“I’ve gone from using hard-core every day and being homeless to having a roof over my head and working,” Thompson says. “With your heroin habit supported, you can start thinking about bettering your life. It gives you a chance to think and get your head back together.”
For years, a small fleet of vans has functioned as a mobile needle distribution system throughout the greater Vancouver area, offering addicts clean syringes free of charge. Crack pipes are sold in vending machines for 25 cents. At Insite, North America’s only legal supervised injection facility, drug users inject heroin, cocaine and methamphetamines, under the watchful care of nurses, at a rate approaching 200,000 visits a year. Last year the facility celebrated its 10-year anniversary.
The February 2014 death of Academy Award winner Philip Seymour Hoffman attracted some attention to harm reduction. New York State — where the 46-year-old actor was found unresponsive with a needle in his arm — is lowering access barriers to a drug called naloxone that counters the effects of an opiate overdose. But the legacy of America’s “war on drugs” makes it politically complicated to get a harm-reduction program like Insite off the ground in the U.S.
Even in relatively progressive Canada, heroin maintenance is controversial.
In October 2013, federal Health Minister Rona Ambrose implemented a regulatory change that closed a “loophole,” as she called it, banning the prescription of drugs like heroin, cocaine and ecstasy. But Vancouver doctors refused to accept what they described as Ottawa’s interference in the treatment of their patients.
On March 25, a local health care provider and opiate users will enter the Supreme Court of British Columbia in a battle with the federal government to continue with the city’s efforts to prescribe pharmaceutical heroin. The plaintiffs are Providence Health Care and five SALOME patients.