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Insight on Insite

by Archives October 7, 2008

Darlene Palmer started using drugs at age 11. The victim of abuse, she would spend the next 26 years of her life sometimes homeless, sometimes hungry and always hoping for a fix – wherever and whenever she could get it.
“I couldn’t deal with reality, so I used [drugs] to escape it,” she told the crowd.
An image flashes on-screen of a couple lying sprawled on a bare mattress surrounded by garbage and discarded clothing, wearing next to nothing, looking dazed and confused.
“These are heroin users,” said Gillian Maxwell, introducing herself to an audience of students, teachers and activists last Thursday evening.
This picture is only one of many common to Vancouver’s downtown east side, which in 1997 was declared an emergency zone, with the largest outbreak of HIV ever witnessed within a developed country.
Originally from England, Maxwell’s formal black suit and conservative looks are almost clashing at first sight with Palmer’s funky coloured clothing, unruly blonde hair and more outgoing personality. Palmer has learned about life the hard way, a heroin user on the streets of Montreal; Maxwell’s booksmart knowledge about addiction-related illnesses reveals a more business-like approach.
But both women’s faces light up as they see each other and warmly embrace.
Despite their contrasting looks and history, these two women have a strong common ground: both work hard at promoting harm reduction, to ameliorate drug users’ living conditions.
Maxwell is a trained mediator and negotiator and works as a spokesperson for Vancouver’s safe injection site, Insite, the first health assistance facility of its kind in North America.
Palmer works as a street worker for Montreal’s Cactus centre, where she counsels and guides users addicted to hard substances such as cocaine, meth and heroin – the same background she managed to escape a few years earlier.
Both women promote harm reduction – a pragmatic response that focuses on keeping people safe and minimizing death, disease and injury associated with higher risk behaviour, while recognizing that it may still continue despite the risks.
The harm reduction philosophy, which is supported by the UN drug agency and the World Health organization, maintains a neutral value and humanistic view of the drug user.
“Everybody is a drug user, even if it’s not intravenous drugs. Alcohol, cigarettes, coffee – most of us can barely spend a whole day without consuming some sort of stimulant,” said Maxwell. “I don’t think it’s fair to ostracize intravenous drug users, labelling their addiction a crime or a disease.”
Many, on the other hand, see this view as far too sympathetic, and fear that the harm reduction approach might just encourage people to use intravenous drugs by making it seem socially acceptable.
Insite provides users with both a safe facility and sterilized material to inject the drugs, with medical professionals on hand to assist patients if an overdose should occur.
“It’s not the typical shooting up joint,” admitted Maxwell. “Rather it looks a bit like a fancy hair salon.”
Visitors are greeted in a brightly light, modern reception, and then are shown to a room of minimal design with 12 cubicles neatly lined against the right side of a wall.
After the drug has been injected using only sterilized syringes and antiseptic cleansing, users may then proceed to the “chill out room,” a comfortable area with seats and tables, while still under strict supervision from the nearby health care professionals.
It’s not difficult to see how some might find the Insite process more of an endorsement of risky behaviour rather than a rehabilitation clinic.
Therein lays a major distinction. “The main goal of such a site is not to get people off drugs, it’s to reduce the number of people getting infections,” explained Pierre C

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