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It is legal to shoot heroin, and all other outlawed drugs, within a 1,000 square foot area of Vancouver, Canada. The people behind InSite, who campaigned for 20 years to make this happen, were in London last week. They talked about their battle to open a supervised injection facility and how they convinced everyone - including the addicts - that it was a good idea.
In Downtown Eastside Vancouver, 6,000 of the 16,000 residents were drug users. The district had the highest percentage of people converting to HIV in the Western world. This is where, in 1991, Liz Evans and Dan Small opened their 70-bed homeless hostel.
Within the hostel, 90 per cent were injection drug users, 50 per cent were HIV positive, and Dan cites an instance where three generations of the same family were being given CPR at the same time. This is why Liz and Dan fought for 20 years to open and secure the InSite supervised injection facility.
But local people had some other ideas, Dan said: “One of the mayors was polling for the opening of a psychiatric institution to put people from Eastside into. Someone took the time to send me a little note by YouTube saying that we should give them all heroin with cyanide, and here’s someone talking about a concentration camp.”
Even the addicts were opposed to the idea. Liz said: “There was a lot of internalised self-hatred among the drug users. If you asked drug addicts if they thought it was a good idea to open a supervised injection centre, they’d look at you and say: ‘No, that would be like handing candy to a baby, it would be terrible.’”
Dan says that Eastside drug addicts were largely perceived as sub-humans, deserving of their affliction. He explains how InSite campaigners went about changing this: “We did a lot of public education over more than a decade, [introducing the idea] that everyone with an addiction is someone’s family member, and that no one deserves to die because they’re a drug addict.”
Liz says: “It was a massive feat, turning around the minds and hearts of the public, to see why something like InSite could even be useful. It took place over hundreds of conversations, presentations, protests and other events.”
They marked the number of overdose deaths between 1988 and 1998 by putting 2,414 crosses in a local park. Then a 50-foot banner that read ‘The Killing Fields’ was dragged across a busy highway, stopping hundreds of cars. They carried coffins outside City Hall, and collected signatures outside cinemas and inside local restaurants. Every Conservative MP received a copy of their petition, and campaigners blockaded the Prime Minister’s office.
InSite opened, after a 10-year battle, in 2003, but this was challenged in the courts, so they continued fighting for a further decade. On 30 September last year, the Supreme Court of Canada ruled unanimously to keep InSite open.
InSite inspired support from all number of unlikely sources: judges, who against the odds ruled in favour of the supervised injection facility; churches that listed ‘Save the safe injection site’ as the subject of their Sunday sermons; and a Conservative mayor, who sacrificed his political career for the cause.
Dan said: “We were realising that it didn’t matter what political background you were from, you could understand this - if you took the time to look at the evidence and the humanity of it.”
InSite aims to promote harm reduction and keep people alive. The Canadian government’s key objectives were to reduce public disorder, transmission of infectious diseases and risks associated with needles, and increase contact with health services. Over 40 peer-reviewed papers indicate that all of this has been achieved - overwhelmingly.
Though Liz recognizes that InSite is just a small part of the struggle against the huge and complicated issue that is addiction, she believes it to be vital. “It’s given drug users a sense of home, a place, community validation. To conceptualise now not having InSite... I mean, it’s beyond the pale.”