Pubdate: Sat, 25 Nov 2000
Source: Vancouver Sun (CN BC)
Copyright: The Vancouver Sun 2000
Contact:  200 Granville Street, Ste.#1, Vancouver BC V6C 3N3
Fax: (604) 605-2323
Author: Frances Bula, Vancouver Sun
Series: Searching for solutions - Fix on the Downtown Eastside
Bookmark: Safe Injecting Rooms


Most Of The World's Safe Injection Sites Are In Europe, And The German
City Leads The Parade.

Olle has come to Frankfurt this Thursday, as he does every week, to do
his shopping. The 25-year-old information-tech student buys a week's
supply of heroin near the Hauptbahnhof, the central train station, to
take back to Mannheim, where he lives with his parents an hour's train
ride away.

Before he heads home on the late-afternoon train, he walks over to 38
Elbestrasse. Next door to the Cafe Bistro La Bella, and across the street
from one of this area's many legal brothels, is a tall, narrow, five-storey
building built in classic old-European style. It's indistinguishable from
its neighbours except for the frosted glass on the front window and a small
plaque on the wall that says Drogennotdienst: Drug Emergency Service.

There is a group of five people standing on the sidewalk in front,
some waiting to go in, others pausing on their way out. Inside the
door, Olle goes up to the staff desk and indicates that he's been
there before so he doesn't need to fill out the two-page form asking
his age, where he lives, what type of drugs he uses and so on. Since
there's no line-up, he goes straight through the door to his left,
into a trapezoid-shaped room lined with a stainless steel counter and
mirrors at each station, like a very minimalist beauty parlour. On the
wall, two graphics are posted: No cell phones, no crack smoking.

Olle picks up two needles, some distilled water, a few swabs and a
spoon with a small square of white -- a filter -- in it from Sybille
Breitfelder, who sits at a raised counter that allows her to keep an
eye on all eight chairs in the room.

He takes off his belt, sits down and begins his ritual: cooking up his
heroin in the spoon, using the filter to take out the impurities as he
loads his syringe, wrapping his belt around his left arm and then
injecting. He injects twice, one after the other, into his left
forearm, then sits quietly for a few minutes, letting the rush work.
He's careful not to make any noise because the man next to him is
shooting cocaine, and coke users hate noise right after they've fixed.

Then Olle gets up, puts on his belt, gets some paper towels, wipes
down his station, throws his used needles into the plastic garbage can
filled with soapy liquid and packs the rest of his dope, along with
another needle that he buys from the front desk, into his corduroy
shoulder bag. In all, he has spent about 20 minutes in the room, well
under the 30 minutes usually allowed.

He won't be back for another week. When he's home in Mannheim, he does
one fix in the morning and another at night in his room. But he has to
come to Frankfurt to buy his heroin, and he likes this injection room
because it's quieter and he never has to wait.

The Consumption Room

This "consumption room," as it's called here, is one of four in
Frankfurt. Three are in the red-light district that forms a transition
zone between the train station on one side and the financial district
on the other. The fourth is in an industrial district a half-hour tram
ride away on the eastern edge of the city.

The users range from functional people like Olle, including the
occasional bank worker in a suit, to a significant proportion who are
long-time and much more ravaged-looking users.

It is the injection rooms that attract all the attention around the
world. They are the model for places as diverse as Madrid and Sydney
that have opened injection sites recently and they draw a steady
parade of Chinese bureaucrats, Bavarian policemen, Russian social
workers, Australian journalists and today, a Vancouver reporter.

The Frankfurt Way

But they're only one part of what has become known as "The Frankfurt
Way" -- a way that Frankfurt politicians, police, businesses, and
civil servants now proudly defend to critics both at home and abroad.

"Help for the addicts, hard on dealers" is the shorthand description
for The Frankfurt Way. The long description includes much more:
changes in sentencing for dealers, in police connections to
immigration officials, in co-ordination with treatment and job
training, in business support for drug programs, in health care and
psychological counselling, in the previously almost non-existent
methadone program, and much more. In total, it costs Frankfurt, which,
like all German cities has a large budget and is responsible for
funding social programs like housing and welfare, a little over $10
million Cdn a year, with almost as much again thrown in by the state
and federal governments.

It will even include in future the mind-boggling initiative of giving
free heroin to hardcore users -- mind-boggling because $40,000 of the
total cost of the experiment, in Frankfurt anyway, is being funded by
the local business community.

Calling it The Frankfurt Way makes it sound as though it was easy, as
though someone came up with the perfect plan, right from the
beginning. But it was far from that. It took years of negotiation,
confrontations with both the national government and other provinces
in Germany, resistance from Frankfurt's home state, Hessen and many,
many mistakes. But now, after years of gradual evolution, the system
that seems so radical to so many is accepted as the norm in this city.

Frankfurt is a comfortable, prosperous city. Its ultra-modernist bank
towers light up the skyline at night, overshadowing the spires of the
few remaining old cathedrals -- a visual symbol of Frankfurt's motto:
"Modern Metropolis with Tradition."

Although the city itself is small, only 670,000 people, the
ever-efficient German train system makes it easily accessible to the
six million people who live in Hessen and beyond. Added to that, its
airport, the O'Hare of Europe, is one of the biggest on the continent.

Its tree-lined, busy pedestrian mall, lined with department stores
like Haufkof and Peek & Cloppenburg, and every kind of shop from the
downscale Woolworth's to the much more upscale Douglas, is reputed to
pull in more money than any other consumer strip in Germany. So when
an open drug scene started developing in the 1980s in one of the
central city parks -- the equivalent of having one, say, in the plaza
in front of the Vancouver Art Gallery here -- people were horrified.

By 1990, there were anywhere from 500 to 2,000 people standing around
in the main park area every day -- a spot with a large,
trellis-covered plaza and stone benches that proved to be ideal for
hiding from police, fixing drugs and generally hanging out. Ambulance
sirens were a constant, with 20 to 25 calls a day. Other German cities
had drug scenes but theirs were more hidden. This was right in the
middle of the city, so that thousands of bank and insurance-company
employees had to walk past it on their way from the train station to
work every day. Frankfurt, thanks to the busy airport, was the perfect
entry point for the drug trade.

Police tried cracking down. They arrested hundreds, filling the jails
with not just people but their drugs as well -- in Frankfurt, as
everywhere, prison bars are no impediment to the drug trade. Soon
enough, they were out again. Even if they weren't, the crowd never
seemed to diminish. It was like scooping thimbles of water out of the

Over at the Fachhochschule Frankfurt, the university that trains
social workers, other things were happening. Two researchers,
Hans-Volker Happel and Werner Schneider, were studying how heroin
addicts recover. They looked at studies from around the world and
found out many of them came to about the same conclusion: 60 per cent
of heroin addicts recover from their addiction eventually, whether
they are in treatment or not.

While a study like that might not have been big news elsewhere, it was
a news flash in besieged Frankfurt when the results were made public
in 1988, kicking off a whole new discussion about whether there wasn't
a better way to deal with drug problems.

Instead of just arresting them, some people started to say, why don't
we just try to keep them alive and healthy until they get clean
themselves. When the Greens and the Social Democrats got enough votes
in the municipal election of March 1989 to form a coalition
government, one of the first things they did was to create a drug
policy department and put Schneider at the head of it.

The first thing Schneider did was to start holding Monday morning
meetings with the heads of every group that had some responsibility --
the police chief, who reported to the state, the state prosecutor, the
city health officer, the school superintendent, business leaders, AIDS
groups -- to come up with a strategy.

Not much happened at first. People talked, but no one could agree, the
scene continued and drug deaths skyrocketed. From 80 in 1989, they
jumped to 108 in 1990 and 147 in 1991.


Finally, in 1992, the group got enough of a consensus that its members
agreed to two things: The police would make a massive move to close
the park as of Nov. 17, 1992 -- "Doomsday." But, in exchange, the city
had to have some place for the drug users to go, so -- with no help
from the state of Hessen, which refused to participate at first -- the
city opened up a couple of industrial buildings on the east side of
the city, opposite a Samson plant, as a drug resource centre.

In the meantime, doctors had agreed to expand the local methadone
program from almost nothing to what eventually grew to 1,200 users.
And the city's chamber of commerce raised one million marks -- about
$800,000 Cdn -- the first year in order to fund drug programs.

So that November, after telling people about the drug-resource centre
and providing buses, police surrounded the park. But there were still
no safe-injection sites. The result: People were fixing everywhere --
in the showers, in the

toilets, in the rooms with the shelter beds, at first at Eastside,
then at the four other drug-resource centres that were opened in the
red-light district near the park. And about 400 people who were still
roaming around outside, mainly in the district now instead of the
park, were fixing out in the open. Since Frankfurt has no back alleys
or empty lots, that meant they were on the sidewalks or in between
parked cars on the street.

Finally, in 1994, the city decided to open injection rooms in four of
the five drug-resource centres, on the basis of a legal opinion from
the state prosecutor about how to interpret federal law, even though
the national government was thundering that what they were doing was
illegal, while other German states and other towns in Hessen were
appalled and critical.

Almost eight years to the day after Doomsday, Frankfurt's drug-squad
chief, Michael Hallstein, and his undercover-team head, Heiko
Gottschalk, a tough, wiry man with a near-shaved head, are standing
out in front of the Druckraum, the city's largest, 12-seat injection
site on Niddastrasse. Hallstein likes to go out with his officers to
walk the area once a week so he stays in touch with what's going on.

Surrounded by their team of people -- distinguishable only by the
hearing-aid-like devices in their ears that allow them to communicate
with one another -- Hallstein and Gottschalk are figuring out where to
roam tonight to pick off dealers. While they're talking, one
exceptionally stoned member of the small crowd of users in front of
the Druckraum starts lighting up a crack pipe -- a move that prompts a
team member to chase him off down the street.

Then Josch Steinmetz, the Druckraum's young director, comes out, on
his way home from a long day, and stops to talk for a minute.

"It's The Best Way For Us"

There are no more enthusiastic fans of the Frankfurt Way than police.
It was their chief who broke the logjam in Frankfurt by saying, "Let's
do this" back in 1992. For them, having drug-resource centres,
injection rooms and, after several years of learning to work together,
a good relationship with the social workers who run them has been a
gift from heaven.

"It's not the perfect way, but it's the best way for us," says
Hallstein, whose ebullience bubbles over in a constant stream of
energetic German. He's thrilled to show visitors the bar charts
showing how crime -- street robberies, car robberies, break and enters
- -- have dropped dramatically since the Frankfurt Way started in 1992.

Or the statistics showing that Frankfurt has reduced the number of
dealers from 5,000 to 1,400, and altered the population of addicts
from outside the city. About two-thirds of those using the rooms now
are from Frankfurt. Before, two-thirds of the addicts in the city were
from outside Frankfurt.

Lower-level officers will grumble quietly that the "left-leaning"
social workers sometimes make it difficult for police to pursue
dealers when they duck into the drug centres for sanctuary. Or that
the centres themselves are just catering to drug users, who often deal
as well to support their habits.

But in general, they and Hallstein are grateful that they're no longer
wasting their time chasing addicts -- the weakest link in the drug
chain -- around the streets. Under this system, police put a lot of
pressure on people to go into the rooms; Hallstein says that's
essential for this system to work. Many users were so used to the
street, they wouldn't even go into consumption rooms unless police
were practically shoving them through the door.

Now, the main nuisance they have to deal with is the crowd of anywhere
from five to 30 people who continue to hang out, fixing right on the
street on Moselstrasse, helped out by an anomaly of Frankfurt drug
culture -- "servicemen," men who tote around bags of swabs, needles
and other paraphernalia for addicts that they exchange for drugs.

That mainly happens around the corner from the Druckraum and across
the street from Cafe Fix, the drop-in centre that has no injection
site but provides a needle exchange, cafe and social services for users.

As well, crack has become a real problem in recent years. Since
smoking isn't allowed in the injection rooms, crack users are still
out on the street, forcing police to chase them around.

Still, most of the time they are free to concentrate on dealers.
Because of the Frankfurt Way, Hallstein says, judges whose courts
aren't clogged with petty cases now give them tougher sentences -- a
year and a half for a second trafficking charge involving four grams
of cocaine in a recent case. As well, immigration officials work
closely with police so that a refugee charged with dealing can be
moved to the top of the immigration department's list and deported.

Contrary to a story that is circulating in Vancouver, Frankfurt police
have no ability to load people on to trains and make them leave the
city. Hallstein says the police tried that a few times in the early
years, but the addicts, using the train system, were back in the city
before the police officers in their cars. There is no legal mechanism
in Germany that can compel an adult to stay in a particular city. In
fact, rulings have even established that people have the right to
collect welfare anywhere they wish in Germany.

Hallstein admits that he meets skepticism from other police officers
in Europe who come to Frankfurt to ogle their system. They think he's
making up stories about their success. Or they believe him but don't
think it would work in their city. Or it would work, but, politically,
no one will ever go near it.

"You need an open mind to work in this way," says Hallstein. But, like
everyone else in Frankfurt, he makes the point: It's easy for other
cities to ignore it, to pretend they can just strong-arm their way
through the drug wave because it isn't in their faces, the way Munich
and Berlin do. In Frankfurt, it was in their faces, so they had to
find something else.

The Debate Continues

Like everywhere else in the world, there is debate in Frankfurt and
all over Germany and Europe about drug-resource centres and
safe-injection rooms. In fact, two separate groups of European cities
have formed coalitions to lobby for their preferred version of drug
policy in the European Union, where most of the world's approximately
60-odd safe-injection sites exist. Places like Basel and Bern -- the
first two cities to establish them ever in the late 80s -- Frankfurt,
Zurich, Hamburg, Rotterdam and Zagreb are part of a16-city group
called European Cities on Drug Policy. Their opponents, led by
hard-line Sweden, have formed a coalition called European Cities
Against Drugs that includes cities like Berlin, London and Paris.

Within Frankfurt, there are echoes of the same debate. On the main
street near Elbestrasse, Taunusstrasse, business owners and employees
have differing opinions about whether the drug rooms are a good thing.
At the Cafe Bistro La Bella next door to the Drogennotdienst, Mithu
Abid Khan says the drug centre is no problem. Sometimes the addicts
come in and people don't like to sit near them because they smell, but
that's about it.

Swedish and British tourists, along with suburban Frankfurters who are
down in the area, say it seems relatively clean and safe -- a
neighbourhood they have no problem parking their cars in or walking

But half a block down the street at an upscale store specializing in
Italian and Spanish shoes, Orlando Bentenna says the situation is
terrible, with crack smokers using the pedestrian mall next to his
store to smoke or draping themselves over cars, stoned. "It's a
catastrophe," says Bentenna, before turning to serve the elegant young
couple looking at women's thigh-high boots.

A local business association that represents the collection of Turkish
delicatessens, Asian food stores and jewellery shops along the street
still maintains a low-key but consistent opposition to the rooms. But
they are completely ignored, says Frederike Tinnappel, a reporter for
the local daily paper, Frankfurter Rundschau, who covers health policy
issues. "The politicians and everyone want these sites."

Further away, Gerhard Becker, the director of a treatment facility in
Eppstein, a forest-surrounded village a half-hour train ride from
Frankfurt, worries sometimes that the centres and rooms don't put
enough emphasis on encouraging people to quit drugs altogether. So
does one of his current patients, Lawrence Huwe. "It makes living in
the scene easier," he says.

Yet Huwe himself, the 28-year-old product of a middle-class upbringing
who's been on heroin since he was 16, is at this treatment centre in
Eppstein because of his contact with the injection room on
Elbestrasse. He came to use the consumption room. He lived there for a
year in the shelter beds. And it was a social worker at Elbestrasse
who got him started on a treatment process that is far more
co-ordinated and carefully linked than anything in B.C.

He went to a detox for three weeks, then to a "motivation house,"
where he lived drug-free until he could get into the Eppstein
treatment centre. Now, after 10 months at the centre, he has moved
into the transition house near the centre and is working at a
children's daycare. He's planning to stay in the transition house as
long as possible while he goes to school to study education.

Not every story is as positive as Huwe's, of course. Statistics for
the Elbestrasse centre show that, of 490 people who visited during the
first week in May, only 12 asked to go on the methadone program and 14
requested counselling and help getting into a treatment program.

But for director Wolfgang Barth and others who believe in the
Frankfurt Way, those 14 a week are important. They're the ones who are
ready to make a change. And they're alive to do it, because they've
had a place to go, clean needles to use and people watching over them,
ready to pump oxygen into their lungs and call an ambulance if they
overdose in the room.

Not one has died in an injection room since they opened.
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MAP posted-by: Richard Lake