supervised more than 3,000 injections.
Now VANDU is going to court to keep the Insite clinic open. "Hundreds of our members use Insite on a daily basis," said Diane Tobin, president of VANDU. "Many of them would be dead today without it. If this was a cancer treatment centre, they wouldn't hesitate, but because we're drug users it's like we don't matter."
According to Livingston, novice users coming to the Downtown Eastside area contract HIV and/or hepatitis C within six months. "If you grab 100 addicts, 35 of them are likely to be HIV positive and aboriginal people are seven or eight times more likely to be HIV positive.
"Because this place is like a village, people won't out themselves about their HIV. Everyone from the community will know. Their lives are already hard enough. But if nothing else is working for you, that's the last thing you'll do. Many have never taken AIDS meds. I call it dying with your boots on."
Tomorrow, second of two parts: the destruction drugs and related disease wreak in Insite's neighbourhood.
Elaine Brière is a Vancouver writer and photographer. Find her previous articles and images here.
This article originally appeared in The Positive Side magazine published by the Aids Information Exchange in Toronto.
A treatment guide for HIV-positive injection drug users and their caregivers is available at www.catie.ca/pdf/Prefix/enprefix.pdf or by calling 1.800.263.1638. For more info on harm reduction, visit www.canadianharmreduction.com. ![[Tyee]](http://thetyee.cachefly.net/ui/img/ico_fishie.png){kind=small}
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Working Man
5 years ago
Comments on "Where Carla and Wayne Shoot Up"
I work donwtown in Gastown and I cannot see where these reports are coming from. If anything, the "Safe Injection Site" has had the effect of bring drug abusers from all over Canada to reap the benefits of all the social agencies that have sprung up around Insite.
What has also sprung up around Inslte is a thriving drug market near and around the old Woodward's building. The user comes to the dealer with a sloten DVD for example, and the drugs are exchanged. I often see junkies ride bikes I cannot afford and sell them for drugs.
Ironically, the only time the police take any action is when a movie is being shot in the area. All the dealers and junkies vanish for the duration.
So this is obviously no solution whatsoever. It is only condoning illegal hard drug use and attracting more and more people to the area. I know this because I see it every day.
And of course, Insite and all the other "agencies" buy people jobs and make politicans feel good. They can say they are doing something about the problem, even when it is nowhere near the level of action that really needs to be taken.
Fact is, these people have to be moved to affordable housing outside downtown and given access to adequate health, addiction and psychiatric service. I can hardly wait to hear the NIMBY wails when one is proposed to be built in Burnaby.
DPL
5 years ago
Working man claims the drug addicted folks come from clean across Canada to use the area to do drugs. Strange as what I've read and heard in the area,Most addicts come from a few blocks away max. We lived even closer than Working Man to the corner of Main and Hastings than he does. Alexander Street. Sure dealers are around. wonder if any addicts in Kerrisdale use dealers as well? Of course they do and there is big bucks in drugs, just ask someone who is hooked. My idea of heavy drugs is the odd cigar, but addiction is just that. If the site keeps people alive and educates them to the options possible we are starting a rehab process. Wasn't that long ago that John Turvey of DEYUS started the first needle exchange program. MY God, the world was coming to an end. No doubt Working Man wouldn't like that either, even if it has cut down the Hep C and AIDS infections. Get a life WM., enter the real world Drugs are a hell of a problem and everyone knows someone who has been or is addicted. Sure we all wish it didn't exist but it does so lets' deal with it rationally, not the Nancy Reagan way of "Just say no" Didn't work Nancy. wont' work WM
verso
5 years ago
WM do you have some evidence of this besides "seeing it everyday"?
Do you actually ask these people where they come from?
Frankly, if some one does come here from out of province solely to use the safe injection site (not likely) then I have no problem with that... esp, if the other option is sickness, disease or overdose in whatever city they are coming from.
We should be pushing for these sites in every major city in the country... It will happen eventually.
Here I agree with you, at least in part... this isn't just a local issue but one the whole region needs to deal with. Where I don't agree (if this is what you are suggesting) is that we force people to move. It would never work. If we can provide them affordable housing in livable neighbourhoods, with treatment available near by, many will go on their own.
ubiquitous
5 years ago
Are you telling me that this didn't happen before insite opened?
shmendrick
5 years ago
If drug users are in fact comming to use Insite, all that proves is that there should be more of these clinics so that people are not 'comming from all over Canada' to use this one.
I suppose this could be just this guy making this stuff up because he gets big bucks from the junkie lobby.
The science backs InSite, (from what every report seems to say), and it is saving people's lives. If less people are dying, less people are getting infected with disease, and more people are being referred to treatment, how can that be a bad thing? What is your solution? Ship these people to the burbs? Why not provide the services you suggest where these people already live?
I'm betting most of the increase in junkie density is just locals using the resource. I find it hard to believe that junkies are hopping on trains in droves to go to Insite.
Moosebeer
5 years ago
The American's have been engaged in a "War on Drugs" using police and jails for decades now and the problem is getting worst, not better. Obviously a new approach is needed. If Insite can save lives and get people off drugs then I say lets keep it open. It appears to be working.
NoLeftNutter
5 years ago
The science backs InSite, (from what every report seems to say), and it is saving people's lives. If less people are dying, less people are getting infected with disease, and more people are being referred to treatment, how can that be a bad thing? What is your solution? Ship these people to the burbs? Why not provide the services you suggest where these people already live?
Not sure what the science actually says, shmendrick. Despite more than two thousand referrals the number of users hasn't changed and as for the site reducing disease, about 85% of the users attend less than once per day. How are they fixing up to protect themselves from disease the rest of the time?
As for treatment options, we're unable to force addicts into treatment so what is the logical solution? How about anyone convicted of a crime while high being forced to get treatment and to be clean, prior to being released back into society?
Working Man
5 years ago
Sure it was. It is just more than ever now.
bob the cat
5 years ago
(m. jagger/k. richards/m. faithfull)
Here I lie in my hospital bed
Tell me, sister morphine, when are you coming round again?
Oh, I dont think I can wait that long
Oh, you see that Im not that strong
The scream of the ambulance is sounding in my ears
Tell me, sister morphine, how long have I been lying here?
What am I doing in this place?
Why does the doctor have no face?
Oh, I cant crawl across the floor
Ah, cant you see, sister morphine, Im trying to score
Well it just goes to show
Things are not what they seem
Please, sister morphine, turn my nightmares into dreams
Oh, cant you see Im fading fast?
And that this shot will be my last
Sweet cousin cocaine, lay your cool cool hand on my head
Ah, come on, sister morphine, you better make up my bed
cause you know and I know in the morning Ill be dead
Yeah, and you can sit around, yeah and you can watch all the
Clean white sheets stained red.
God I loved that stuff.
Percy
5 years ago
What's missing from this article is some discussion of community impact, which is apparently of no concern to the special interest groups giving the sound bites. Whether or not this is good for--let's be honest--criminal riffraff--might not be good for the honest sober folks who are paying their bills.
shmendrick
5 years ago
As for treatment options, we're unable to force addicts into treatment so what is the logical solution? How about anyone convicted of a crime while high being forced to get treatment and to be clean, prior to being released back into society?
I think it is about time people realise there is no 'logical solution'. The drug program will not dissapear. there will alway be people who get focked over due to their own actions or those out of their control. there will be junkies...always. we help people out who get cancer from smoking, or fat from eating shit and not exercising. we fix up those who cause accidents even if they kill people. why not help out junkies then?
I have to agree that its is not too likley that someone who lives in the DT eastside is going to be saved from disease by InSite, but it is an option that people have, and having clean needles certainly cuts transmissions rates, so I can't see how is does anything but give people a bigger window to get off the street.
That from pg 5 of the report. That is pretty important.
yah, spending a bunch of tax $$ putting people in jail/treatment is going to make a lot of sense... do you have any notion of how hard it is to kick a serious addiction? These people will jump thru the hoops, and then most will be back at it soon after being released to the street.
To get straight, you need a community, you need support, and you need a sense of self worth. Incarceration provides none of that.
I can never understand folks bitching about money spent on a compassionate response like InSite, but have no problem suggesting we spend 10 times more to put them all in jail and forced treatment. I'm also betting that most of these folks are not doin' crime when high... they are doing crime when they need a fix. As was mentioned before the incarceration route has been tried and tried and you can see just how much success they've had with that by looking south.
really, the only thing close to a solution starts and ends with compassion.
Working Man
5 years ago
Sure it did. It is just happening more now. Insite did not solve any problems and far as I can see and it is concentration them around one place. I see it every day, Monday to Friday. How many of you do?
ubiquitous
5 years ago
What happened WM, it took you an hour to think of 2 more sentences to add to your response? Did you even read the article? Click on the links provided? Do you understand "harm reduction"?
Well, I do for one. Every day. Saturday and Sunday as well.
Of course not. It seems as though you believe that insite should have been an instant panacea to the DTES drug problem; that insite should have dispersed drug users or even stopped drug usage altogether. That's not the (short term) point of insite. I suggest that before you make such insidious remarks WM, read the article.
verso
5 years ago
That's my hand up, WM... like it matters. You don't have to live or work there to have an informed opinion. In fact, I'd put the opinions of those who have actually read the reports above your "observations" any day.
Working Man
5 years ago
Where did I say that? Insite is more of a panacea for politicians to claim they are doing something about the sameful situation in that area when in fact they are doing practically nothing. There is not less drug activity since Insite opened, there is more. Are they related? I have my suspicians. But there are tons of dealers around that area now, way more than a couple of years ago. Go stand at Abbot and Cordova and see what you see. It is shameful that the city, province and police would all it to go on at all.
Real action is needed, not bandaids like Insite.
ubiquitous
5 years ago
You didn't actually say that WM, which is why I said "It seems as though you believe..."
When you say,
and
it implies that because you still see drugs in the DTES that, in your opinion, insite was a failure. I'd like to see you actually respond to the measures of success of insite rather than pass off opinion, or as Verso more acurately says, observation, as fact.
la_bandolina
5 years ago
'CAUSES' of addiction? Ms Briere writes...
"Using opiates continually over the long term creates opiate dependency -- the drug is needed to generate an endorphin-like high. Bill Nelles, founder and director of the Methadone Alliance, a user-led group of activists and professionals in the United Kingdom (U.K.), talks about the long-term effect of opiate use on the brain. After six months or so of continual use, dependency takes place. "Opiates, unlike alcohol, are easy on the body," he says, "but what does happen is that the brain shuts down the whole endorphin system...In many, if not most users, these changes may not be reversible."
er... Ms Briere, I'm a little concerned that this kind of statement could be used to support "drug use causes addiction" ideation in our community. My idea is that you can just leave it out, as the complexity of scientific study of drug use trends and of addiction are beyond the scope of mass media, but if you are interested in presenting some info about trends and correlations in addiction and drug use please consider seeking out such information from scientific studies, rather than using heresay from clinic advocates such as Mr. Nelles for this purpose.
On the other hand, we may be interested in hearing what Mr. Nelles has to say about operating methodone programs, something which he has special knowledge of.
If I wanted to talk about what 'causes' drug addiction, I might start with a presentation by Bruce Alexander to the Senate :http://www.parl.gc.ca/37/1/parlbus/commbus/senate/Com-e/ille-e/presentation-e/alexender-e.htm
where I notice some hints as to what scientific studies have to say on the matter.
Aside from this difficulty, I enjoyed learning a little about Carla and Wayne and the DTES SIS.
NoLeftNutter
5 years ago
It's not clear to me how providing someone a path to engage in self destructive behaviour that almost always leads to premature death is compassionate.
shmendrick
5 years ago
Don't put words in my mouth... a straw man sure is too easy to knock down, dontcha think?
What not clear to me is how providing addicts with a place they can shoot up with clean equipment, not die if they OD, etc, a place that is likely the closest any of these people ever come to somewhere they might get help and/or talk to someone who might actually care whether they live or die is 'providing someone a path' to self destruction. Let's not forget these people are shooting up with or without InSite.
I'm not sure if you set that straw man up on purpose or if your assumptions about harm reduction did it for you.
If you need a primer on what compassion is: http://en.wikipedia.org/wiki/Compassion
snert
5 years ago
They don't need compassion. All that's needed is common sense. Nothing that has been tried seems to work with any degree of success so why not just admit that these people have a chronic illness, give them the drugs they need, pension them off and find a place where they can live out their days in relative tranquility. I suspect that some may then start to recover on their own. If they don't have to try to keep functioning through the fog of intermitant withdrawl they just might start to see the light of day. This method can't be any worse than anything else that's been tried.
shmendrick
5 years ago
my common sense tells me that everyone needs compassion. Yes, junkies too.
Working Man
5 years ago
You make a good point, snert. The lefties here talk about compassion and the need for "treatment" but they will not act themselves nor actually have the guts to stat that sticking needles in your arms is harmful and should not be tolerated.
Socialism is conservatism and chacterised by righteous inaction.
bob the cat
5 years ago
Why are there so many addicts in Vancouver?
verso
5 years ago
Funny, I don't think anyone here has claimed that drug addiction isn't harmful... but I've read lots of arguments about making it less harmful.
And, WM, it's not just your favorite punching bag o' lefties supporting Insite... it's the VPD, the right leaning NPA, your beloved BC Liberals (who knows where they fall on the political spectrum these days), and the Federal Cons now too (though probably not out of compassion -- hoping to pick up a seat in Vancouver, no doubt). Be sure to save some of that indignation for them too.
Umslopogaas
5 years ago
And meanwhile our best young boys and girls die in Afghanistan as a record poppy crop comes to harvest.
NoLeftNutter
5 years ago
Shmendrick - I don't think my point is a straw man. I suggested a solution you replied by suggesting compassiion. To do so in the context of the SIS suggests that you support the site. Your suggestion that the site is a path "to talk to" someone is misguided. The statistics show that even after the equivilant of close to 50% of the registered users have been "referred" the numbers are not declining......
Frankly, the SIS is another do-gooder cop out by it's supporters who lack the character to honestly address the issue. The SIS isn't about "harm reduction", getting people off drugs is harm reduction.
OneWomanArmy
5 years ago
Ok, First off I live in the DTES and Working Man, you need an education and I'm gonna give it to you.
There was always drug dealers and there will be drug dealers until drugs are legalized and taxed by the Federal Govt. Glory be THAT day.
Second, there's not MORE drug dealers, there's LESS people DYING from drugs and INSITE is the reason for that.
People who would have become an HIV or a HEP C or Endocarditis patient at a hospital, costing YOU Mr. Working Man, MUCH MORE Tax Dollars are now DROPPING DRASTICALLY because of the Safe Injection Site.
And let's just get this point: Drug dealing is everywhere. You are so blatantly stupid regarding that point.
Whether they're wearing the latest Hugo Boss Cologne in a 60,000 new car or they're pushing a grocery cart down the street selling jib it's the SAME DAMN THING except one looks nicer than the other.
And those same people from the West End, YES, THOSE DRUG DEALERS, come down to the DTES and Supply the little dealers with their DOPE to sell.
So let's get an education today Working Man.
Jeesh, there's an ignorant **** around every corner.
OWA
Now hush up with your whining and let your ears open wide to hear what's really going on here. Or I'll have to spank you, you naughty boy. LOL
OneWomanArmy
5 years ago
HAHAHA...
Sticking needles in your arm should not be tolerated. My Goddess this is a laugh a minute.
There's nothing wrong with sticking needles in veins if you rotate and do it properly. That's why places like Insite have a real model, with veins and red juice flowing through it so that people can learn about vein health and again, SAVE THE TAXPAYERS MONEY.
Those people now KNOW how to inject properly and won't have to keep going to the hospital for all the problems that come from injecting improperly.
If I snap my whip will you neocons run back into the hole you came out of?
**giggle**
Truman Green
5 years ago
la_bandolina, perfect! I had trouble with that same paragraph.
And also: "the brain shuts down the whole endorphin system."
This is not true.
While there is controversy regarding the scientific appraisal of addiction, (brain disease or environment models) noone of any repute makes this strange claim because the opiates--heroin, morphine and codeine--bind to the same receptors in the brain as our natural opiate-like substances--endorphins or enkaphalins.
Therefore, the most productive way to regard opiate reaction is that it prolongs the pain-reducing effect of natural endorphins, which provide temporary analgesia in the event of trauma. This temporary analgesia is provided to mediate the endangerment into which an acute pain-sufferer would be placed, and which would render him incapable of immediate response in a fight or flight situation.
Opiates merely prolong this response and provide a respite from chronic suffering and pain. And to do this they do not "destroy the endorphin system" but rather employ it.
Other issues: Methadone has no therapeutic value as suggested in the article. And it is just as lethal if an overdose occurs.
It is used for one reason only: It is legal as a heroin substitute and provides only the analgesic dimension (no euphoria) of the opiates.
Elaine Briere makes the following claim:
"Many people on methadone, which is a depressant, still use STIMULANTS like cocaine and heroin to get high and overcome the slowing down effect of methadone."
Also, Ms. Briere, heroin is NOT a stimulant. Er, that's why heroin is known as "down" on street, and cocaine is known as "up."
Methadone, invented by Nazi researchers as a pain-killer is just that, an analgesic.
Heroin is NOT a stimulant, it is an analgesic and works as a depressant. The real reason that methadone is often insufficient is that it does not provide the euphoria associated with heroin usage and this is because it has a less efficient receptor-binding capacity.
(If truth be told, heroin doesn't really provide euphoria, but rather allows it; the eurphoria is provided by the imagination of the user, who finds him/herself in the absence of pain.
Imagine!
It's unfortunate that, as la_bandolina suggests, Briere has presented so much hearsay and folk wisdom about addiction in this article.
I, too, would strongly recommend the work of Bruce Alexander, who concluded that the susceptibility to addiction is best calculated by the history and environment of the user, and that in the absence of certain compelling circumstances, heroin may not be addictive at all.
Such circumstances are usually comprised of the extreme prior need to extinquish various kinds of psychological, emotional and physical pain.
Almost all researchers will finally admit that heroin, if used only for acute pain, is seldom, if ever addictive, and it is totally intuitive that it should not be addictive in the absence of causative environmental factors.
Which should be of no surprise to anyone. The opiates are, afterall, merely exogenous endorphin analogues.
Harm reduction is a humanitarian and compassionate intervention, and prevents much suffering and death by overdose, but the overall degradation associated with drug addiction in our society will never be seriously diminished until the substances are decriminalized and regulated, and addiction itself is understoood to result from a rational and inevitable confrontation of suffering and pain.
I also hope that hiv positive people will seriously consider the possibility that ALL of their so-called "hiv symptoms" are actually not related to the retrovirus, but rather, are merely side effects of the antiretrovirals.
And that beyond excruciating mental anquish resulting from perceived inevitable pathogenesis (often causing real somatic symptomology like stress-related flu-like symptoms), there are NO hiv symptoms and that hiv is merely a harmless retrovirus.
climber
5 years ago
Walk down Hastings any day, all you will hear is up/down? Up/down?, for blocks, I chose not to buy either because I quit it all. Thankfully I had the support of my friends, was in good physical shape and had a little hope left. Whatever works, if someone is getting high at Insite and they can get help to quit, maybe they will reach out. The war on drugs has been lost, all we should do is reduce demand, a very tall order, but worth it. People quit when they want to, you can't make them, but it is human and the right thing to leave the door open. Bottom line is, give it funding, keep it going for a while more. Bob the Cat, there are lots of addicts in Vancouver 'cause its a port city, always been junk here, back in the past, like before the '80s, most people that used H were already badasses, not so now.
Ryu
5 years ago
Question to Insite detractors: What do you propose as a solution to the festering open wound of the DTES?
DPL
5 years ago
RYU. You certainly hit the issue straight on.They have no solution just a lot of talk. Three previous mayors of Vancouver, two who became premier and one a senator all support the system. the present mayor does support the site as well. Are they all twisted dumb persons. well hardly. So WM if you can't come up with anything beyond, they should stop , simply go away. studies an practices elsewhere don't seem to be understood by you guys. The staff in that place keeps people alive and I wouldn't do their job, couldn't do their job, but by God they are doing the job and we all all better off because they are. Drugs cost the st stem for sure but if one person ends up with HIV and lives for a few years the cost is higher than allowing them to do their injecting in a place that isn't a back alley. Oh Gosh I'm starting to sound like the results of all the studies.
Truman Green
5 years ago
I would also like to warn illegal drug users that these drugs are manufactured by criminals and their agents, without regard for quality control or even the most basic cleanliness or sterility procedures, and a certain percentage of them are bound to be contaminated by adventitious agents, notable common bacteria such as staphloccus and streptococcus, and mycoplasmas, which are capable of destroying the human immune system.
These illegal substances are therefore extremely contraindicated for human health and I would therefore recommend strongly that they not be used.
It is extremely irresponsible to inject any of these possibly contaminated substances into your bloodstream.
They could contain any of a wide range of disease-causing agents.
alive
5 years ago
What to do with people who do not fit the mold?
If they have money, some relative will send them to a private clinic for a "vacation"!
If they are poor, society needs to step in!
Neither approach will help a lot unless there is understanding and help afterwards.
Here we are bickering about what it costs,even if it is obvious that putting them in jail is even more costly.
Hitler solved such problem by mass executions; addicts,"morons' homosexuals were eliminated as well as any oppositon.
Somehow i have not heard anyone suggesting such a drastic solution, but sense that some writers have absolutely no compassion!
We are talking about PEOPLE!
We should be past the age where the elderly was set adrift on an icefloe, when they became a burden to society!
Wman and others: you have no idea what you are wittnessing walking to your office, all you see is cripples and panhandlers, dealers and addicts.
If you spent a week with one of them, perhaps you might just grasp how and why they are there cluttering your view.
OneWomanArmy
5 years ago
^^YES!
And Truman, if you thought I was OK with the fact that injecting street drugs wasn't harmful because of the agents that get added to a drug, that's NOT what I was saying.
What I was saying was: being opposed to injection based on some moral argument is ridiculous. Plus, it depends on WHAT you inject and HOW you inject it.
Now, if we had pharmaceutical grade products, taxed and sold by the F govt. and we had Insites all over BC then we'd really be doing harm reduction.
IAMC
5 years ago
I ask, how do these addicts get the money to buy drugs?
The couple featured in the article, don't seem to have an income. Maybe they get social assistance, I don't know.
They are paying cable bills. They must have an apartment.
I don't put them down. I know how hard it is for some people to keep it together. These poor folks have probably burnt every bridge they ever had. We are probably catching them on a good day.
I hope they have a future. I am saddended by this story.
Truman Green
5 years ago
We're on the same page, One Woman Army!
I agree with everything you wrote.
Realist
5 years ago
As a previous member of the drug trade I can assure you that there is absolutely no way that anyone will prevent the production, sale or consumption of drugs in our society. Drug dealers have a huge advantage over the police who must obey certain laws and proceedures. Dope dealers do not have any such conditions on their businesses (do not be confused, dope is a very high end, lucrative business). Who do you think is going to win that kind of war? Unlimited financial resources verses penny pinching government funding.In the business the war on drugs was a welcome one as we knew the only way we would ever be put out of business was if the government came to it's senses and legalized the trade and controlled the profit. Unfortunately, they will never do this and thus the war is already lost. Until this truth is understood and followed (Do you think Steven Harper is not aware of this basic truth?) there is no hope of any meaningful prevention of the dealers profiteering at the suffering of others. The next time you whine about your car being broken into or stolen remember that the truth was out there and the people who could make a difference are just not interested in the least about our petty losses.
billy pilgrim
5 years ago
it seems insane to me that one level of government can legislate these drugs as being illegal and another level of government can facilitate their use.
these drugs are either illegal or they're not. legalize these drugs and get rid of the slimey dealers standing on the corners selling a product with no consistency or quality control.
if a senior government took control they could also spread the sites around so the business owners in one location wouldn't have to bear the brunt of the problem.
jwstewart
5 years ago
Truman;
This is far too simplistic to be of much help. Big Mac's and Whoppers are in and of themselves not addictive, but there are people addicted to them.
The addiction (disease) is contained within the addict, not the substance they crave. Everyone experiences physical, emotional and pyschological pain, it is a part of life. So then everyone who has or will suffer pain could become dependent on a quick repreive from it.
Fundamentally though, an addict is consciously causing harm to themself by abusing drugs. Is it wise to depend on someone with a fatally self-destructive disease to reliably practice harm mitigation techniques ? That sounds like a recipe for disaster.
If, for example, a non-addict, with HIV was found to be having unprotected sex, they would in many jurisicitions be locked up, preventing the further spread of infection.
Why then should an addict with HIV not be locked up for sharing needles ?
Frankly, I think the harm mitigaton technique needs to be applied to society as a whole. Maybe anyone found injecting outside of the SIS should be locked up for not injecting safely.
Truman Green
5 years ago
jwstewart, you asked the following:
"Why then should an addict with hiv not be locked up for sharing needles."
My answer: Because hiv, once known as htlv-3, Robert Gallo's little brain child--which he thought at first might come in handy as a CANCER-CAUSING VIRUS, is in reality A PERFECTLY HARMLESS RETROVIRUS.
And anyway, now they've got a vaccine for hpv (human pailloma virus) which supposedly causes cerival cancer, so you'd think they be happy without insisting on selling truckloads of dangerous anti-retrovirals.
And locking up people who do no harm is not good, jwstewart.
(Gallo, first called this retrovirus human t-cell lymphotropic virus because he figured he had discovered the mother lode: a virus that caused cancer. (get it?...lymphoma) Of course when it was found that retroviruses don't really cause cancer in humans they brushed it off and claimed that it caused severe immunodeficiency instead. And being as how the world's full of idiots--not to mention very stupid people--they sold this crap to ex presidents and special UN envoys, not to mention the entire population. ALMOST
Go here for a bit of common sense:
http://www.rethinkaids.com/body.cfm?id=60
Montaigne, the French co-discoverer now claims that hiv could never cause anything all by itself and claims that it would require a "co-factor," like mycoplasmas. Mycoplasmas vectored by contaminated illegal drugs is a likely suspect, but just to fulfill Montaigne's need for distance from the conventional Aidist hypothesis, NOT.
By a weird coincidence Gallo had just cleaned up Montaigne's old LAV (lymphadenopathy associated virus) and claimed that he'd discovered it after getting a copy in the mail.
Incidentally, retroviruses like hiv can only kill about 1 in 500 cluster differentiation type 4 T-cells, (a kind of immune cell that matures in the thymus gland) at any one time, not to mention the fact that T-cells replicate so quickly that a miniscule diminishing of their numbers (1 in 500) would cause ABSOLUTELY NO DAMAGE TO THE IMMUNE SYSTEM because they would be replenished too quickly.
Interestingly, it looks like the Aidists are now abandoning their silly CD4 hoax. Read the article in the latest New Scientist magazine (How HIV Burns Out The Immune System) in which they now claim it's CD8s which do all the damage, or at least a fantastic new role for cytokines, which are no longer immune messenger cells, but have conveniently become "virus-killing chemicals.
It's all pseudo-science and nonsense, jwstewart.
Oh, and jw, the people who should be locked up are the members of the corrupt Aidist science industry who have invented this ridiculous and evil hoax to get hiv positives to go on dangerous anti-retrovirals for the rest of their lives. They've already killed hundreds of thousands with AZT, but are apparently not satisfied yet.
By the way, REAL sexually transmitted diseases sooner or later get into the general population. Despite early Aidist claims that 90 million Americans (and 850 trillion Africans) would die of Aids, Aids has retained its original risk groups: drug users and young gays, who by the way, nearly all use illegal drugs.
And so, jw, to repeat why hiv positive drug users should not be jailed:
because you've been punked by the Aidists and don't have the brains to realize it.
No offence!
Truman Green
5 years ago
Oops, Montaigne should be Montagnier, Luc, who was not a French philosopher.
bob the cat
5 years ago
THE PUSHER
Words and music by Hoyt Axton
You know I've smoked a lot of grass
O' Lord, I've popped a lot of pills
But I never touched nothin'
That my spirit could kill
You know, I've seen a lot of people walkin' 'round
With tombstones in their eyes
But the pusher don't care
Ah, if you live or if you die
God damn, The Pusher
God damn, I say The Pusher
I said God damn, God damn The Pusher man
You know the dealer, the dealer is a man
With the love grass in his hand
Oh but the pusher is a monster
Good God, he's not a natural man
The dealer for a nickel
Lord, will sell you lots of sweet dreams
Ah, but the pusher ruin your body
Lord, he'll leave your, he'll leave your mind to scream
God damn, The Pusher
God damn, God damn the Pusher
I said God damn, God, God damn The Pusher man
Well, now if I were the president of this land
You know, I'd declare total war on The Pusher man
I'd cut him if he stands, and I'd shoot him if he'd run
Yes I'd kill him with my Bible and my razor and my gun
God damn The Pusher
Gad damn The Pusher
I said God damn, God damn The Pusher man
OneWomanArmy
5 years ago
I'm glad we agree Truman. Between you and Bobb999 I find solidarity, which is a nice touch to all this dialogue that can get a bit flippant at times.
I sometimes wish I could practice more tolerance with people like Working Man. What he doesn't realize is our battles are one in the same. His head is just too full of War on Drugs rhetoric to really allow anything else in.
No, it's not nice to have to buy things off the street, not knowing exactly what you're getting. That's why I almost always purchased a Hydromorphone (Dilaudid 8mg). It easily breaks down with H20 and it's probably the most pure you can get besides getting the actual stuff NAOMI is using.
When you purchase things like heroin and even morphine capsules that you have to break down, you really don't know what you're getting.
However, you cannot mistake a true Dilaudid. It has a specific shape and the official logos and numbers on it. Plus they are usually sold right out the person's presciption bottle. That's the BEST you're going to get until the government decides to use NAOMI's results.
The real deal NOW.