Rare Clarity

Insite doesn't do enough to change addicts

By Susan Martinuk

Calgary Herald

March 5, 2010

Corey Ogilvie wanted to document life in Vancouver's notorious downtown eastside (DTES) by spending 30 days living alongside the residents of North America's poorest, most destitute and drug-infested neighbourhood. Film clips of his journey are posted on the Internet and, as one would expect, are highly revealing.

In one clip, he determines he must do drugs to understand addiction. While coming down from a crack high, he decides to try heroin. So his street buddies send him to Insite, Vancouver's safe injection site.

Ogilvie's smuggled camera reveals Insite staff doing everything but stick the needle in his arm as they aid him in his quest. A staff member shows him how to prepare the heroin, fill the syringe and find a vein. He's clearly a novice and the worker asks the obvious question, "So, can I ask? Why the drug use?"

When Ogilvie fails to offer much of a response, the worker offers an upbeat, "It's OK. You don't have to say anything. It's not a big deal."

I don't believe that Ogilvie had any intention of showing how ludicrous life can be at Insite but, intended or not, that's the lasting effect of the above.

The problem is, shooting up drugs is a big deal. Those who work in the DTES and see the harmful impact of drug addiction should understand that better than most. But no one at Insite wants to be the bad guy and make the judgment that injection drug use is bad. Hence, even those trying drugs for the first time are not questioned. (I hope the word doesn't get out to young teens who would be thrilled with a safe place to experiment with new drugs.)

Consequently, up to 800 people float through the facility each day, getting clean needles or shooting up in a clean facility under the watchful, non-judgmental eye of nurses and Insite employees.

No doubt troubled by my columns that question the twisted philosophy that underlies safe injection sites (that nothing can change the behaviour of a drug addict, so we might as well try to limit the damage by offering addicts clean facilities and basic medical/ social support), Insite leaders recently invited me for a guided tour of the facility.

I was very impressed with the sincerity and concern that Insite staff have for those who come through their doors. They are truly kind and compassionate, and provide addicts with a very human (and humanizing) element to their day. For that, I offer kudos.

Yet I came away thinking that Insite's main gauge of success is engagement, not treating addiction, reducing numbers of addicts or providing addicts with a way out. Maybe social interaction is enough for some, but I remain unconvinced that facilitating drug injections and perpetuating a destructive lifestyle is the best way to afford someone their human dignity. These non-judgmental interactions may make addicts feel better about their behaviour, but I didn't sense that the Insite philosophy had any room for the notion that addicts could actually change their behaviour -- at least not the addicts in the DTES.

Insite does have 12 detox beds and 18 'transitional' beds for those who are hoping to get into treatment. They have daily programs such as yoga, health care or counselling for these residents. But, again, I never got the sense that they had much hope for addicts beyond the Insite facilities.

Insite leaders seemed uncertain about what treatment facilities existed and where they were located, but still insisted that they weren't the kind of facilities that would be a good fit for DTES addicts. I'm under no illusion that there are sufficient treatment facilities available, but isn't any addict going to be out-of-his-comfort zone in an addiction treatment facility? Since the intent is to change lifestyle patterns, I would certainly hope so.

If DTES addicts really require a different kind of treatment facility, then why aren't we providing them with one instead of spending millions on a facility that fuels the addiction?

I can already see the letters saying, "Martinuk lacks compassion" or "she's a mean, hard-line, right wing ideologue." But, in truth, I am writing out of compassion for addicts entrenched in the DTES culture. The difference is, contrary to the safe injection site, my compassion moves me to do what I can to set them free.