Has HARM REDUCTION become HARM PRODUCTION
Has HARM REDUCTION become HARM PRODUCTION?
The harm reduction philosophy which generated so much interest in 1997 and which led the Vancouver-Richmond Health to adopt it as policy and which was to be the cure all for the Downtown Eastside's drug problems hasn't lived up to expectations. In fact, this policy of harm reduction appears to have created an atmosphere of harm production.
In Feb 2000, city council approved the harm reduction Vancouver Agreement. Three broad areas of work were outlined in the VA. They were community health & safety, social & economic development and community capacity building.
In April 2000, Don McPherson, the city drug co-ordinator developed policy which was to close the open drug scene. Previously, in July 1998, city planner Nathen Edelson also struck a social development strategic plan with five key areas of work. These pillars included, reducing incidences of drug addiction, improve conditions at the street level, reduce drug-related crime, help the community find a common future.
In 1998, researcher Penny Parry in response to the Downtown Eastside drug epidemic authored a report, 'Something to eat, Somewhere to go and Someone who gives a damn'. In this report, Ms Parry estimated that there was 1,500 IV drug-users in the Downtown Eastside. In response, different levels of government injected $3 million dollars into the Downtown Eastside.
So what has happened since this windfall and implementation of harm reducing policies in the Downtown Eastside?
Well according to statistics from the BC Centre for Excellence in HIV and AIDS, the number of addicts in the Downtown Eastside has grown to a whopping 5,800 individuals. Women are acquiring HIV at a rate of two to one in the DE. The Safe Injection site which was to prevent overdose deaths hasn't lived up to this goal. In fact, in a nine month period since the Injection site opened, overdose deaths in the Downtown Eastside stood at 44 persons. Just before the injection site opened, overdose deaths were 41 individuals.
In responnse to the escalating open drug scene in the DE, the Vancouver police department adopted a policy of enforcement. They spent an extra $2 million dollars to address the worsening drug market in the DE. To no avail, the open drug scene continues to flourish. Numerous taxpayer funded drug outreach programs and contact centres for addicted persons have opened--yet poverty and drug addiction remains rampant.
So what gives?
Well for starters the Downtown Eastside has been treated by professionals as one big institution. It was thought that if programs were put in place that Downtown Eastside drug addicts would have increased opportunities at survival. Curbing drug use was supposed to be the goal, however, putting all the programs in the DE in fact, has created the production of harm.
Just this last Saturday evening, City Councilor Peter Ladner, a friend of his and myself did a walk-a-bout in the Downtown Eastside. Wanting to witness how the programs were operating and desiring to know whether they may have exacerbated the drug scene--.was our mission.
Our first visit was the area around the public funded health contact centre. This centre is located across the street from the Injection site and next door to the Carnegie centre. In theory the contact centre is to be the first point of contact for drug-misusers. Standing steps away from the contact centre were about a dozen or so drug addicts. On this extremely cold night, they were huddled together next to a large dumpster. They were either piping up or injecting up. They were flailing about and most of them seemed desperate. Of course, there didn't seem anything humane about this situation. I, for one wondered what purpose the contact centre provides to these sorry souls.
Walking down an alley just behind Hastings street between Main and Columbia, I pointed out to Councilor Ladner how people were gathered in the exitways of buildings. They were out of the elements and this allowed them opportunities to shoot up or pipe up.My thought was they were close enough to the contact centre so perhaps, they could run in to use the washroom or grab a cup of coffee. My other feeling though was that these individuals preferred the alleyways and streetscapes to the contact centre. Again, the conclusion I drew was outside, they could do their drugs but inside, they couldn't.
But wait, isn't this what the injection site was built for?
On our journey, we walked down the alley and back up Hastings street to the injection site. We were buzzed into Insite, which is the official name of the injection site.We introduced ourselves to the gentleman working the front reception desk. He offered us a tour but we couldn't access the injecting rooms for confidentiality reasons. Fair enough, so we asked some questions instead. One of my questions was whether its accurrate research that IV users are using Insite, on average, 4X a month. The staff answered yes.
My concern is that the site is being used primarily for the use of recreational users since those with deep drug problems would be consuming drugs more than once per week. My conclusion is that this may have the unintended consequence of fostering drug use. Or as Councilor Ladner articulates--whether this is an enabling behavior which needs addressing..
I concur with Mr Ladner. Questioning this enabling aspect of drug mis-use, I believe is important. Siince these programs operate on the premise of reducing harm and are presented to the public as improving health care, I think the public needs to be engaged whether all the associated funding which goes into these programs and which direct individuals to Insite is appropriate.
Providing consumption sites,contact centres and outreach programs may quite possibly be producing harm and consequently this whole idea of harm reduction needs to be further explored.
Justice demands that any further funding of programs other than Insite should be re-viewed. Unless there can be clear statistics provided on the usefulness of the program, I'd say we must act now. So far, the statistics being presented are not promising.
Jamie Lee Hamilton