Pubdate: Thu, 04 Jul 2002
Source: Monday Magazine (CN BC)
Section: Cover Story
Copyright: 2002 Monday Publications
Contact:  http://mondaymag.com/monday/
Details: http://www.mapinc.org/media/1150
Author: Ann Hoang

NEEDLE CITY

There Are No Quick Fixes For Victoria's Growing Heroin Habit

Every used needle left under a bush or in a back alley stairwell tells a 
story, and Garth Greatheart is usually the one who listens. In the parking 
lot of a small downtown office building, she finds a 7-Eleven serviette, 
the wrapper from a syringe, and the blue cap from an empty sterile water 
tube. The pile of trash tells a simple story: someone had something to eat, 
and a fix of heroin.

In the back of another Blanshard Street building, there is a plastic bag 
crumpled underneath a recycling container. Inside are 10 unused needles 
wrapped together with a plastic band, some alcohol swabs and a lighter. 
It's likely someone hid the stash there to use later, or simply forgot it.

Four times a day, Greatheart does her 20-minute "rig dig," touring along 
Cormorant and Amelia streets and picking up used condoms, syringes (rigs), 
needle wrappers and general trash, which is sometimes mixed in with urine 
and feces. Greatheart, program manager for AIDS Vancouver Island, is among 
a handful of AVI volunteers who make daily trips around the neighbourhood 
cleaning up rigs and wrappers. It's a dirty job. Rubber gloves are 
mandatory, and tongs are recommended.

In another alleyway between two buildings, there is a bloody tissue lying 
on the ground.

"This tells me that someone stood here and had a fix," says Greatheart. 
"There's no needle here. That's good."

In a back alley stairwell, she picks up two used needles with caps on them. 
"Whoever it was that used this has a conscience. I see a story everytime I 
see a wrapper or a rig. This isn't about the addiction. [They hide because 
of] the shame of using drugs."

Her keen eye scans parking lots, corners of buildings and underneath rows 
of bushes. She combs the greenery and walkways in between a restaurant and 
several lawyers' offices on Amelia Street. Today, there are wrappers 
scattered along Greatheart's route, but few needles. That's good news. It 
means more people are using the needle exchange program, run by AVI's 
Street Outreach Services (SOS)--the oldest such program in the country.

Greatheart returns to the AVI office and finds three men sitting outside. 
She knows what is about to happen. One of the men starts to pull something 
from his pocket. "Not here," she says, and the men immediately get up and 
walk down the street. She doesn't get involved in any "say no to drugs" 
debate, doesn't make moralistic comment. She just tells them to move along, 
which means they'll probably end up at the parking lot of the building down 
the street for their fix.

"We're not here to fix the problem," says Greatheart. "It's not that 
simple." However, many area residents and businesses see a different story. 
"A lot of people see it as terrible junkies whacked out of their minds."

Many people cling to the stereotype that drug users are always homeless and 
poor. Some blame the needle exchange for condoning drug use. Others phone 
the needle exchange, angry about the used needles on their property.

"They think it's our fault because we give [needles] out," says Greatheart.

Watch Where You Step

The simple fact that businesses and residents are finding needles points to 
a greater problem: There are more needles on the ground. In the last two 
months, residents and AVI employees have found an increasing number of rigs 
in the downtown neighbourhood, more so than in previous years. Greatheart 
doesn't know the reason for it, but says the increase is seasonal. In 
summer, drug users from the mainland often come to Victoria for a "rest." 
Not from the drugs, but from the violence and other hardships that come 
with living in a larger urban centre like Vancouver.

Two weeks ago, AVI staff met with residents and business owners from 
downtown, North Park and Fernwood. They were concerned about the increasing 
number of rigs, particularly in and around parks and schools. The meeting 
concluded with the formation of a community working group, which will meet 
regularly to find a solution to the increased number of needles in the 
community.

"Having the community come together for this, it wasn't a tar and feather 
kind of meeting," says Miki Hansen, AVI's executive director. "We wanted to 
find a solution to something that is pretty scary."

Dyan Dunsmoor-Farley says part of finding a solution to the needle problem 
is not to waste time placing blame.

"The bottom line is there are places we won't tolerate [drug use]," says 
Dunsmoor-Farley, chair of the North Park Neighbourhood Association. 
"Especially in our parks. People have to feel safe when they go there. 
Families and children need to feel safe in these areas."

Last October, residents called the police department about increases in the 
number of drug users at Central Park, behind Crystal Pool. An officer was 
temporarily assigned to that area and neighbours said drug use there went 
down to almost nothing within two days. But the assignment wasn't 
permanent. And that's the problem, say residents. They want to see more 
police presence in their neighbourhoods, particularly in areas where drug 
use and dealing are known to happen.

One of these places is the Fernwood Square, adjacent to the Belfry Theatre. 
Another is Central Park.

"[Policing] is not very routine," says Dunsmoor-Farley. "We find ourselves 
in between two community police offices. And as soon as the downtown area 
starts to take their efforts away, we don't see any [cops] around here."

There has been an increase in the number of police patrolling downtown, and 
beat cops regularly patrol well-known drug areas, but Sargent Keith Lewis 
says "we can't be everywhere. If we had the numbers we would be out in all 
these areas, but we can't."

Lewis adds that the police have not noticed any significant increase in 
used syringes on the streets.

However, city workers are finding more used syringes in Victoria, 
especially around Centennial Square and the adjacent parkade. Some of the 
precautionary measures the city has taken to reduce the danger of used 
needles on the streets includes needle disposal units in the Centennial 
Square public bathrooms, and hard plastic garbage bin liners that are meant 
to prevent punctures. City outdoor workers are also trained to properly 
dispose of used syringes, and to never dig into garbage bins. They're also 
given "dirty pay," an additional 25 percent of their salary for time spent 
picking up needles and feces from city property. Private property owners 
figure out their own solutions--many downtown businesses now restrict the 
use of their washrooms, for example, in an effort to keep people from 
shooting up there.

No Quick Fix

One of the solutions discussed at the community meeting was a safe 
injection site, where people can go to shoot up. Such sites, which would 
provide bathrooms, safe disposal of old needles, and access to new ones, 
are used in Europe and are attracting more interest from people who are 
realizing there is no quick fix for the city's drug problems.

The mere fact that the community was in favour of such an idea surprised 
Greatheart. Six months ago, it would have been difficult to get people to 
stop criticizing drug users, much less agree on an alternative drug use zone.

"People's attitudes are starting to change because they're seeing we can't 
just make these people stop using drugs," says Greatheart.

In addition, heroin is crossing social boundaries. It's accessible and 
cheap, about $20 a fix. The needles, alcohol swabs and sterile water are 
available from agencies like Streetlink and AVI, or can be purchased from 
any pharmacy.

"We're starting to see all kinds of people getting involved with drugs," 
says Kulli Meyer, executive director of the Dallas Society, which provides 
counseling for drug and alcohol addiction. "We're seeing kids having 
problems with it, it crosses the broader spectrum of society. There are 
drug users in Uplands. It's becoming more public. People are talking about it."

There are now an estimated 1,500-2,000 current injection drug users in the 
capital region, and the Victoria needle exchange program distributes 1.6 
million needles annually. They get a 100 percent return rate. Some months, 
the return rate exceeds the number of needles given out.

Either way, it's a significant increase from 1989, the program's first 
year, when a mere 98,000 needles were handed out.

The new needles are provided by the Ministry of Health and disposed of by a 
Vancouver bio-tech firm. The Vancouver company ships the used needles to 
centres in Calgary and Washington State, where they're incinerated.

Exchanging Troubles

No one wants used needles lying on streets, or in garbage containers, where 
someone might risk getting pricked. But despite the service that the needle 
exchange offers, not everyone is in favour of it. Critics say providing 
clean needles promotes drug use, and often cite a study by two Canadian 
researchers who found higher HIV infection rates in those using needle 
exchange programs versus those who did not.

However, the researchers, Julie Bruneau, an assistant professor of 
psychiatry at the University of Montreal, and Martin T. Schechter, a 
professor of epidemiology at the University of British Columbia, say their 
study has been misinterpreted. In an April, 1998, op-ed piece in the New 
York Times, Bruneau and Schechter wrote that their results were "not 
surprising. Because these programs are in inner-city neighbourhoods, they 
serve users who are at greatest risk of infection. Those who didn't accept 
free needles often didn't need them since they could afford to buy syringes 
in drugstores. They also were less likely to engage in the riskiest 
activities."

The critics were quieted down when The Lancet, a respected British medical 
journal, published a study last year in favour of needle exchange programs. 
It found that in 29 cities worldwide where such programs are in place, HIV 
infection dropped by an average of 5.8 percent each year among drug users. 
In 51 cities that had no needle exchange or comparable facility, 
drug-related infection rose by 5.9 percent a year. In addition, a study of 
medical literature released last year by University of California-Davis 
researchers found that most published studies about needle exchanges 
indicated that they significantly reduced the risk of HIV transmission.

Treating injection drug use as a neighbourhood nuisance or blaming needle 
exchanges for the increasing the number of rigs on the streets won't solve 
the long-term problem. Communities are starting to accept the need to spend 
money on prevention and finding solutions rather than lobbying for tougher 
criminal and drug laws.

Prevention and treatment is also likely to be less of a financial burden on 
taxpayers. A 1998 report by former provincial health officer, John Millar, 
concluded that putting more money into harm reduction services, such as 
needle exchanges and methadone clinics, which supply heroin users with an 
alternative, less-harmful drug, will reduce future costs, particularly in 
policing and healthcare. There are an estimated 15,000 injection drug users 
in the province, twice as many as there were 10 years ago. Of these, 25 
percent are HIV-positive and 88 percent have hepatitis C. Millar said 
investing $6 million in expanding methadone availability alone could save 
the province $30 million annually in the long run.

The Never-Ending Story

In 1993, deaths from heroin overdoses mushroomed to 331, an eight- fold 
increase over six years. This prompted a report by then B.C. chief coroner 
Vince Cain. The report found that heroin was present in 90 percent of 
drug-related deaths. In 1999, illicit drug-related deaths claimed 385 
people in B.C.--more than motor vehicle accidents. Each year, more people 
die from overdoses than from breast or prostate cancer, but government 
funding and community fundraisers to find solutions to these problems are 
nowhere in sight. And the reason is likely because drug users are 
considered the lowest of society, says Greatheart.

About two months ago, a man who overdosed on heroin managed to get himself 
to the AVI office. He could barely speak. The staff called an ambulance and 
he was sent to the hospital. Had he gone straight to the hospital on his 
own, Greatheart says he probably wouldn't have received immediate attention.

"Drug users are seen as people who made a choice to do it, so they're not a 
big priority," says Greatheart. "You have that attitude even in the 
hospitals. That's why when someone goes to the hospital for treatment, we 
often send a staff member with them. Someone to speak for them."

Two weeks ago, a staff member from the Fernwood Community Association found 
a man lying on the ground outside the FCA office, with a needle still in 
his hand. When he didn't wake up, the staff thought he had overdosed. They 
called the police, who managed to wake the man up, and then sent him home.

Incidents like that can't be ignored, and are forcing communities to find 
solutions.

"And this isn't just a Fernwood problem or a North Park problem," says 
Meyer. "Every community has to find a solution to this problem, including 
all levels of government, schools, parents, everyone needs to be part of 
the solution."
- ---
MAP posted-by: Beth