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September 02, 2005

Volunteer heroin injectors in Vancouver

In Vancouver some public spirited heroin addicts are volunteering to help debilitated addicts inject themselves. This project will sound crazy to most Americans, but it's actually a plausible harm-reduction strategy.

The organizers of the program have reason to believe that incapacitated drug abusers are at high risk of spreading HIV, hep C, and other blood borne diseases.

The program makes sense when you think about it. Addicts who can't shoot up are likely to share needles with anyone who is willing to inject them. So, fellow addicts are stepping in to protect the most vulnerable, and ultimately society at large.

Thankfully, Vancouver's drug enforcement climate is sufficiently enlightened to allow the Vancouver Network of Drug Users to get the word out.

Here's the full story from today's Globe and Mail:

Too sick to shoot up? Call a volunteer
Thursday, September 1, 2005 Updated at 7:40 PM EDT
Canadian Press

Vancouver — Addicts, crippled and blinded by their drug use and too sick to shoot themselves up, will be helped by a volunteer team of users to get high safely.

Forty members of the Vancouver Area Network of Drug Users will be patrolling the Downtown Eastside, a slum and open drug market that teems with disease, offering injection education and assistance.

“Most of the stats show people who are incapable of injecting themselves or have a hard time have the highest rate of HIV,” said Diane Tobin, the new and first female president of the users' harm reduction group.

VANDU, which is wholly run by volunteers, has 12 members trained and walking the alleys now. Ms. Tobin said they hope to get a room where people can also come to them.

“There's a huge need out there,” said Ms. Tobin, who is back on heroin to deal with withdrawal from methadone.

“A lot of people can't inject because of blindness, injury, stroke. They're still heroin addicts. They're at the mercy of anybody and a lot of the time they don't use clean needles. It's whatever's in their pockets.”

Women and young injectors are also more likely than other injection drug users to need help injecting.

Health Canada is calling for a change to the law that prevents peers and nurses in the city's sanctioned safe injection site from helping people inject.

Health care workers can only supervise and offer medical assistance if a user hurts themselves and gets sick or overdoses.

If nurses help an addict shoot up, they could be charged with possession or trafficking.

“We need them to help,” said Ms. Tobin.

“And we need more places like the safe injection site. It's so busy now, it's being used all the time and people are sitting on the street, getting people who don't know what they're doing to inject them.”

VANDU is also busy coping with the hot heroin going around the Downtown Eastside.

It has been blamed for a recent cluster of nine overdoses.

Ms. Tobin is trying to spread the word to users to taste their drugs first.

“Good heroin has a bitter taste. The bad stuff has a more chemical taste. Do it with a friend and help each other. Don't do it alone,” she said.


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back on heroin to deal with withdrawal from methadone.



Yeah, I know. But it's all the more remarkable that Ms. Tobin's taking time to help the even less fortunate.

I have to wonder whether the statement about being on heroin because of methadone withdrawal wasn't a slightly inaccurate or incomplete paraphrase by the reporter.

Knowing what I know about Vancouver's IDU problems and its methadone maintenance problems, it wouldn't surprise me at all to hear someone say "Being on methadone was such a demeaning hassle that I decided I'd rather be a junkie." Or, even more likely, "I couldn't get methadone (or stay in a methadone program), so I went back to heroin."

I may be a little out of date, not having lived in Vancouver for a couple years, but when I left, it was impossible to run a methadone clinic that was open during non-business hours. Anyone who wanted to be on methadone had to present themselves three days a week to get their dose, always during the working day. Doctors technically had the right to prescribe methadone out of their offices, but hardly any docs did because they felt their licenses might be at stake.

The status quo ensured that if you wanted a regular job, you couldn't go on methadone. Almost anyone who was still functional enough to hold down a a job could have sustained a heroin habit and got better customer service from their dealer.

Yeah, I know. But it's all the more remarkable that Ms. Tobin's taking time to help the even less fortunate.

Definitely. I was really expressing my continued amazement that we haven't come up with a better solution than methadone - not that it doesn't save lives, because it does.

Why not just snort it? It's so easy and there's no loss of product.

I first came to Vancouver in 92, and in 93 there was the "china white" string of ODs that killed several dozen people - the supply got 3 times as strong as it was normally. This year, there've been deaths - due to strength or something toxic cutting the heroin, they don't know: but it's looking like harm reduction is making a difference.
NAOMI is trying a different strategy for harm reduction: providing heroin 3 times a day to addicts for whom methadone hasn't worked. The idea is that, if you're not living for your next fix & doing what you need to do to get the money for it, you might actually be able to put together a life outside of addiction, which is helpful for breaking addiction in the long run.
The frustration I've been hearing from Downtown Eastside activists is that harm reduction is being twinned with heavy police enforcement (people are being moved along and SROs are closing: Olympics in 2010, everyone look happy!), but there aren't enough counselling resources there for those who would choose to use them. Harm reduction is working, and now we need more resources to detox beds and therapy. It's like they didn't believe it'd actually make a difference...

In European programs which supply heroin to addicts, some participants find jobs and support themselves for long periods and some participants do not.
In any case, heroin use will eventually kill your liver, as will alcoholic drink.
But alcohol damages and destroys vastly many more lives than all drugs combined, including heroin and abused prescription drugs. Yet your corner bar will not anytime soon shut down.
The nasty organized crime still with us in the US gained its solid foothold during
the Prohibition era, beginning in 1919 with the Volstead Act outlawing the
commercial production and sale of alcoholic drink. After 14 years of
hooch nurtured extortion, murder, government corruption, and unabated alcoholism, the American people realized the cure did more damage to society than the booze and repealed the act in 1933.
A fine instead of jail for marijuana possession is one result of the lesson learned --and the current government Methadone program is another result.
Rather than drive the addict underground where you can't control him, instead tempt him with a supervised government fix (methadone is highly addictive) to avoid jail
time. At least it provides an alternative to criminalization.
But the lesson does not extend to the black side of town where, often, white suburbanites stopping off to grab an urgent fix, make up a substantial portion of the customer base-- and a tiny fraction of those busted for drug offenses.
US domestic drug enforcement policy is both schizophrenic and racist.
The US has more people currently incarcerated than any other country in the world and a higher percentage of its population behind bars than in all but a few countries--
and, in the US, the bulk of these are young black male drug law violators; and the resultant devastating effect upon the health of black communities is worse than the effect of the drugs on black communities.
A seller of drugs may stop selling and an addict may stop using and may lead
thereafter a conventional life, putting the past behind him. But a young black
ex-con will rarely escape the ex-con's negative social stigma, which often denies him a job and legitimacy in the world outside his community-- compounding the
marginalization he suffers by the color of his skin. The cycle is insidious:
racism induced unemployment leading to sale of drugs to advance materially, leading to jail time and stigma as an ex-con entailing yet more unemployment, leading to more drug sales-- sustaining the drug selling and using lifestyle and entrenching
a gangster class.
Hundreds of thousands of young black men are stigmatized and caught in the cycle throughout the US--undermining the potential recovery of conventional family and social life in their communities as a whole-- perhaps for generations.
These young black men are a lost generation, lost to their communities--and both
are direct casualties of the "war on drugs".
To callously and grievously damage the black segment of society as this bigoted drug enforcement policy does, is to socially and morally weaken America as a whole- and is evidence of the strong subcurrent of racism that yet runs behind the facade of US equality, a racism substantially responsible for the drug trade in the black community --a blind racism precluding recognition that the US "war on drugs" especially as practiced in this racist way ----is a cure worse than the malady.

The problem with a program like this (i.e. having workers inject addicts) is that if someone dies -- or even OD's and survives -- there's suddenly a huge chain of liability, from the person who injected the heroin to the person in charge of the place where it happened, to the government officials who approved the program.

Safe injection sites are one thing, but this is an entirely different beast.

Considering the main appeal of safe injection sites is their relatively low cost (compared to imprisonment and/or government-sponsored rehabilitation), I somehow doubt a program so potentially costly will ever be approved.

Ya I guess it is remarkable that Diane has taken the time to help out the drug users in her area but to me being one of the unfortunate ones being left behind because of the her love of the high it is like a slap in the face. Charity begins at home,but my brother and I never truly had a home with her so I guess it doesn't count.

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