How the Public Sees Harm Seduction

What follows is written by Christina, who just celebrated her 15th birthday. She is in Grade 10 here in the Vancouver area.

Nobody, myself included, has ever said it better.

Insite

A Chair Missing Three of Its Legs

By Christina Larsen

Teacher: Mrs. Sharpe

November 8, 2009

Outline

I. Introduction

Thesis- The Safe Injection Site (Insite) in Vancouver uses money to supply a clean and safe environment for drug addicts to inject themselves with illegal substances. The money used to run this facility would be better spent on treatment.

II. Downtown East Side

A. History

B. Why Downtown East Side?

i) The Addictions

III. The Health of Drug Addicts

A. Physical Effects

i) Internal Damage

ii) Tolerance Building

B. Emotional Effects

i) Brain Chemical Imbalances

ii) Emotional Cycles

IV. Criticisms of Insite

A. What is Insite?

B. Unsuitable Way of Treatment

C. The Failed Four Pillars Approach

D. The Budget for Insite

V. Conclusion

Most people pay taxes, and others have jobs. Most people are responsible, contributing citizens of society. Drug addicts however, are not like most people. They have addictions that are so strong that it consumes their entire life. It does not matter if they once had jobs or have families. All that matters is the drug that is slowly killing them. Every waking second is about their next fix. Drugs are poisons that are derived from plant defence mechanisms called psychoactive alkaloids.[i] These were used to ward off the herbivores. When the herbivore eats the plant, they experience the “high” and stay away from it. Yet addicts want this feeling, they need it to dull the pain and the loneliness they feel. It is illogical and unnatural, but it is an issue around the world, especially in the Downtown East Side in Vancouver. The Safe Injection Site (Insite) in Vancouver uses money to supply a clean and safe environment for drug addicts to inject themselves with illegal substances. The money used to run this facility would be better spent on treatment.

Originally, Gastown was a thriving industrial community complete with sawmills, great transportation, a main library, a city hall, banks, hotels and theatres. But, like all good things, it came to an end: in the late 60’s businesses re-located, decreasing the economy’s productivity. When less and less people walked through the Downtown East Side, the other community centers like the library and the theatres followed suit. The following decade, most people with mental health issues could not afford housing anywhere else but the Downtown East Side due to supply and demand. Soon after, many drug addicts and dealers called the Downtown East Side their home. In the late 80’s heroin, the drug of choice at the time, changed to cocaine, a highly addictive drug. Drug addicts living in the Downtown East Side had to support their habit somehow, and they did this by stealing. Due to the increase in robberies, the only businesses that made a profit were second hand shops that bought the stolen items. This made legitimate businesses hard to come by. In the 90`s, almost all of the businesses had moved elsewhere, leaving a poor, poverty-stricken, highly unemployed, and addicted Downtown East Side behind.

The problems in downtown Vancouver did not get any better, nor did the health of the drug addicts residing there. The health of drug addicts who use cocaine and methamphetamines ranges from ear, nose and throat problems such as bronchitis, bleeding, sinusitis and coughing up mucus and blood to unhealthy weight loss due to higher than normal metabolisms, and everything in between.[ii] Drug addicts either sleep too much or too little, have periods when they feel they have extreme strength which could cause injuries, teeth problems, vomiting, seizures, irregular breathing, haemorrhaging (bleeding of the brain), and the list goes on. What makes the addictions maintain in severity is tolerance building. This occurs as an addict needs more and more of their drug of choice to feel `normal`. However, drugs do not limit themselves to destroying the physical health of the user, they affect the mental health as well.

Drugs change responses of brain chemicals called nero-transmitters. They do this by causing the brain to release too much or too little of these chemicals.[iii] Vital nero- transmitters that are affected by drugs are as follows; norepinephrine, dopamine, serotonin, and acetylcholine. Norepinephrine and dopamine is adrenaline, and too much of it that is released can result in a more violent behaviour. Serotonin, also called 5-hydroxytryptamine is responsible for the high. This nero- transmitter constricts the blood vessels, making the user feel ‘happy’. Acetylcholine or ACH relays information between nerve cells in the brain, effecting the physical movement. Drugs that take a shorter time to affect the brain do so because they are similar size and shape to the normal brain`s nero-transmitters. The ingested drugs take about twenty to thirty minutes, whereas injected drugs take only fifteen to thirty seconds. A marijuana high can last up to several hours, whereas a cocaine high, lasts about an hour. While all of the brain chemical changes are taking place, the drug addict feels euphoric. He or she thinks that they are on top of the world, can do anything they want. Any pain or loneliness they feel, diminishes. Unfortunately for the addict, that joy comes to an end, and is followed by extreme depression. Wanting to feel that sense of euphoria again, the addict buys more drugs and shoots up. This vicious cycle continues to occur until the addict can get their next fix, until he/she can feel happy again, until he/she walks across the street, opens the door the Safe Injection Site, sits in a comfortable cubby, is supplied a clean needle, and is able to shoot up while a nurse is watching him to make sure he is safe so he/she can do it all over again the next day.

The Safe Injection Site opened its doors in June of 2003, when Health Canada granted Vancouver Coastal Health an exemption from section 56 of the Controlled Drugs and Substances Act (CDSA). This led to North America`s first Supervised Injection Site, otherwise known as Insite. It is located on 139 Hastings Street in the Downtown East Side. Insite is open from ten in the morning to four in the afternoon, seven days a week. Around 650 drug addicts use Insite each day. This means 650 human beings who desperately need support and help continue to shoot up, easily forgetting about what they really need, which is treatment. The high they experience is more important than anything else; it makes them feel good, so why should they stop? They are getting what they want, which is their drug of choice and the ability to use it. Insite only provides the ability to use the drugs safely.

Insite is only focussed on harm reduction. It is quite clear that Insite does not provide the four pillars approach. It has failed to supply the other three key pillars; prevention, treatment, and enforcement. Insite itself is the complete opposite of prevention. By letting addicts shoot up, they are allowing this behaviour. As for enforcement, making it legal to use drugs in Insite is most definitely not enforcing the law. As for treatment, that`s a big one. Drug specialists say that the best way for someone to get clean is to take the temptation away. Again, Insite is doing the exact opposite by enabling drug addicts to use without any consequences or second guesses.

Tony Cement, Canada`s former Health Minister is against Insite. He said ``Advocates have given an overly rosy picture of the Vancouver facility, which focuses on `harm reduction` by letting addicts shoot up and receive medical help in a safe, clean environment.`` He said that treatment is key in the solving the issue. Clement continued by saying ``The best way to reduce harm is to get addicts off drugs and to provide supports for that addict.``[iv] Due to the fact that Insite was so controversial, Tony Clement had a committee issue a study. This committee found that Insite only had five percent of the Downtown East Side`s addicts actually using it.[v] This concludes that Insite is not helping most of the addicts living in the Downtown East Side to kick their habit.

Addicts can have a moment of wanting treatment, but when they hear it can take anywhere from one week to four weeks for a detox bed, the moment often vanishes. It does not make any sense that while an addict has to wait for treatment, they can go shoot up at Insite any time. Insite makes it easier for addicts to continue to use because if they were caught on the streets using drugs, then they would be either fined or arrested, whereas in the safety of Insite, drug addicts are free to use without any consequences. The whole point of making something illegal is to make people not want to do it, or at least make it harder for them to do it. The drug addict using Insite may not think of his/her addiction as big a deal that needs fixing, but instead a normal way of life.

If the four pillars approach clearly states that treatment is part of it, then why would a drug addict have to wait for treatment? Because most of the funding is being put towards Insite, leaving little for treatment facilities and detox beds. So little in fact, that British Columbia, with 8,000 addicts,[vi] has only one hundred detox beds. Patti Smith, a worker at Vancouver Native Health said; ``We need to be able to respond to these people the minute there is a window. They`re taking responsibility and we need to acknowledge it right away.``[vii] So, prevention, enforcement, and especially treatment are not receiving the attention they deserve. Let`s compare Insite; a clean, chic setting complete with a coffee bar and background music to one of the very few detox beds; a dingy, unwelcoming facility that you have to wait for days to enter. As a drug addict, which would you rather be in? People do what is easiest for them. Why wouldn’t they continue to do something that makes them feel euphoric, at least part of the time, when the alternative would be a dull and boring place? Treatment must be appealing to use. John Turvey, a founder of a needle exchange noted ``They`re jumping all over this Safe Injection Site and forgetting about the treatment programs that were supposed to go with it. What about abstinence and the 12-steps?``

Not only does Insite fail the four pillars approach, but it costs a lot of tax dollars to do it. The budget for Insite is three-point-five to four million dollars a year. This tax money should not go towards allowing and enabling drug addicts to use, but rather to treatment centers. Wasn’t that the whole point of Insite? Once informed of ‘treatment options’ addicts are supposed to go to treatment. But they don’t because there are not many treatment beds available. Insite is giving no hope to those who desperately want to overcome their addiction, but cannot because of the lack of funding. The main purpose of Insite is to decrease the amount of sharing needles. Yet 40% of regular Insite users who have AIDS still share needles.[viii] Money being put towards Insite for that purpose is being wasted, because the addicts who are informed about the dangers of needle-sharing do not get the message.

It is very surprising that despite Insite`s many problems, it continues to run to this day. Giving needles to drug addicts is like putting out a forest fire with a garden hose. It just will not work. The prioritizing of the four pillars approach is all wrong, and shows that we as a community accept drug use. Insite seems to be more about sustaining the addicts’ lifestyle, than about ending their addictions. Addicts will not own up or admit they need help, especially when a neighbourhood sets up a place where they can shoot up. These addicts need help, but it should not come in the form of a free needle. Some addicts will continue to use this debilitating program until they die. Mahatma Gandhi put it well when he said; `` Recall the face of the poorest and most helpless man who you may have seen and ask yourself if the step you contemplate is going to be of any use to him. Will he be able to gain anything by it? Will it restore him to a control over his own life and destiny?``[ix] This quote can be applied to drug addicts. They are some of the poorest and most helpless of people, due to their overwhelming and negatively life-altering addictions. We offer Insite, but users will not gain anything by continuing to use drugs, and supplying them with needles to do so will not give them control over their life. The bottom line is that no matter how clean a needle is, it is still a needle that injects drugs into a person, continuing a deadly cycle that keeps their addiction, an addiction. Isn’t that exactly the opposite of what everyone wants for these people?

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[i] Munoz, Mercedes and Courtwright, David. What Causes Addiction? California: Thomson Gale, 2005.

[ii] http://helpguide.org/mental/drug_substance_abuse_addiction_signs_effects_treatment.htm

[iii] Schwartzenberger, Tina. Substance Use and Abuse. New York: Weigl Publishers Inc., 2007.

[iv] http://www.nationalpost.com/news/story.html?id=497292

[v] http://www.nationalpost.com/news/story.html?id=497292

[vi] O'Neill, Terry. "No Quick Fix." National Edition 16 Jan. 2002: P24. Print.

[vii] Carmichael, Amy. "Vancouver's Safe Site Popular With Junkies." The Toronto Star 26 Dec. 2003. Print.

[viii] Carmichael, Amy. "Vancouver's Safe Site Popular With Junkies." The Toronto Star 26 Dec. 2003. Print.

[ix] "The Commission on Medical Instruments." Letter to General Public. Oct. 2002. MS