Vancouver: Harbouring Their Drug Problem by Feeding the Addiction?

This is the fifth of six blogs written as part of the assessment for North American Cities, a second year undergraduate course in Geography at the University of Manchester. Required to write a blog of 1500 words on an issue of their choosing, Alice Kiernan chose to write about Vancouver …

In 2010, Vancouver hosted the Winter Olympics. I remember seeing an article on the news about the social problems the city was facing running up to the games, but as a naïve and disinterested 16 year old whose preservation of ‘street cred’ was at the forefront of her mind, I turned a blind eye.

Street cred in mind, I am reluctant to admit that I am a self-confessed fan of American TV series, Glee. Last year, the world, and I, was baffled, shocked and sorrowed at the news of young Glee actor, Cory Monteith’s tragic death.

Monteith battled with a history of drug abuse and was visiting Vancouver at the time of his death. Not a wise choice for a man with such a background.

When I looked into this more, it soon became apparent that the problems I briefly heard about back in 2010 had not resolved themselves.

Vancouver, on the surface, seems like a clean-cut city, but beneath this exterior are a hidden myriad of social problems – drugs being the main one. Along with the drug problem comes its two ugly sisters – health problems and homelessness – but this is far from a fairy-tale.

Of course this trio of troubles isn’t unique to Vancouver, but they are more visible. The city has battled for years with a severe drug problem, mostly in the DTES (Downtown Eastside), where drug dealers line the streets in broad daylight, often in the presence of police.

There are an estimated 1,600 homeless in Vancouver – something the mayor pledged to eradicate by 2015 – with 46% revealing they suffer from mental health problems. Of course, this percentage may be unrepresentative of the actual number of people suffering with mental illness, since respondents self-identified as mentally ill – i.e. some may have not disclosed information accurately and/or based their diagnosis on personal beliefs/experiences rather than medical diagnosis.

Many believe these problems have stemmed from the closure of Vancouver’s only mental health institute and the explosion of the drug trade (for more on this, click here). Surely these three must be linked and tackling one would help to alleviate the others?

Given its close proximity to the border and harbours, Vancouver has a hard time regulating what’s coming in and out of the city. The drug trade thrives in Vancouver and it is often reported that cocaine is brought into Canada, finding its way to Vancouver’s DTES. In 2002, substance abuse cost Canada a staggering $39.8 billion.

However, although the regulation of drugs entering the city is difficult, Vancouver is pretty revolutionary in its approach to the problems they face surrounding drugs. They receive a lot of opposition on these unconventional methods.

But let’s face it; in a city where it’s quicker to have drugs delivered than it is a pizza and for around the same price or less (it’s around $10 for heroin – which is about £6), a radical approach is probably what’s needed.

The City of Vancouver has devised a ‘four pillars’ drug strategy which focuses on harm reduction, prevention, treatment and enforcement. They have implemented this programme learning from other developed cities such as Zurich and Sydney who have managed to reduce the numbers of users consuming drugs on the streets, overdose-related deaths and HIV incidence in users.

Vancouver pumps the bulk of its budget surrounding this strategy into the harm prevention pillar. I’m talking about InSite; Vancouver’s revolutionary approach to drug users.

This is a centre (est. September 2003) open to all drug users to access as and when it suits them and provides them with free equipment such as needles and equipment for them to mix the chemicals to pump around their bodies. All of this takes place in a sterile and well-lit environment, overseen by two medically trained nurses.

It’s a place users can go in with their drugs (that’s the only bit that isn’t free), shoot up, and leave as high as a kite with no legal battles to fight. In essence, it’s a legal crack den.

It sounds, in theory, ridiculous; a free centre with operational costs of around $3 million for people to go and shoot up legally, funded by tax payers money? Absurd, you might be thinking. I jumped to that conclusion at first as well.

But when you delve a little deeper into the benefits of InSite, it’s actually not all that bad.

In a hefty report published by B.C. Centre for Excellence in HIV/AIDS it can be seen that the four pillar strategy has helped reduce cocaine use over a fifteen year span, from 38.1% in 1996 to just 6.9% in 2011 – a whopping 31.2% reduction. It also states that access to treatment has improved by 14.9% in the same time period.

They’re clearly doing something right with changes like that.

At one point in Vancouver’s past, they had the highest prevalence and incidence of HIV/AIDS outside of Sub-Saharan Africa. This is largely down to the sharing of needles amongst drug users. The average lifetime cost of treating a HIV infection per person is estimated by the B.C. Centre for Excellence as $250,000.

So when you sit and do the maths, it works out as quite cost-effective.

A centre which serves 12,000 drug users at a cost of $3 million is the equivalent cost of treating 12 drug users who have picked up HIV from unhygienic methods.

Alright, it’s still a lot of money we’re talking about here – but surely that’s more sensible than letting the percentage of the population affected by HIV creep up to an alarming level again?

That’s one of the main arguments against InSite. Many contest the notion that the taxpayer should have to foot the bill for a social problem that is (mostly) self-inflicted. It’s a tough call. But when you weigh up the cost-effectiveness of the programme, it’s hard to dispute that it’s working a lot better than having no system in place.

The Mayor in Vancouver supports InSite given its higher quit-rates than any other official programme and the reduction of HIV infection. Opposing arguments claim that InSite merely condones drug use.

The main opposition comes from the Conservative party/government in Canada. The federal government have introduced the ‘Respect for Communities Act’, making it near-impossible for new centres like InSite to be built. Many policing bodies agree with this.

Conversely, Vancouver Police Department support InSite and other similar initiatives. I guess to them, it makes their job easier. They’re not bogged down with as many cases of abusive and difficult people to deal with (after all, drug addicts can get pretty violent).

The Drug Treatments Courts take a similar stance. They don’t demonise non-violent offenders and instead encourage and support them to access healthcare programmes. Again, at first, I was a little bit puzzled about this. My stance on it was: a crime is a crime and you should do your time.

But then I considered addiction as a health problem, a mental problem, rather than a social problem, and then it made sense.

Some believe that the money spent on prisons and trying to cut drug supplies would be better spent invested in rehab and outreach – and that’s exactly what InSite is. Maybe increasing the awareness of what it is InSite does to the tax-payer is the way forward.

Many think InSite is merely a promotion of drug use. I would disagree.

Drugs are such an uncontrollable part of society and I believe Vancouver have done a pretty good job of making an otherwise invisible problem more accountable and thus, controlled. Others argue, as do I, that regardless of where the consumption of drugs is taking place, it will always take place. So why not make the drug use within the city more accountable, safer and more cost-effective?

InSite (see image below) offer services to help people get clean, but maybe working on a compulsory ‘get clean’ basis would make the service even more effective in terms of cost and social benefit. The problem is: that’d only work if people wanted to be helped to get clean, not just assisted to shoot up.

Source: Maclean's 1

Source: Maclean’s 1

The question of legalisation is a split one, too. Walter McKay (former Vancouver Police Department officer) believes that no matter how many dealers are taken off the streets; more will be ready and waiting to replace them – so legalisation may be the way forward.

Dave Hamm (president of Vancouver Area Network of Drug Users) believes the federal government have taken a far too militant approach to drugs, but doesn’t want to see the same mistakes made with the privatisation of tobacco and alcohol.

Legal or not, Vancouver’s drug problem is a real big one, with no simple solution. But one thing’s for sure – they’re having a good crack at solving it in a (albeit) controversial, yet effective way. We can only wait and see if it proves to be a success in the long run with their on-going plans.

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