Philip Benmore #0221356 Canadian Studies 477/ Struthers Highway to Hell; Government Responses to Drug Addiction in Canada
The streets are filthy and
lined with discarded trash. It’s late although it is not quite dark; the cool autumn dusk of a busy Vancouver afternoon begins to settle down. The shadows are beginning to move here on the edge of a corner on East Hastings, moving in and out of the darkness. The fading, tinted neon lights of the decrepit Ivanhoe and Balmoral Hotels cast an awkward glow on the scene, bathing the rain soaked asphalt in a shimmer of orange, green and faded red. With the shadows you shift into an alley. Beside you a man dressed in what appears to be the contents of a Salvation Army scrap bin is heating a teaspoon full of heroin over a lighter. As you shuffle away you notice him removing an old needle from the inside his tattered jacket pocket,clean it with his tongue and use it to gently siphon up the heroin in the old teaspoon. This is a typical scene on Vancouver’s Downtown Eastside. This is Canada’s 'Ground Zero.' In these dilapidated streets and alley-ways one of the greatest human crisis of our time is taking place and like most others before it, it is being largely ignored by those in power.
Recognizing the clear
problems. then Vancouver Mayor, Philip Owen drafted what would come to be known as the Four Pillars Drug Prevention Plan. In it, Mayor Owen outlined how the city must respond to the problems and proposed the creation of several social policy based initiatives, the most prominent being a safe-injection site. This essay will explore the history of Vancouver's Downtown Eastside and the need for a safe-injection site, look into the early history of the drug trade in this area and the early attempts by government to prohibit addictive substances, especially opium and other opiate by-products. As well, it will look at government policy attempting to respond to addictions and responses to poverty through their various intersections.
This essay seeks to explore the
evolution of addictions policy in Canada, paying particular attention to several themes and political motifs which over time have influenced the creation of social policy,
including but not limited to, Chinese racial and moral panic, drug hype, the early prohibitions, creation of an othered user and finally the harm reduction strategies of the end of the twentieth century. In its path the paper will pay particular attention to the city of Vancouver and the evolution of its down town east side community leading towards the creation of North America’s first safe injection site.
The core of Vancouver's
Downtown Eastside is made up of five parts; Gastown, Chinatown, Strathcona, Oppenheimer, and Thornton. These areas have existed since the early days of the city, when it was little more than the lumber and fishing outpost called Hastings Mill. The city grew from these small communities and neighborhoods which slowly turned into the ‘skid rows’ that they are today. In terms of the history of the area, the histories of Asian Canadian immigrants is corseted throughout them. Historian Kay Anderson, defines Chinatown in this way, “Chinatown in North America is characterized by a concentration of Chinese people and economic activities in one or more city blocks which forms a unique component of the urban fabric. It is basically an idiosyncratic Oriental community which formed amongst an occidental urban environment. (Anderson, 9)” In this passage Anderson gives a fairly theoretical explanation of what Chinatown is. The heroin problem in Vancouver grew out of Chinatown. Is there any coincidence between Canada’s largest Chinese settlement and sweeping poverty and widespread addiction? Opiates, as Catherine Carstairs describes, “are the world’s best pain killers, as an elixir for the romantic imagination, and as a dangerous cause of moral decay.(Carstairs, 16)" When it first arrived in North America, opium was a sacred medication which new Canadians brought from their homes in Asia. The white settlers in the new colonies of British Columbia carried with them the stigmas of over eight hundred years of shame for the use of opiates. “Traditionally opium smoking served many purposes in China: it was an elaborate social ritual for the elite, a painkiller and aid to hard work for labourers, and a medicine that countered fever, diarrhea, and cholera. It was particularly widespread in
the southern coastal regions of China, which provided most of the immigrants to Canada.(Carstairs, 40)” Due to its nature, opium is a completely romanticized substance associated with the stereotypical eastern, almost fictional, oriental culture. This stigma associated with opium and its by-products like heroin carries on into the twentieth century and leads to a campaign for Chinese exclusion. Carstairs describes this stigma quite accurately, “Reformers and journalists described evil Chinese traffickers leading young white (and usually female) Canadians to ruin and demanded stiff penalties.(Carstairs, 16)” This clearly moral panic which surrounded opiates and the general response did not in any way attempt to comprehend the true scope of the problem at all. Rather it racially profiles the Chinese as a sort of barbarian who would like nothing more than to turn young Canadians to evil and to morally corrupt ways through foreign and therefore evil cultural influence. These sorts of broad generalizations and widespread cultural ignorance lead not only to Canada’s first race laws but also to Canada’s first prohibition laws.
The first substance to be reigned in
was alcohol, which fell under fire in 1878, as a part of the Canada Temperance Act, which allowed for any county or municipality to prohibit the sale of alcohol. In 1907, as Carstairs discusses, angered citizens took to the streets to demand the prohibition of opium. During the parades several Chinese and Japanese businesses and houses were smashed with bricks and rocks. Among the businesses most targeted were those that sold and trafficked opium. The federal government responded by sending then young Deputy Minister of Labour, William Lyon Mackenzie-King, to investigate the causes for the riot. Mackenzie-King himself was an advocate for temperance and naturally was “appalled that opium manufacturing was still being allowed.(Carstairs, 17)” In his report on the incident Mackenzie-King warned that opium smoking was not limited to the Chinese in British Columbia, but rather reached to all Canadian citizens. In particular he warned for the safety of young white women and girls. In his presentation
he presented a clipping which documented a “young, pretty white girl found in a Chinese opium den.(Carstairs, 17)”
Three years later, in direct response to Mackenzie-
King’s report, the federal government passed an act which “forbade the possession of opium and other drugs for non-medical purposes." The sale or possession of morphine, opium, or cocaine became an offense, carrying a maximum penalty of one year’s imprisonment and a five hundred dollar fine. In this same law, smoking opium and the use of any of the aforementioned drugs carried a minimum fifty dollar fine and a month's imprisonment. In her book A White Man’s Province, author Patricia Roy describes the typical political discourse on opiates and the Chinese of the period. To help calm the mass hysteria she describes, the Province of British Columbia and other municipalities across the country ordered police to search Chinatowns and root out the illicit substance which was sure to be found there. “News of such raids helped confirm the image of Chinatown as a plague spot. (Roy, 16)” Further, these raids helped to confirm the countries worst fears, that was that the Asian population was responsible for the drug trade and the flood of such illicit substances into Canada at all. “Opium smoking was decidedly a Chinese pastime. When asked to explain what the difference was between a white man getting drunk and a Chinese smoking opium, a Member of Parliament noted that the difference was great, ‘the one being a Christian habit and the other a heathen vice.’(Roy, 16)” Judge Matthew Begbie (aka the Hanging Judge) drew a direct connection between this heathen vice and Chinese industriousness, describing that if they would no longer smoke opium, rather that they would occasionally get drunk, they would no longer be formidable competitors for the white man on the labour market.(Roy, 16)” Throughout most of the literature in the period there is a straight connection made between opium and the Chinese. One of these is Emily Murphy’s 1922 study The Black Candle, which discusses in great detail the problem of opium in Canada and does quite a bit more to link directly the Chinese immigrant population to the illegal drug problem.
In her analysis, Carstairs argues, “she (Murphy) takes great care to distance herself from what she considers prejudice or racism. ‘We have no sympathy with the baiting of yellow races, or with the belief that these exist only to serve the Caucasian, or to be exploited by us.(Carstairs, Murphy, 22)’” In this passage Murphy creates several typecasts of the Chinese. She condescendingly describes them as being “a friendly people.” Further along she makes several comments about the Chinese as being visitors to this country who, because of their race, have a severe handicap. She gives them certain demonic qualities saying “a visitor may be polite, patient, persevering, as above delineated, but if he carried poisoned lollipops in his pocket and feeds them to our children, it might seem wise to put him out.(Carstairs, Murphy, 22/23)” This notion that Chinese people were out there ready to destroy Canada by means of drug distribution, is actually the rationale by which the first social policies around the subject of addiction are crafted. That is that the evil Chinese barbarian was bringing opium on mass into a country in which he should not be entirely welcome into in the first place. The construction of the Chinese as root to the spread of opium takes a different turn after World War One.
After the war anti-Asian organizing began to increase,
particularly in Vancouver where not only was there the country's largest Chinese population but also there was the country's highest number of drug arrests. Both of these factors, combined with the economic tension of the post-war years and the early 1920's, helped to create a sense of resentment toward the Chinese amongst other Canadians. Following this same sentiment, the Vancouver Sun ran several articles calling for, among other things, the abolition of Chinatown and the preservation and protection of ‘good little boys and girls’ from joining the ranks of the addicted hordes. It is also in this time that the propaganda began to change in such a way as to transform the user as being portrayed not as an innocent addict but in a more 'Hobbesian' way as an evil dope fiend. Rather than viewing addicts as people in need, the media at this
time chose rather to castigate them as being morally and ethically corrupt with completely wasted bodies, that is that they are "zombies". As one might imagine, this castigation created a certain level of moral panic as people began to become more and more afraid of the supposedly invisible threat of the dangerous drug-fiend who wandered the streets looking for not yet addicted youth upon which it could easily prey. In the summer of 1921, the Sun published Hilda Glynn Ward’s novel The Writing on the Wall, in which a pair of wealthy caucasian Vancouver residents become addicted to opiates and are subsequently lured into joining the Chinese army which is in the process of dominating Canada through means of mass addiction. The Government and the media continue through this period to use the Chinese as a scapegoat for the increasing number of addicts. Meanwhile behind the scenes in an effort to find answer to the problems of the drug trade the Rotary, Gyro and Kiwanis Clubs launched an investigation into the trade itself, seeking to find actual causal relations and to find some viable solutions or treatment plans. Early in the following year the predominant Vancouver newspaper of the time, the Vancouver Daily Globe ran its own anti-drug campaign, “running anti-drug articles on its front pages for several months and increasing its distribution by one third in that time (Carstairs, 26)”
The articles in the
special issues which followed used racial stereotypes to create mass stigma and anger towards Chinese ‘criminals’ and at the same time provoke sympathy and compassion for whites who were accused of the same crimes. The response to these articles was as one might expect, mass hysteria amongst the average citizenry. This hysteria also spread amongst those in government and quickly resulted in the passing of several antiAsian laws to keep a racially pure country. More importantly though, these laws were meant to keep the country free of the corrupting dangers of opium and by this point in history, cocaine, both of which were being openly blamed on the Chinese presence. Also “the anti-Asian discourse in Canada in this period constantly emphasized the the
intelligence of the Chinese and their craftiness as reasons to prohibit their entry into Canada.(Carstairs, 26)”
By the time the moral drug panic ended in the early nineteen
twenties there was a clear connection which had been made between the opium trade and the so-called demon Chinese, who were now no longer just the topic for discrimination in the media but as well by government. In the early nineteen twenties the government drew a direct connection between the Chinese and opium and created, through legislation, more stringent penalties for drug trafficking, taking the minimum sentence one could receive for mere possession from its original three months imprisonment to a new, stiffer six month sentence. And at the behest of MP Archibald Carmichael an amendment was passed ordering the immediate deportation of all Chinese who were convicted. Others argued for there to be more corporal forms of punishment including the lash and other forms of beatings for Chinese criminals only. In the following year the Chinese Immigration Act was passed which finally prohibited entry to all Chinese. However not completely, as students and some select merchants were allowed into the country. By 1923 the numbers of drug hype had finally come to an end with the passage of the immigration act in that same year. Now most Chinese were either deported for convicted use or were heavily jailed.
As part of the the 1923 policy
bonanza the federal department of health attempted to do a proper survey to ascertain some sort of exact number users in the country. In order to glean this information the department was able to solicit the assistance of several police chiefs. With their help the government was able to collect the following information: there were roughly 9500 users of narcotics in the country, 2500 of which lived in British Columbia, another 3800 in Quebec and 1800 in Ontario. The rest are scattered throughout the other provinces except in Prince Edward Island where there were none(Carstairs, 38). These surprisingly low numbers are likely because the number of Chinese opium smokers was not included in any of the totals. In 1922 alone, for example, there were over 519 drug
arrests in British Columbia of Chinese men. Only these sorts of statistics demonstrate just how skewed the above numbers are and further demonstrate just how difficult it is to track and present accurate statistics around something like drug use and more importantly drug addiction. This is likely because of two reasons. One, the bulk of the information collected by the department of health was gathered from one of two possible sources, first, Doctors who were only aware of patient use and therein patients who had subsequently become addicts because of treatments; and secondly from police reports which, although they show the number of convictions, they do not show the number of users or addicts. It is also important when reviewing the numbers generated by police to remember, as Carstairs argues, “tells us more about the practices of police forces and judges than they do about drug use.” Put more succinctly, there is a direct link between police policy and high statistics. Since doctors and police are our only sources for data we have no way of actually differentiating convictions, that is alleged drug users and those who are actually addicted. The second reason is that the information collected, as I mentioned above, did not take into account the number of Chinese drug users and therein addicts. They were not counted as rigorously as the statistics generated by white users. Where Asian numbers are counted they are not done with any sort of accuracy. Thus it is clear that throughout these so called “crack downs” of the early twenties and attempts by the federal government to give themselves some sort of a sense of just how significant drug use actually was, these statistics were a relative failure as it is with these rather inaccurate numbers that governments and subsequently police officers based the bulk of their response through policy and enforcement. Throughout the 1930’s, largely as a result of these accumulated statistics, the police began to seize smaller and smaller quantities of substances and supplies. This is due primarily to a shortage of desirable drugs which in turn is caused by the great depression’s affect on international shipping and the noted difficulties in production.
This, combined with the lower incomes of the working class users made it more difficult for an average person to get a hold of their desired substances.
What this gave rise to
however was an increased use of more readily available, although certainly less popular, substances such as codeine, paregoric, and poppy heads. The other major problem caused by the difficult procurement of substances was a rise in the use of stronger drugs such as heroin and therefore the first noted mass usage of hypodermic needles as a means by which an addict could get a stronger longer lasting ‘hit.’ Although these stronger drugs were infinitely more expensive the infrequent drug users sought them out.
For white users in the 1930’s the low drug supply forced several
users to travel the country in search of readily available substances. Some found ways of getting drugs through semi-legitimate means. Usually that was through their doctors whom they would con into giving them the desired medical equivalents to their drug of choice, particularly morphine.
As Carstairs notes, many users known as “hop-heads”
began to memorize the symptoms by which a normal doctor would prescribe morphine to them, such as faking the symptoms for kidney failure. Doctors who were deemed by the Narcotics division to be too liberal in the prescriptions of these sorts of medications were openly condemned by the division's head Colonial Sharman who quoted by Catherine Carstairs here: “There is, he wrote to one doctor,’ a great freemasonry amongst these gentry who, for example, in the course of a trip across Canada ‘riding the rods,’ habitually stop over at certain points, frequently at smaller places to the complete exclusion of others, because they by means of information exchanged amongst themselves, know just where they will be met with the reception they desire.' [Sharman claimed that] most doctors provided drugs out of sympathy rather than out of a desire to make money.(Carstairs, 57)” The point from all of this is that in response to the prohibition of substances, combined with the faltering depression economy, there was created a culture of addicts who literally traveled from little town to little town in search
of their next fix and more importantly the next willing doctor.
By 1934, the
government had finally caught on to the various schemes of the user to solicit their chosen substances and also to obtain cheaper, although still decent, replacements for their drugs of choice. It was clear to the policy makers that their supposed crack down was not working so the newly minted department of Pensions and National health set about to ban the legal substances which were being used as natural substitutes for the illegal ones. In a 1934 study the department concluded that “codeine was being used as a carry-over drug for users who could not find a sufficient supply of either morphine or heroin.(Carstairs, 58)” By the end of the year the narcotics division had managed to limit the amount of codeine retail druggists could sell and completely prohibited others from selling it at all. This of course led to an increase in the number of peddlers selling stolen codeine on the street. In the following year in British Columbia, the B.C. Pharmacy Act restored the status of codeine to be available in pharmacies with prescriptions only. In 1936 the Division of Narcotic Control did a report on codeine use which noted that use of the drug had significantly dropped off as result of the new prohibitions. Although hot on the heels of this report, as Catherine Carstairs notes, the Vancouver News Herald reported that one drugstore in Vancouver was on its own selling roughly two hundred ounces of codeine each month. The store in question, the article noted, was frequented by known users who later admitted to police that they were injecting the drug by means of hypodermic needles.
The arrival of the
Second World War in 1939 made access to banned substances even tighter for addicts. With the passage of the War Measures Act, codeine was placed under extraordinarily tight regulations. The availability of codeine was reduced to small amounts by prescription only. Also in 1940, codeine was placed on a list of substances controlled by the “Narcotic and Opium Drug Act” which meant in essence that anyone found to be in possession of the drug was subject to the heavy penalties which were instituted in the
decades previous. That is, lengthy prison sentences and heavy fines. Throughout the war the prohibitions of these substances continued with the stiff penalties and heavy policing. However as I have discussed at length above, addicts found several other methods for achieving their fix. It is important to note at this point that although alcohol is no longer subject to the prohibition laws of the 1920’s, it is still under rationing and is therefore only available in limited amounts.
At the conclusion of the war four years
later, Vancouver RCMP Constable Price performed a survey of fifty two users in the city. Of the group he surveyed forty five were white. From the data he collected he was able to make some assessments about the average addict: “the average addict is male, approximately 34 years old and had obtained generally about grade eight level education, had worked for about three and half years, was arrested at about 21 years old and subsequently became addicted to drugs at that same age. He would likely therefore have been using drugs regularly for about ten years. (Carstairs, 63)”
These
numbers, while seeming somewhat definitive, are not so at all. Rather they draw upon several racially motivated generalizations and in a few of the select case studies which Price performs, demonstrate the racial prejudices which are evident in all the policy initiatives of the time. In one of these case studies Price follows the story of a girl known in his report as “B.” “B was a woman, twenty-one years of age. She began working as a prostitute as a young teenager and had been addicted to drugs since she was seventeen years old. She was the child of Russian immigrants on the Prairies and came to Vancouver’s East End with her father as a child, after her mother left the family. Her father worked as a bootlegger and a fence, and her stepmother was a prostitute. Price noted that her attitude to police was resentful and rebellious. (Carstairs, 63)” Throughout the section devoted to ‘B’ Price refers to her as a “sullen foul-tongued girl, mentally dull and lacking in any moral sense.(Carstairs, 63)” In this sense the police were able to castigate addicts as social pariahs who were less than human.
The
post war period saw a marked transition in the ways in which users were able to procure drugs. Also, the drugs themselves changed as users of opiates particularly switched from the once common ‘smoking opium’ first to the lower quality ‘mexican brown heroin’ and then to the higher grade white heroin which had to be imported directly from Asia. Opium injections of its smoking forms was all but extinct on the West Coast by 1946, replaced by the new stronger, longer lasting heroin. Foolishly the RCMP claimed that this new substance was arriving in western Canada via the eastern United States and more importantly from Europe. So no very obvious connection was drawn between Vancouver’s status as a port city and its clear reputation as the centre of the North American heroin trade. The bulk of the drug dealing business had its home, unsurprisingly, on the downtown east side where most of the dealers of the period had rooms in the grungy residential hotels along Main Street. They could often be found at the Broadway Hotel beer parlor which is still today at the corner of Hastings and Columbia. This, along with several other underworld establishments were, as Carstairs notes, the known places in the city where one could find drugs quickly and without any difficulty. Vancouver, unlike almost every other city in Canada, had multiple corners where dealers and peddlers would meet a relatively small number of buyers rather than, like the metropolitan cities of the east where large groups of people would gather at certain points during the day. In all of these however all drug sales took place in as strict security as possible. Dealers only sold to known addicts and contrary to the hype and moral panic generated around the Asian opium trade forty years previous, there are virtually no records which prove that drugs were ever sold to children.
When
he drafted the Narcotic and Drug Act in 1911 it is important to note that the act’s author, William Lyon Mackenzie King, did not consult a single doctor about how his new piece of policy should look or take shape. Rather, as Carstairs notes, he consulted the chiefs of police in the two cities which he felt badly needed to be morally reformed: Montreal
and most importantly Vancouver. It was not until 1920 however that the responsibility to enforce the act fell to the newly minted body “the ministry of health, where presumably there would be more of a medical focus.(Carstairs, 119)” Although this was not the case; The Opium and Drug branch (later renamed the Narcotic division and even later the division of narcotic control) acting as a go between between for the medical profession and the government, would make recommendations for the government with regard to narcotic controls and regulations. As I’ve described already, the division was created with the express intention of acting as a watchdog for the medical profession and to primarily ensure that the aforementioned banned substances would not be prescribed to anyone who did not actually need them. The colossal flaw in this plan is that the division was entirely composed of non- medical officials who were vicious bueracrats and lobbyists. In fact, between the years 1920 and 1961, the commission expressly refused to hire anyone with any connection to the medical profession. As a result the commission was filled with the anti - drug crusaders of the early twentieth century who were not interested in the opinions of doctors or other experts. The division imposed strict penalties for any doctor who prescribed treatment which involved any of the banned or suspected substances. Following the lead of the division the government made it illegal for any doctor to prescribe any drug to a user “unless he or she was suffering from a condition other then addiction (Carstairs, 120).” Throughout the following three decades the division lead a very discreet witch hunt again, implicating doctors who were merely attempting to help their patients. It was not until the late 1950s that the division began to even consult doctors with regards to the treatment of addicts and to the formation of policies around that treatment. However, the division did not completely defer to the wisdom of the doctors just yet, as on the first of January, 1956, the government banned the importation of heroin into Canada (Carstairs, 126). Even though several doctors argued in favor of the drug, stating that it still had a useful
place in medicine.
Unsurprisingly the use of banned substances exploded in the
1960’s as part of the 60’s youth movement and the city of Vancouver was once again at the very centre of the explosion. This proliferation of drug use did not go unnoticed by the federal government who struggled to gain some sort of understanding of the substances which were bring used and why and how this culture had been created and more importantly how it could be controlled if at all.
With the 1968 election of the
Trudeau government came a re-invested self interest in Canada. In the first years of his government Trudeau set up many royal commissions to investigate various problems and identity issues within Canadian society. In 1969, commissioned by then Minister of National Health and welfare, John Munro: “The commission of inquiry into the non medical use of drugs,” arrived to investigate the burgeoning use of non medical drugs. The commission was also intended to investigate what would be possible for government to do in order to respond properly to the drug craze and more importantly attempt to control the use of substances which, as is demonstrated in this paper, for the decades previous had not been in any way successful.
The commission was led by
Gerald Le Dain, a notable law professor from the Osgoode Hall law school at York University in Toronto.
Amongst its many conclusions as to how the government should
respond to the non medical drug problem, the commission makes specific recommendations with regards to the specific nature and response to Opiate narcotics. Many of the recommendations made with regards to opiates and how users and addicts should be treated hints at the harm reduction methods and even safe injections sites of the decades to come. Le Dain lays out an effective step by step plan for the creation of policies which, unlike almost all their predecessors, do not write the addict off as worthless but rather return the addict to the centre of the equation. At the head of all this he lays out a plan which he titles “The Priorities of Social Policy.” These should not be misread as sweeping measures for all of Canada’s social policy, rather they offer
three important directions and priorities around which policies regarding opiates must be shaped. They are “1. The prevention, as much as possible, of the further spread of opiate narcotic use and addiction. 2. The treatment of the user or addict to render him less socially dangerous. and finally 3. The treatment of the user or addict for the purpose of improving his chances of being a useful member of the community and of improving the quality of his life.(Le Dain, 264)” These directives lead clearly to a system which does not punish the user or castigate the addict but rather leads to a system where harm reduction is prized above all; where the government recognizes that drug addiction is a mental illness and not merely an act of social deviance and should be therefore treated as such. So that the best solution to any of the problems outlined in this paper and by the commission itself. It is one where they offer harm reduction not only to the addict but also to those around them. Shifting the attention of the paper to the city of Vancouver one can view and see examples of this sort of ‘harm reduction’ policy making strategy in practice.
In the year 2000, after literally decades of failed
attempts to clean up the east side, then mayor of Vancouver, Philip Owen, drafted an emergency plan which followed the model of harm reduction. It was called: “A Framework for Action: A Four pillar Approach to Drug Problems in Vancouver.” In the plan there is a firm strategy for finally attempting to solve the cities century old struggle with addiction. In his introduction to the report, then mayor Philip Owen describes the situation at the point of the writing of the report, “Since 1993, Vancouver has averaged over 147 illicit drug overdose deaths per year. Many of these occur in the Downtown Eastside, as well as in other neighbourhoods throughout the city. Hundreds of individuals have contracted HIV and hepatitis C from injection drug use and the fear of drug-related crimes in the city has increased. These trends must stop. We cannot ignore this issue. We cannot incarcerate our way out of it and we cannot liberalize our way out of it. Rather, all levels of government must play their part in managing it. What we need
is a balance of public health and public order.(Owen; Macpherson, 4) The four pillars of the plan are as follows. Pillar one: “Prevention, involves education about the dangers of drug use and builds awareness about why people misuse substances and what can be done to avoid and to prevent addiction.(Macpherson, 7)” The first pillar covers education around drug use and seeks to prevent youth from falling into the clutches of addiction. The second works in tandem with the first and its treatment, “Consists of a continuum of interventions and support programs that enable individuals with addiction problems to make healthier life decisions about their lives towards abstinence. These programs include but are not limited to: detoxification, outpatient counselling and treatment as well as housing, employment, social programs and life skills. (Macpherson,6)” The third pillar deals with the more practical and governmental side of the problem, that is managing the situation. So naturally this third pillar is Enforcement. Enforcement strategies are key to any drug strategy. In order to increase public order and to close the open drug scene in the Downtown Eastside, more effective strategies will include increased efforts to target organized crime, drug houses and drug dealers and improved coordination with health services and other agencies to properly link users and addicts to available programs throughout the Vancouver region. Finally, the forth pillar, Harm reduction is without doubt one of the most important pieces of the puzzle. “Harm reduction is a pragmatic approach that focuses on decreasing the negative consequences of drug use for communities and individuals. It recognizes that abstinence - based approaches are limited in dealing with a street entrenched open drug scene and that the protection of communities and individuals is the primary goal of programs to tackle substance misuse.(Macpherson, 7)” This concept comes directly from the language used in the Le Dain commission mentioned earlier and as such marks a fundamental shift in the ways in which policy makers think about drug addiction. That is, that policy should be drafted with considerations for both the addict and society
as a whole. It is therefore quite clear that policies of the past, which sought to deal with one to the exclusion of the other, did not succeed for this reason.
As part of the “Harm
Reductions” strategy which came out of the aforementioned report, the creation of a trial safe injection facility is recommended. That is the creation of a safe clean place where addicts and users could come with their own heroin, receive a clean hypodermic needle and under the supervision of a medical professional, inject their heroin. Doing it in this manner obviously prevents the spread of various diseases such as HIV and AIDS. Such sites have already been established to great success in Berlin, Amsterdam, Wellington New Zealand, throughout Australia and in Switzerland. In all of these locations and subsequently at the Vancouver facility addicts would be able to use their substance at very little risk to others and more importantly to themselves. The following passage was taken from Insite's website and describes the process for someone walking into the site off of the street.
“Clients who enter Insite are assessed and
led through a waiting area to a 12-seat injection room where they can inject their own drugs under the supervision of trained medical staff. They have access to clean injection equipment including spoons, tourniquets and water, aimed at reducing the spread of infectious diseases. After injecting, they move to a post-injection room where, if appropriate, staff can connect clients with other on-site services. These include primary care for the treatment of wounds, abscesses and other infections; addiction counseling and peer support; and referral to treatment services such as withdrawal management, opiate replacement therapy and other services. Along with the on-site coordinator, two registered nurses are present at all times with an addiction counsellor and physician support available on-call. Program assistants from our partner, the PHS Community Services Society, help greet and register people, as well as provide peer contact to encourage safe injection practices and orient drug users to use the site.(Vancouver Coastal Health Webpage)”
What sets the Vancouver site apart from others like it is
that the Vancouver site houses other social programs other than the injection site. At the sight there are staff from various detoxification and rehabilitation programs who are there to admit users wishing to become clean and sober right away to their programs. Also, addicts looking for legitimate employment can speak with employment councilors who also have offices at the site. By finding solutions to several of the problems described in this paper, the safe injection site, later named Insite, provided the most viable solution for the East Vancouver community. However it would be a gross misstatement to say that the site was universally popular, as several observers have condemned it as an institution of ‘rabid socialism.’
When the Vancouver Safe injection
site, christened “Insite,” opened in August 2003 it was not fully functional under its terms of reference. For the first three years it would have to be on what was known as a trial. To open Insite in the first place the Vancouver Coastal Health had to get the plan approved by the Canadian Supreme court as the site technically violates “The Controlled Drugs and Substances Act.” The site was obviously initially approved with some slight provisions. For the first thee years of its existence the site was considered as a ‘trial run.’ At the end of the three years Insite would once again come before the court. In the trial period the site was charged with the task of carrying out sufficient research around harm prevention and safe injection facilities to build a sufficient case to return to the Supreme Court in 2006. In 2006, when the trial was slated to expire, Health Minister Tony Clement extended the deadline another six months until December of 2007. In the months leading up to the deadline there was an academic stampede and virtual media frenzy which exploded on both sides of the issue. During the onslaught both the federal government and the RCMP funded reports against the site. One such report was published in March of 2007 by a social policy think tank called the institute for Global Policy Studies. In the report author Colin Mangham attacks the constitutional grounding for the report as well as questioning the success of the various other sites in
the world, compared to the success of tougher laws and more enforcement.
As well it
was widely speculated in the Vancouver newspaper the Georgia Straight that with a wave of new senate and supreme court appointments, the prime minister was attempting to end Insite and subsequently we saw the effort by government to find a way to clean up the Eastside by increasing policing and by making the prohibition of these substances much more strict. On October 2, 2007, Minister Clement once again extended the research period until June of 2008. In April of 2008, less than three months before the site was to go before the Supreme Court, “ The Vancouver Area Network of Drug Users and the Portland Hotel Society mounted a constitutional challenge to the federal government’s power to close the facility, arguing that the site addresses a public health crisis.(Vancouver Coastal health website)” As a result “On May 27, 2008, Justice Ian Pitfield of the B.C. Supreme Court ruled that the federal government does not have the authority to close Insite. Justice Pitfield granted Insite an immediate exemption and gave the federal government until June 30, 2009, to amend the country's drug laws to allow for medical use of drugs if tied to a health care initiative. (Website)” Currently the federal government has further extended the trial and are waiting on an appeal of the Pitfield ruling scheduled for April 27th of this year. Bibliography1. Anderson, Kay, J. Vancouver’s Chinatown: Racial Discourse in Canada, 1875 - 1980.
Kingston. McGill-Queen’s University Press. (1991) 2. Carstairs,
Catherine. Jailed For Possession: Illegal drug use, regulation, and Power in Canada 1920 - 1961 Toronto. University of Toronto Press. (2006) 3. Elliott, Richard. Malkin, Ian. Gold, Jennifer. Establishing Safe Injection Facilities in Canada: Legal and Ethical Issues Canadian HIV/AIDS Legal Network. (2002) 4. Le Dain, Gerald, et al. The Final Report of the Commission of Inquiry in the Non-Medical Use of Drugs Ottawa, Government of
Canada. (1973) 5. Macpherson, Donald. “A Framework for Action: The Four Pillar Approach to Drug problems in Vancouver.” Vancouver, City of Vancouver. (2001) 6. Macpherson, Donald. and Mulla, Zarina. “Preventing Harm from Psychoactive Substance Use.” Vancouver, City of Vancouver. (2005)
7. Murphy, Emily F. The
Black Candle Toronto. Thomas Allen. (1922)8. Roy, Patricia. The Oriental Question: Consolidating a White Man’s Province, 1914 - 1941 Vancouver, University of British Columbia Press. (2003) 9. Roy, Patricia. A White Man’s Province: British Columbia Politicians and Chinese and Japanese Immigrants, 1958 - 1914 Vancouver, University of British Columbia Press. (1989)