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

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.

Is Breaking Really That Bad? How it’s Heroin, Not Meth, that’s Albuquerque’s Vice.

This is the second 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, Nicola Carter chose to write about Albuquerque …

Albuquerque, New Mexico, has been pushed into the spotlight thanks to a certain bald meth dealer hitting our screens in early 2008. If you haven’t seen AMC’s Breaking Bad, I suggest you do so. Lock the door, take the phone off the hook and clear a week in your calendar. Shot and based in Albuquerque and chronicling the life and crimes of chemistry-teacher-turned-meth-dealer (Bryan Cranston, below right) and his petulant protégé (Aaron Paul, below left), Breaking Bad paints an altogether grim picture of drug use in the United States. Prostitution, murder, gang mentality and violence all feature heavily in the show – officially named the most streamed (both illegally and legally) show in the world. What is really interesting though, is the city behind the story – a real life city faced with a real life drug problem.

The term “Breaking Bad” itself is a southern colloquialism, meaning to stray from the straight and narrow; in Albuquerque’s case, a move towards drug usage. Methamphetamine, Breaking Bad’s primary drug of choice, is arguably not the drug which causes the most problems in Albuquerque – Albuquerque in fact has fewer patient admittances for methamphetamine abuse than both the state and the national average. Government figures show that Albuquerque only really stands out as a “problem” city in terms of heroin usage and abuse of prescription painkillers (you can check out the 2008 report here). There’s a problem with these official figures, though. Whilst there may be less patient admittances, how does that translate to actual figures of users? No-one is naïve enough to think that every drug user goes into a rehab program – nor that every user is even on any kind of radar. Many people can (and do) keep their addictions secret, from family, friends and colleagues.

New Mexico as a state doesn’t have the best reputation for drug usage. New Mexico had the highest rate of drug overdose deaths in 2008 and in 2011 – that equates to more people dying from overdoses than from all road traffic accidents per year. Española, just 85 miles South West of Albuquerque, has a level of drug related deaths roughly 6-7 times the national average (that’s 42.5 drug related deaths per 100,000 In Española, compared to the US average of just 6).  Whilst Albuquerque isn’t perhaps as bad in terms of statistics, try this interesting test. Internet search “Albuquerque drugs”. Yep, you find this delightful fellow as the first result.

Ouch. Now a bit of a comparison – do the same with “Baltimore drugs”. Supposedly the heroin capital of the US, but no self-professed drug dealer posting his home address on the internet. Do the same with Chicago, or Tucson, which has approximately the same population as Albuquerque. This poses a more interesting question about the culture of Albuquerque, perhaps. What kind of city would facilitate such brazen illicit activity on the internet and more importantly, perhaps, why is there a need for such a thing?

I read an interesting article recently written by a born and bred Albequerquean in Time magazine recently that really opened my eyes. There’s no aspiration, the piece argues – no hunger and no means of escaping the “city of mediocrity”. Apathy is what really rings true with this piece – low income families, poverty, a culture of brazen lawlessness (remember our friendly neighbourhood drug dealer, just a Google search away?) and a wild sense of isolation. The piece, any many more that you can find all over the internet also highlight the use of prescription drugs as gateways to harder substances, like heroin. One small scale study, on a group of seven high school students, found that every single one of them knew someone who’d abused prescription drugs, and every person interviewed for a news story said that the route to heroin started with prescription drugs. Teens in New Mexico are twice as likely to experiment with heroin than in any other state, resulting in $300,000 worth of heroin being sold in Albuquerque every day. Taking into consideration that heroin is now the cheaper alternative to prescription drugs (80-mg of Oxycontin, a prescription opiate based painkiller, costs $40-$60, compared with $20 for a bag of longer lasting heroin) that could be the equivalent of 15,000 users per day. Of the 13 high schools in Albuquerque, 9 have full time drug counsellors.

So what does this mean for the city? The drugs abuse stories that hit the media are usually extreme cases or based on sweeping generalisations – like this story from 2012 where a two year old child tested positive for methamphetamine. Albuquerque has a crime rate 53% higher than the US average. Since 1999, Albuquerque has had consistently higher levels of arson, theft, assault, murder, auto theft, robbery and rape than the U.S average. That’s staggering for a city of just over half a million. Maybe not surprising though, in a city where 22% of the residents live below the poverty line. This online map is awesome for tracking areas of the city. Areas of the city such as Trumbull Village, popularly and infamously known as the War Zone, is plagued by drug related shootings and crime – and 30.3% of the population live below the poverty line. Areas like Santa Fe show just how much drug policing can impact an area; a 20% decline in property crime (including burglaries) is largely attributed to an increase in drug related arrests.

The relationship between poverty and crime (read more here) has been the subject of numerous  academic studies over the years.  Put simply: high crime rates are considered by both the UN and World Bank to be a barrier to development. Albuquerque has both high crime rates and high poverty rates, perhaps both helped along by the high rates of drug abuse and usage? Figures from 2011 state that almost half of all US prison inmates were incarcerated for drug offences. The Albuquerque Journal publishes arrest records for the city, and a substantial number of these are for drug related offences. There are countless reports and testimonials from ex-addicts who explain the lengths they went to for a fix; burglary, prostitution, muggings or even kidnapping. Many others may have been committing crimes to pay for their drug habit. Heroin is cheap, yes, but expensive enough that many users are forced to steal to feed their addiction. The sheer cost of the law and order associated with the drug trade is staggering – police officers, judges, courts, prison services, lawyers. Drug enforcement cost the American Government as a whole billions of dollars (a recent estimate is $41.3 billion) a year – not including the cost of crime indirectly caused by drugs.

It seems Albuquerque’s problems with drugs are actually quite well exemplified by Breaking Bad; the ease with which Walt accesses drugs, and how easily he finds buyers for his meth, Jesse’s using of drugs to escape a painful childhood, and the murders that seem to occur in every episode. If only ending Albuquerque’s relationship with drugs was as easy as ending Breaking Bad

Albuquerque has a heroin problem; a problem that’s debilitating and demobilising for the city. A drug problem that exacerbates the other problems in the city; that drives and maintains poverty, which increases crime and reduces aspiration. The infiltration of heroin into high schools and the young age at which addiction is starting is crippling the city, breeding another generation of addicts and perpetuating a culture of lawlessness. The amount of money being poured into drug policing in the city clearly isn’t enough: in 2010, a 16 year old girl overdosed on heroin and died, following a two year struggle with addiction. Based on a state average life expectancy of just over 78 years, that’s 62 potential working, childbearing, tax paying, life enjoying years lost. And overdose and drug related deaths are on the increase. Reducing this number will be a hard slog, but kicking the heroin habit might just be what Albuquerque needs.