Pubdate: Tue, 03 Apr 2018
Source: Philadelphia Daily News (PA)
Copyright: 2018 Philadelphia Newspapers Inc.
Author: Aubrey Whelan


At the height of a heroin epidemic in Vancouver, British Columbia,
Inspector Bill Spearn -- then a rookie cop -- was assigned to a beat
in the heart of the crisis.

It was 1996, and though he had been responding to overdose after
overdose in Downtown Eastside, one of Canada's poorest postal codes,
Spearn wanted no part of the harm-reduction measures the city was
considering to save the lives of people in addiction.

A safe injection site, where drugs could be used under medical
supervision, was out of the question: "I thought it would be a big
magnet," he told a crowd at Temple University Medical School on Monday
night. "I thought it would empower people to use drugs." A few years
later, with the debate still raging, he left the neighborhood for
another position in the police department.

In the meantime, Vancouver did open a safe injection site in the
Downtown Eastside, the first in North America. Years later, Spearn was
promoted to sergeant and found himself on the same patrols he walked
as a rookie. The first thing he noticed, he said, was that no one was
overdosing on the street.

"The light bulbs started going off in my head: This might not be such
a bad idea," he said of the safe injection site.

These days, Spearn heads his department's organized crime task force,
and in his spare time travels across Canada talking about how police
can get on board with harm reduction policies. He came to Philadelphia
at the behest of the Public Health Department, which has been holding
informational meetings around the city about its plan, announced
earlier this year, to sanction a safe injection site. It was Spearn's
first time speaking about these sites in the United States, where the
concept is controversial.

Before Monday night's community meeting, Spearn spoke with City
Council members whose districts include Kensington, where drug use is
most visible and most concentrated, and the police officers who patrol
the area. Police Commissioner Richard Ross spent an hour with Spearn.
Ross traveled with a Philadelphia delegation to Vancouver last year,
and said talks with that city's police chief "moved the needle" for
him, though he's still not in support.

"I'm still at a point where you have to convince me," he said Tuesday.
"I'm not at the point where I'm like, ‘Hell no, get away from
me,' which is where I was."

Still, Ross said, he remains concerned about how his officers would
police a safe injection site -- and about how community members would
react to a site in their neighborhood. And at least one harm-reduction
measure Canada is trying would be inconceivable in Philadelphia, Ross
said. Spearn supports a pilot program in Vancouver where people
entrenched in heroin addiction are prescribed medical-grade heroin as
a form of treatment.

"I think that lost a lot of people. It's a bit much," Ross said.

Spearn said after Monday night's meeting that he had been impressed
with the local police department's willingness to listen: Philadelphia
was one of the first American cities to send its police chief to tour
Vancouver's safe injection site. And he was staggered, he said, by the
number of deaths in Philadelphia. About 200 people a year were dying
of overdoses in Vancouver by the time the city opened a safe-injection
site; an estimated 1,200 people died of overdoses in Philadelphia last

"The problem is much worse here -- and it's not just a Vancouver
problem, it's not just a Philadelphia problem, it's a problem that
affects the entire continent, and it's spreading," he said.

Spearn and Sarah Evans, who was the first director of Vancouver's
first safe-injection site, Insite, and now works in harm reduction in
New York, fielded questions from a crowd of about 75 Monday about how
the site operates, who it serves, and how Evans and her staff wrangled
the legal questions surrounding the site.

Vancouver's site was able to operate under an exemption from the
country's controlled substances law, Evans said. Still, she stressed:
"Every site in the world has to address that question: Can I do this
without getting arrested?"

For Spearn, the sites' benefits have been clear: they've cut back on
overdose deaths and gotten more people into treatment. But the sites
are not a panacea, he said -- Vancouver's treatment system has not
kept up with its harm reduction methods. The police department has
begun advocating for treatment on demand, meaning that people who ask
for help are immediately taken to a treatment facility.

As in Philadelphia, fentanyl -- a synthetic opioid far more powerful
than heroin" has made its way into Vancouver's drug supply, sometimes 
without the user's even knowing it has been added. Overdose deaths have 
spiked past the levels he saw as a rookie in the '90s; about 80 percent 
of cases involved fentanyl. But Spearn shudders to think what the death 
rate would have been without the city's safe injection sites: Insite 
alone, he said, revives seven to eight people a day.
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