Skip

North America's first supervised drug injection site.
February 2, 2010 8:14 AM   Subscribe

Insite, operated by Vancouver Coastal Health, operates North America’s first legal supervised injection site. Slate writer offers harrowing illustrations of the people who go there and the neighborhood they live in.
posted by elder18 (38 comments total) 11 users marked this as a favorite

 
Check out some of the street names on the booth roster. It's like a well-mopped Hamsterdam.
posted by Burhanistan at 8:18 AM on February 2, 2010 [1 favorite]


Even more harrowing: this full episode of The Fifth Estate about Insite, plus several supplementary interviews. (The videos should play for everyone, but if they're blocked outside of Canada, please let me know. Some, but not all, of CBC's video content is geographically blocked.)
posted by maudlin at 8:25 AM on February 2, 2010 [1 favorite]


Sorry, my initial post should say "Slate writer Matthew Powers..."

Someone hasn't had their tea yet.
posted by elder18 at 8:29 AM on February 2, 2010


"Staffers are required to go through therapy sessions, and a lot of emotional processing is done informally, the staff downloading their feelings over drinks at a bar."
posted by cardboard at 8:37 AM on February 2, 2010


Caption of the last photograph in the Slate slideshow:

"Downtown Vancouver seen from City Hall. The Economist magazine ranked Vancouver as having the highest quality of life of any city in the world."

Canada is a wealthy nation with good health care and good social programs. And people still need this. Onsite is a good thing. This is a complicated problem.
posted by 256 at 8:43 AM on February 2, 2010


"Staffers are required to go through therapy sessions, and a lot of emotional processing is done informally, the staff downloading their feelings over drinks at a bar."

I thought this was remarkable too. I think that while this might be a useful place, I wonder how many of the staff members there develop substance abuse problems from the stress of working there.
posted by elder18 at 8:45 AM on February 2, 2010


Watching sad heroin addicts mutilate their veins all day might also have the opposite effect.
posted by anthill at 8:50 AM on February 2, 2010


why check one of the addicts our out from the Olympic library and ask them?
posted by concreteforest at 8:52 AM on February 2, 2010


One of my friends at school came from working at a Victoria (capital of B.C., for those who don't know, about an hour ferry-ride from Vancouver) harm-reduction centre, passing out needles and providing beds, etc. He did it for about two years, said it was horrible but great. Apparently they're very restricted in where they can give out the needles, because every church and school and blah blah has pushed for restrictions to "protect themselves".

But Insite is a clear good, at least if you're interested in reducing harm among drug users. I understand that not everyone is [Hi, Federal government!]. But on the other hand, I can see why people think addicts deserved to be punished. From the article, "Fisher tried to choose the music once, but the users detested Tom Waits".

Let 'em burn, for that.
posted by Lemurrhea at 9:25 AM on February 2, 2010 [1 favorite]


The three-year legal exemption had ended, and Kerr's application to extend his study of Insite was denied by the Health Minister, Tony Clement. Clement called it an "abomination," and told the Vancouver Sun that "allowing and/or encouraging people to inject heroin into their veins is not harm reduction. … [W]e believe it is a form of harm addition."

How is it that people with this kind of medieval world-view despite all the available scientific evidence can hold the position of Health Minister?. At least people up here can sort of see through all this BS and are overwhelmingly in support of programs like these.
posted by reformedjerk at 9:39 AM on February 2, 2010 [3 favorites]


How is it that people with this kind of medieval world-view despite all the available scientific evidence can hold the position of Health Minister?

He was elected?
posted by philip-random at 9:43 AM on February 2, 2010 [1 favorite]


Our hated, fucked-up, "conservative" federal government has been doing its damnedest to shut down Insight.

Not based on any facts, mind you, but on the emotional feelings of a couple of top-tier, dick-headed ministers.

Based on facts, Insight is an incredibly successful, compassionate, costs-saving program.

Based on emotions, our political swine hate the down-and-out, and would rather see them dead than to offer them effective help.
posted by five fresh fish at 9:45 AM on February 2, 2010 [3 favorites]


Based on emotions, our political swine hate the down-and-out, and would rather see them dead than to offer them effective help.

Everyone is blind to their ideology to some extent, but none are so blind as those who will not see. Every time I hear about shutting this thing down I want to punch one of those guys in the face.
posted by GuyZero at 10:02 AM on February 2, 2010


Based on emotions, our political swine hate the down-and-out, and would rather see them dead than to offer them effective help.

Well, I'd not want to be seen as in any way defending the character of Tony Clement, who is to be sure a first-class douchebag who graduated from laying waste to the Ontario environmental regulatory apparatus and then the health care system under Mike Harris to his current role on the national stage. But he is, in the end, just a garden-variety careerist political hack who hangs his dick out in the wind and follows in the direction of the spray.

There's a whole culture of fear and loathing around addicts and the urban poor - in Vancouver and beyond - that forms the real backbone of this kind of horseshit politicking. As long as there are voters who demand tough-on-drugs stances, no matter how ineffectual, ever at the ready to punish the Tony Clements of the world should they dare side with evidence over unfounded prejudice and emotion, it won't matter which spineless suit fills the job. They simply won't want to be caught endorsing the spending of your hard-earned tax money on some junkie's fix. "Bad optics," as they say.
posted by gompa at 10:10 AM on February 2, 2010 [3 favorites]


Dominic DaVinci's constant lobbying, favor currying, bullying, and so on finally bore fruit.
posted by stevil at 10:20 AM on February 2, 2010


I had the honor of spending an afternoon at Insite a couple of years ago, at the invitation of the staff, and it was one of the most inspiring things I've ever experienced. Insite is the one small place in North America where people who inject drugs are not criminals, are not breaking the law, for a few moments. To know that such a place can and does exist here gives me hope that we can yet change the world.

Insite somewhat notoriously looks like a hair salon: wood floors, stainless steel counters, mirrors. It's a clean, friendly, well-run place. The staff are the sort of compassionate, feisty, counter-culture folks who are drawn to harm reduction. That includes the nurses, the peer staff, and the managers. Some of them put their careers on the line working in the underground supervised injection facility before Insite was opened. I can't speak to how many may or may not develop problematic substance use as a result of the stress of working there. I can say that places like Insite go to a lot of effort to make sure that staff have productive ways to address their stress, and provide a lot of professional and emotional support for what they know is a hard job. Would that more employers provided that kind of resource for stressed employees.

Insite is one part of a long-standing campaign in Vancouver to approach drug policy in a different way. It took years of work to get it open, with dozens of community meetings, dramatic protests by the drug users union, and support from 4 different mayors (a level of political support unheard of in the States). Fortunately, Insite won their most recent legal battle, and is staying open for the time being.

When I was in Vancouver I was able to attend a well-timed Metafilter meetup, and was interested to hear what the Vancouver mefites had to say about it. I was sort of surprised by how much they knew about, and how much they supported it as a matter of course. "Not my thing but of course it should be there" was kind of the prevailing opinion. It's a different level of engagement and support than I usually find in the States, and part of the reason that Vancouver has some of the best civic drug policies and programs around, at least for North America (a low bar in the world of harm reduction).

For more on Insite and Downtown Eastside, I recommend Dr. Mate's book In the Realm of Hungry Ghosts. If you're in New York you can hear him speak at Columbia Law School this evening!
posted by gingerbeer at 10:32 AM on February 2, 2010 [6 favorites]


More info on the event with Dr. Mate. The Portland Hotel Society runs Insite.

There's an event tonight featuring Dr. Gabor Mate, physician for the Portland Hotel, and Ethan Nadelmann, executive director of the Drug Policy Alliance. Dr. Mate will be speaking about his new book, In the Realm of Hungry Ghosts, in conjunction with Ethan's focus on drug policy reform.

The event is taking place TONIGHT from 6:30 to 8:30 at Columbia Law School, Jerome Greene Hall, Room 101. it's at 435 West 116th St, between Amsterdam & Morningside. (Closest subway stop is the 1 train at 116th and Broadway. Walk across the main Columbia campus via 116th, cross Amsterdam, and it's on the next block.)

posted by gingerbeer at 10:35 AM on February 2, 2010


You might be forgiven for imagining something like Hamsterdam, which, for those of you who haven't seen The Wire, was a (fictitious) bombed out vacant neighborhood that the Baltimore cops turned into a free-zone for drugs. But take a look at the street view and go for a walk down Hastings. This neighborhood is one of the oldest in the city and is right near the heart of downtown. It's bordered by Strathcona, a residential community which hosts a lot of the city's art scene, and Chinatown, one of North America's largest, as Gastown, a heritage district filled with designer shops and upscale lounges. And when I say "borders", I mean these neighborhoods all mix and mingle together within a few blocks of each other. Unlike Hamsterdam, people live and work here.

It's really an amazing place and hard to describe. I was having a discussion about this recently. The downtown eastside draws all kinds of words like "shocking", "harrowing", "staggering", "unreal"; but there are neighborhoods that are twice as bad (if not more) in Detroit, Baltimore, Washington, East LA; equally as poor if not more, and much much more violent*, and with no support networks in place. But they are forgotten, or else not remarked upon, perhaps because they blend into the landscape, and because people come to expect that this level of poverty is not remarkable; or perhaps because people simply don't go there. Here what is shocking is not the level of poverty or addiction per se, but how visible it is due to the accessibility of the neighborhood, and how stark the contrast is with the immediate environment. It is rare to see such crippling poverty so closely surrounded by such affluence as you see in Vancouver.

*Here's Vancouver's homicide map from 2009. Note only one in the DTES.
posted by PercussivePaul at 10:55 AM on February 2, 2010 [4 favorites]


If you live in or around Vancouver and have business downtown, the DTES cannot be avoided. Thus we are talking about it, which is good. The talking part, that is.
posted by philip-random at 11:19 AM on February 2, 2010


I ran around with some crackheads in one night in Vancouver in the Commercial Row area. The evening had unexpected aspects...for instance everybody I met was white. But the same rip-off deals and treachery abounded. At one point, me and my buddy were sold amphetamine, a substitution which I've never seen here in California.

Another day I saw the scene in front of the Portland hotel. There was a woman with a big "sample board" of glass stems for sale...nice, in Cali you have to go into a head shop...no street service. What struck me that day was that just about everybody in the sizable crowd seemed pissed off.

One aspect of the Portland Hotel I don't see mentioned yet...it is (or was, did it move?) across the street from a police station. Which, if you think about it, is a very good place to put a legally sanctioned drug-taking place. The police station seemed oblivious to the scene across the street. Canada is different.
posted by telstar at 2:58 PM on February 2, 2010 [1 favorite]


Canada is different, except for the Federal Government, which is American.
posted by ovvl at 4:56 PM on February 2, 2010


In nature.
posted by ovvl at 4:56 PM on February 2, 2010


Uh, sort of. Mostly the PM. Okay, let's rephrase this.
posted by ovvl at 4:58 PM on February 2, 2010


dramatic protests by the drug users union

Is this a typo??
posted by availablelight at 5:01 PM on February 2, 2010


dramatic protests by the drug users union
Is this a typo??


Nope. Vancouver Area Network of Drug Users - VANDU.
posted by metaname at 5:12 PM on February 2, 2010 [1 favorite]


Which, if you think about it, is a very good place to put a legally sanctioned drug-taking place. The police station seemed oblivious to the scene across the street.

Well, yeah, Main and Hastings is a major police headquarters, and across the street is the old Carnagie library which is a beautiful old building that is now a sort of social service center which is ground zero for a street scene of sprawling, milling chaos, people mingling on the street 24 hours a day with carts and wares and open drug use. However, the neighbourhood is also incredibly vital, there are new buildings going in, a block from that epicenter there is a great new upmarket Chinese Brasserie sort of asian tapas, I go for pho and banh mi all the time right around there; it is all central and an undifferentiated part of the best parts of Vancouver. And the fact is, I feel safer walking there at night than I do in any of the suburbs. I don't know what sort of an image people get from reading descriptions of the Downtown Eastside, it is absolutely the worst off area code in Canada and testament to the total failure of social services in this Province, but it's also a beautiful and inspiring area that's both livable and attractive. There's an urban garden going in on an empty lot, there's Pivot, an organization based right there that launches legal battles defending the rights of residents, and literally right around the corner from the open drug trade, there are some the cutest quaintest quietest neighbourhoods in the city. Whatever one's frame of reference trying to get a picture of the place from the outside, it's a place of history and dignity that warrants consideration and projects like Insight and the particularly inspiring Dr. Mate mentioned upthread need all the support they can get.
posted by kaspen at 6:23 PM on February 2, 2010 [1 favorite]


Is this a typo??

Without VANDU, especially Dean Wilson and Ann Livingston, Insite would not exist.
posted by docgonzo at 9:13 PM on February 2, 2010


VANDU was essential. They excelled at the big visual symbols: coffins carried into Council meetings, thousands of wooden crosses in a park for the people who'd died of overdoses.

Drug user advocacy groups have a long history, going back at least to the Junkiebonden in the Netherlands in the 70s. There's an international network of drug users (INPUD). Even New York City has a drug users union.
posted by gingerbeer at 10:09 PM on February 2, 2010


I'm not upset by the drug use, but I'm upset by their use of Microsoft Access.

Am I the only one?
posted by problemspace at 11:05 PM on February 2, 2010


oh, wow. My husband and I were in Vancouver back in November, to get a dim sum lunch for his 40th birthday, and we drove right by this place. We were confused, because the crowd outside was very cranky and aimlessly milling. The second time we drove past it, someone had wandered into the street and been hit by a car. We assumed it as a public health clinic -- it just had that vibe -- until about three days later, when we remembered that the health care situation in Canada is different enough that a free public clinic would likely have been a different thing.

I'm so glad that this place exists, and I wish there were more of them. Nobody thinks "Wow, I was considering kicking heroin, but now that I have this nice safe place to shoot up in I don't see the point!"
posted by KathrynT at 11:14 PM on February 2, 2010 [1 favorite]


Possibly of interest: MTV's show "4Real", which chronicles celebrities gettnig involved in charity or other humanitarian work, featured Eva Mendes [brief recap] visiting Insite and other outreach groups in Vancouver's downtown east side in, I believe, 2008.

I lived in Vancouver for seven years and the drugs + crime problem in that city is certainly not limited to that neighborhood. That's just its most recognizable outpost. The effects of this ongoing addiction problem is devastating, widespread, and it's been going on in Vancouver for decades.

That our governments (civic, provincial and federal) are constantly debating the question "is this good for the community?" when the death toll could easily be much, much higher without Insite in place gives me no hope for any government being able to really tackle this problem at any point.

ad
posted by adamd1 at 8:41 AM on February 3, 2010


For more on Insite and Downtown Eastside, I recommend Dr. Mate's book In the Realm of Hungry Ghosts. If you're in New York you can hear him speak at Columbia Law School this evening!

He was also on Democracy Now! this morning. I sat in my car and was willfully late getting into the office since he was so interesting.
posted by Burhanistan at 2:19 PM on February 3, 2010


That's cool, burhan. Glad you got to hear him. I'm about halfway through his book and really enjoying it. Well, maybe not "enjoying" but he's an engaging writer with a lot to say.
posted by gingerbeer at 3:21 PM on February 3, 2010


Ah I just came here to link that Democracy Now interview! Incredibly cogent and far ranging, I feel like Maté deserves an FPP of his own.
posted by kaspen at 1:55 AM on February 4, 2010


For any Portland mefites who are interested:

Dr. Gabor Maté
"Understanding Addiction and Advocating for Reform"

Students for Sensible Drug Policy, Reed College Student Services, and the American Civil Liberties Union are cosponsoring Dr. Gabor Maté's talk on his new book In the Realm of Hungry Ghosts.

Gabor Maté, staff physician at Portland Hotel Society—a residential harm reduction facility in Vancouver, Canada, and North America’s only supervised safe-injection site, provides a bold synthesis of his clinical experience, discussing cutting edge scientific findings in neurophysiology, brain development, and psychology, which go beyond simplistic and distorted nature vs. nurture debates. He proposes drug policy and treatment reform measures that take into account an understanding of brain physiology and interactive psychology of addiction. Maté is the author of In the Realm of Hungry Ghosts: Close Encounters with Addiction.

Friday 2/12/10 7pm

Vollum Lecture Hall
Reed College
3203 SE Woodstock Blvd
Portland, OR 97202
posted by gingerbeer at 4:39 PM on February 9, 2010




Gwrarr! Damned idiots.
posted by five fresh fish at 5:27 PM on February 9, 2010




« Older domestication of the avant garde   |   I Was Born This Way Newer »


This thread has been archived and is closed to new comments



Post