editorial comment Crazy Canucks!!! Then again, having heard Walters before......

By MIKE LEWIS
SEATTLE POST-INTELLIGENCER REPORTER

VANCOUVER, B.C. -- Gina R. is small and sick, 100 pounds of furtive need. Sitting in a coffee shop in East Downtown, her collar covers the abscess in her neck where a handful of times this day -- every day -- she injects the heroin that buys her time as it robs it.

She admits she gets heroin money "however I can." This includes panhandling and selling sex, drugs and whatever else she's able to acquire. Articulate and saddled with an outstanding arrest warrant, Gina R. knows her nine-year, $200-a-day habit creates problems beyond her own.

Gina R. injects a hit of heroin in the hotel where she stays on East Hastings Street in Vancouver, B.C. Canada is planning a study in which carefully chosen addicts are given free heroin.
"I'd like not to do this," said the 40-year-old Vancouver native who has failed attempts at rehab and is HIV-positive. "I see what happens to people. I know what they do to feed the monkey."

The cops who patrol this neighborhood, one of the poorest in Canada, know this, too. Same for the health workers who track the alarming infection rates of HIV and viral hepatitis in the swath surrounding the intersection of Main and Hastings, nicknamed Pain and Wastings.

The problem had proved so intractable that the Canadian government is on the cusp of a radical plan, the first of its type in North America, to solve a handful of opiate-addiction problems by perpetuating one of them -- the addiction. Put simply, local health officials here are about to join the ranks of heroin dealers.

Called the North American Opiate Medications Initiative and funded by the federal Canadian Institute of Health Research, the $8 million program will allow health officials in Vancouver, Montreal and Toronto to distribute for free daily doses of heroin to a small, screened group of longtime addicts.

Endorsed by the Vancouver police chief and patterned after similar studies and programs in The Netherlands, Switzerland and Australia, the program's aim is to stabilize addicts as a way to stem drug-related crimes and the spread of blood-borne infectious diseases. Eventually, proponents of the study hope, these people can be treated for the addiction.

Ann Livingston of the Vancouver Area Network of Drug Users speaks with the VANDU Women's Group during a meeting.

Ann Livingston, director of the Vancouver Area Network of Drug Users, said such a program is "vital," to stop the harm addicts do to themselves and others.

"It's going to help," Livingston said from her office that overlooks the intersection where Gina and thousands of other addicts drift by each day. The 10-block neighborhood of pawn shops, vacant buildings and run-down hotels contains an estimated 3,000 addicts. Some put the number at 5,000.

"It's not just a European pipe dream," she said. "It works."

U.S. health and drug officials' opinions of the Canadian program range from guarded interest to open hostility. In the White House's Office of Drug Policy, David Murray, a top aide to drug czar John Walters, said the program is an example of what medicine and governments must never do.

Distributing heroin is a "hazardous posture," for a democratic society as it is medically unethical, he said. "The government becomes an enabler in these circumstances," Murray said. "We have demonstrated that these people can be treated (by other means)."

What's wrong with methadone? he asked.

Answers vary. Addictive drug experts say that no opiate treatment has been studied more than methadone, a synthetic narcotic. Broadly, methadone masks the dopamine depletion caused by heroin. Dopamine is the body's brain chemical link to pleasure. It is released in small amounts when people eat or have sex, for example. Drugs, particularly opiates such as heroin and morphine, trigger tidal waves of it.

A woman who was apparently dealing drugs is arrested recently on East Hastings Street in Vancouver, B.C

An addict is chemically and psychologically driven to replace the depletion.

Taken orally once a day, methadone generally is considered an effective way to wean an addict from heroin, but scientists agree that it does not seem to work for every addict. Moreover, federal restrictions in both the United States and Canada tightly regulate its distribution. Addicts who manage to get in a program complain that it makes them so sleepy they can't lead any life at all.

Results from the heroin-distribution program in Canada will be compared with those from existing methadone clinics. This will determine, in part, if the program is renewed.

Ron Jackson, director of the Kirkland-based Evergreen Treatment Center, said he's interested in seeing how Canada's project turns out. "I'm generally opposed to this approach," he said, "but let's see what happens."

Jackson has worked with thousands of addicts since 1972. Currently, about 3,000 of the 15,000 addicts in King County are in methadone programs. Vancouver also has about 15,000 heroin users.

"Will they do any better than methadone?" he wondered. "Don't fool yourself that (heroin distribution) is going to have a higher probability of rehabilitating an individual."

But rehabilitation isn't the clear objective. As part of an overall response termed "harm reduction," the Canadian program is an extension of clean-needle programs in the United States and safe-injection sites elsewhere, such as those opened in Vancouver last year. Today, 600 addicts a day use the city's safe-injection sites.

The theory is to reduce the social cost of addicts, since they seem to exist in every society regardless of tough laws and treatment services. In European studies of government-sponsored heroin programs, drug crime and HIV spread diminished when compared to methadone clinics. Some critics have questioned the methodology of those studies.


People wander an alley frequented by drug users behind East Hastings Street in Vancouver, B.C., over the weekend.

Vancouver Chief Constable Jamie Graham said that given downtown's high crime, it's worth a try. "The research is based on sound principals," he said of the one-year study. "I'm not a health expert, but it does not make sense for (law enforcement) to not cooperate.

"We all know we can't enforce our way out of this problem."

Graham said his department will track crime statistics in the area as health officials monitor the spread of disease. If there's no improvement, "we'll drop (police support)," he said.

Canadian and U.S. authorities acknowledge the program would be a tough sell in the United States. Through a spokesperson, Seattle police Chief Gil Kerlikowske declined to comment.

Other officials were not so reticent. Walters, acting as a representative of the White House, has blasted Canadian officials as soft on drugs for the decriminalization of marijuana, the injection houses and the recent heroin program, which has been in the works for several years.

Philip Owen, a moderate conservative who was Vancouver's mayor from 1993 to 2002, said he remembers one private, testy luncheon with Walters two years ago.

"He called the injection houses state-assisted suicide. He spewed all kinds of meaningless verbiage. It was the most bizarre meeting of my life. He's not a straight shooter at all.

"All we wanted to do was recognize the user as sick, not a criminal."

Gina R. admits she's both. And she's eager to stop talking so she can get back to work. She woke up dope-sick, and it's going to get worse if she doesn't score soon. Before she walks back outside, she points to the decrepit building across the street. The sign on the walls says "B.C. Collateral: We buy, sell, trade and loan money on anything of value."

In the building's second story, now boarded up, she got her first taste of heroin nearly 20 years ago. She kicked that habit when she got pregnant. When her baby died, experience told her exactly what would ease the pain. It's been nine years since.

"You can't go anywhere, do anything," she said. "This is my world. The amount of money I've spent on this ... I could have gone anywhere. But it keeps you here, like a chain."

P-I reporter Mike Lewis can be reached at 206-448-8140 or mikelewis@seattlepi.com

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