- The Washington Times - Sunday, November 9, 2003

VANCOUVER, British Columbia — David Lands walked into the upscale office building, checked in with the receptionist and headed inside to shoot up heroin and cocaine.

The frail Mr. Lands was one of the first addicts to use North America’s only government-sponsored safe injection site, which opened in September as a trial project in a seamy downtown neighborhood.

“They should have more places like this,” he said, holding two peanut butter and jelly sandwiches provided by the staff at the Insite clinic as he recovered from his heroin and cocaine speedball. “You’d find less people in the alleys that have overdosed.”

Critics disagree, predicting that providing a legal place for addicts to shoot up only will lead to more drug use. John P. Walters, chief of the U.S. anti-drug effort, called Insite “state-sponsored suicide.”

Those who are using the clinic believe the opposite.

Mr. Lands, 32, who has been addicted to heroin since 1997, said junkies can end up injured or dead from robbers or from overdosing when they use drugs in alleys and other out-of-the-way spots.

“If you overdose, they help you here,” he said. “Not in the alleys. They don’t care.”

A 39-year-old construction worker, who would identify himself only as Joe, agreed that Insite is safer.

“I was in an alley shooting up, and two guys stuck a knife in my throat,” he said, describing a robbery of his drugs. “They would have killed me if I hadn’t given it up.”

Similar clinics operate in Zurich; Frankfurt, Germany; and Sydney, Australia. Canada’s federal government has committed $1.2 million for research during the one-year pilot project at Insite, and British Columbia is paying $2.4 million in costs.

Mayor Larry Campbell, a former police office and coroner, won election last year pledging to establish safe injection sites in Vancouver as part of a “four-pillar” drug policy involving treatment, prevention, harm reduction and enforcement.

He says Insite is a vital part of efforts to reduce overdose deaths and the spread of HIV/AIDS and hepatitis C via dirty needles, and to provide primary health care to drug users.

The World Health Organization has singled out Vancouver as having a high HIV-infection rate in a wealthy, Western city. According to the British Columbia Center for Disease Control, more than 30 percent of the area’s addicts are infected with HIV or have full-blown AIDS, and the city already was handing out needles to addicts in an anti-infection program.

Joanne Csete, a spokesman for Human Rights Watch, praised the opening of Insite as essential to helping users avoid overdoses and infection while exposing them to help toward kicking the habit.

“It’s certainly a step forward,” she said. “We hope they will continue to respect this as a part of essential humane services for drug users.”

The clinic is exempt from Canadian drug laws, allowing the addicts to possess heroin and cocaine inside. Such an exemption can be made for medical or scientific reasons, or if it is in the public interest.

Mr. Lands and Joe the construction worker said Insite requires addicts to bring their own drugs. The clinic provides a bowl containing a needle, a “cooker” and matches to heat up the drugs, and an antiseptic swab.

Junkies using Insite’s facilities have their backs to nurses when shooting up, but they are monitored by mirrors in the 12 injection booths, the two men said. Nurses show those who ask how to inject safely, but otherwise have no direct role in the process, they said.

After injecting, users are monitored in a “chill-out room” — where Mr. Lands got his sandwiches — before leaving. They also can get help if they want to kick their habits.

Vivianna Zanocco of the Vancouver Coastal Health Authority, which runs the clinic with a local advocacy group, said smoking marijuana or crack cocaine inside is prohibited.

She added that worries about drug dealers’ congregating around the site have proved unfounded.

Police maintain a low profile outside, permitting addicts to enter the clinic with their drugs.

“It is not the police intention to intervene or interfere with anyone entering the site, unless there is a lawful reason to do so,” said police Chief Jamie Graham.


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