There are politicians, health-care professionals (especially nurses), and lowly bureaucrats who played significant roles in Vancouver’s harm-reduction movement whom I could not give the credit they deserve. Many of these people helped me with my research and I thank them for that and apologize for the unjustified lack of attention they receive in the story I’ve told here. This list includes Coco Culbertson, Tanya Fader, Andy Bond, Darwin Fisher, Dan Small, Murray Bush, Sean McEwen, Nathan Allen, Russ Maynard, Sarah Blyth, Karen Ward, Dianne Tobin, Susan Boyd, Donald MacPherson, Fiona Gold, Irene Goldstone, Heather Hay, Liz Whynot, John Blatherwick, Mark Tyndall, Warren O’Briain, Maxine Davis, Gillian Maxwell, Thomas Kerr, Evan Wood, Julio Montaner, and Lani Russwurm. My apologies to the people who I’ve missed.
Thank you to Dan McLeod, Yolanda Stepien, Matt McLeod, and Charlie Smith for giving me a home base at the Georgia Straight newspaper and an education in journalism. Thank you to Sandy Stepien and Bruce Lupick for always encouraging me to learn new things and to form my own opinions, no matter how much they diverge from your own. Thank you to my love and best friend Cara Foster, for your honest feedback, early edits, and consistent reassurance that this would all eventually work out.
Finally, I am indebted to those who shared their stories to make this book possible. I express my sincere thanks to everyone whose words appear in these pages. To those who live and work in the Downtown Eastside, I also thank you for holding the place together. I love this neighbourhood. I also appreciate the burden it carries in providing space for so many people who ended up here from across Canada and the United States. Thank you for the community you’ve created.
References
For a complete list of references and sources for Fighting for Space, please visit tlupick.com.
Index
abortion rights in Canada, 79–80
Access, Harm Reduction, Overdose Prevention, and Education (AHOPE), 239–41
Ackenhusen, Mary, 362
addiction
and brain chemistry, 164, 166–70, 217–21
and childhood trauma, 163–72
criminalization of (see criminalization of drugs)
dislocation theory, 72
environmental factors, 69–72
pharmaceutical theory, 66–67
treatment
abstinence-based, 23–24. (see also twelve–steps programs)
Four Pillars approach, 16–17, 143, 230 (see also harm reduction)
services triangle (Swiss), 227, 229
Adverse Childhood Experiences Study, 170
AIDS. See HIV/AIDS
Alexander, Bruce, 65–73, 143, 217, 220. See also Rat Park experiments
Ali, Hameed. See Almaas, A.H.
Alleyne, Bryan, 130–31, 255
and Insite, 270, 323
and Livingston, Ann, 131–34
and Vancouver Area Network of Drug Users, 131–34, 186–87, 190–91
Almaas, A.H., 163
Ambrose, Rona, 355–56
Arvay, Joseph, 310–14, 321–22, 356
Australian Injecting and Illicit Drug Users League, 124
Back Alley, 86–90, 92–98, 121, 377. See also IV Feed
Baker, Don, 255
Balmoral Hotel, 378–79
Barnetson, Randy, 122–23, 125
Barrow Gurney Hospital, 40
BC Association of People on Methadone, 189
BC Centre for Disease Control, 95–96, 268
BC Centre for Excellence in HIV/AIDS, 152, 155, 265, 312, 333. See also HIV/AIDS
BC Housing, 327, 329–31, 335, 361, 363–69
Bell, Matt, 19–24. See also Team Recovery
Bernstein, Scott, 310–11
Bibby, Jack, 337–39, 362, 367
Blais, Stephanie, 56–57, 62, 214–15
Biology of Desire, The, 217-21. See also Lewis, Marc
Blatherwick, Dr Frances John, 54, 117
Blyth, Sarah, 329–30, 376–77, 381
Bond, Andy, 181, 300–01, 303, 318–19, 328–31, 368, 380
Boston Health Care for the Homeless Program (BHCHP), 237–39
Boyd, Susan, 350–51
brain and addiction. See addiction, and brain chemistry
Brière, Elaine, 187–88, 229, 234
Buchner, Chris, 257, 260, 264, 268, 269–70
Bula, Frances, 274–75
Bush, Murray, 268, 319
Cain, Vince, 82, 112
Campbell, Larry, 17, 82, 90–91, 144, 321
and Evans, Liz, 91–92
and Osborn, Bud, 91–92
as mayor, 245–47, 249–50, 257, 261, 283
Canadian Charter of Rights and Freedoms, Section 7, 296–97, 308–09, 315–17, 325–26
Canadian Drug Policy Coalition, 350, 385
carfentanil, 377, 385. See also fentanyl, opioid epidemic
Carnegie Community Action Project (CCAP), 141, 149
Carnegie Community Centre, 29, 31–32, 81–84, 90, 98, 105–06, 120, 122, 141, 151–52, 155, 224–25, 252, 294, 373
Carrall Street Centre for Compassion, Solidarity, and Resistance, 246
Carrall Street injection site (327 Carrall), 246–49, 272
Castillo, Tessie, 175–76
CDSA. See Controlled Drugs and Substances Act
Charlie, Janet, 373, 380
Charlie, Tyler, 373, 380
Chartrand, Michel, 274–75
Chettiar, Jill, 248–49
childhood trauma. See addiction, and childhood trauma
Childs, Robert, 173–76
Chinatown Merchants Association, 245
civil rights. See Canadian Charter of Rights and Freedoms, Section 7
Clark, Bradley, 275
Clark, Christy, 338
Clement, Tony, 300, 303, 318, 325–26
Coambs, Robert, 68
Coast Mental Health, 147
cocaine, 47, 52–53, 57, 130, 151, 159, 167, 344, 376, 383
Coleman, Rich, 363
Colony Farm. See Forensic Psychiatric Hospital
communicable diseases. See names of specific diseases, e.g., hepatitis C
Community Alliance, 190, 243–45
Conroy, John, 296, 309, 326
Conservative Party of Canada, drug policy, 299–300, 317–18, 355–57
Constantine, Dow, 288
Controlled Drugs and Substances Act (CDSA), Section 56, 264, 271–73, 299–300, 304–05, 308, 315–16, 325–26. See also criminalization of drugs
Cort, Robert, 191
Crawford, Craig, 336, 361
criminalization of drugs in Canada, 16, 34, 54, 73, 87–88, 170–71, 313 (see also Controlled Drugs and Substances Act)
in the United States, 67, 258–59
Crosstown Clinic, 353–57, 359, 384–86. See also NAOMI; SALOME
Crowe, Earl, 197–200
crystal meth. See methamphetamine, crystal
Culbert, Lori, 90
Culbertson, Coco, 156–60, 324, 368
Daly, Dr Patricia, 259–60, 310, 322, 367–68
Daniels, Steve, 173–74
Davies, Libby, 113–14, 263, 321
and “Killing Fields” protest, 115
and Osborn, Bud, 114–15, 117–18, 261, 370
and Vancouver Area Network of Drug Users, 123, 370–71
Davis, Maxine, 211
Deloitte, 361
Demarais, Lou, 52–53, 86, 95. See also Vancouver Native Health Society
DERA. See Downtown Eastside Residents Association
DEYAS. See Downtown Eastside Youth Activities Society
diacetylmorphine. See heroin, prescription
Diewert, Dave, 109, 246–47
Dilaudid, 303, 384
dopamine incentive-motivation apparatus, 167. See also addiction, and brain chemistry
dopamine system, 166–68, 218–19
Downtown Eastside Residents Association, 43–44, 75, 105–06, 113, 135–36
Downtown Eastside Youth Activities Society, 52–54, 86, 97, 149. See also Turvey, John
Dr Peter Centre, 211–12
Drennan, Constable Anne, 96
drug overdose
deaths, 17 (see also opioid epidemic)
in Florida, 101
in Massachusetts, 238–41
in Ohio, 20
in the United States, 15, 20, 238
in Vancouver, 55–56, 87, 91, 95–96, 128, 185, 374
prevention and reversal, 342, 375–86 (see also Overdose Prevention Society)
Drug Policy Alliance, 343–44
Dunlevy injection site (213 Dunlevy), 196–200, 208–09
Edel, Uli, 59
Eggman, Susan Talamantes, 343–44
Erickson, Arthur, 137, 214
Eriksen, Bruce, 113–14
Eror, Melissa, 81-82, 85–87, 93, 96–98, 127, 130
Evans, Emyr Wyn, 42–43
Evans, Jane, 42–43, 47, 215–16
Evans, Liz, 38, 162, 255, 316
and “Killing Fields” protest, 108–09, 113
and Insite, 273–77, 304–05, 319–24
and Livingston, Ann, 84
and Osborn, Bud, 107–08, 370
and the Portland Hotel/PHS, 43–44, 55–56, 61–64, 108, 113, 135–36, 136, 138–40, 139, 142, 153, 214–16, 250, 332–33, 336, 361–69, 387–93
and the Hair Salon, 255, 258–59
and Townsend, Mark, 37–39, 157, 369
arrival in Vancouver, 39
childhood, 42–43
nursing practice, 39, 41–42
Evans, Sarah, 232–33
Ewart, Chris, 376–77
Fader, Tanya, 141–42, 149, 189, 299–302, 332, 368
fentanyl, 15, 237–38, 344, 374–85. See also fentanyl, opioid epidemic
Fisher, Darwin, 138–39, 158, 278–79, 368
Fix: The Story of an Addicted City, 106, 231–35, 261, 283. See also Wild, Nettie
Forensic Psychiatric Hospital, 60–61, 146
Four Pillars framework, 16, 143, 226, 230–31, 245, 247, 282, 374. See also addiction, treatment; harm reduction
Four Sisters Co-op, 75–76
Foursquare Church, 122–23, 125, 131
Framework for Action: A Four-Pillar Approach to the Drug Problems in Vancouver, 230–31
Freed, Joshua, 288
Frinton on Sea, 37–38, 42, 216
From Grief to Action, 203–08
Fry, Dr Hedy, 228–29, 271–72, 321
Gaeta, Dr Jessie, 237–39
Gaeta-Hildebrandt, Angel (Molly), 387–93
Gaeta-Hildebrandt, Mikel (Jr), 387, 392–93
Gandhi, Mohandas, 293–94
Gold, Fiona, 95–96, 208–10, 213
Goldstein, Avram, 66–67
Goldstone, Irene, 207–09
Graham, Jamie, 295, 320
Grant, Kevin, 138
Green, Jim, 43–44, 135–36, 391
Hadaway, Patricia, 68
Hair Salon. See Portland Hotel Society, Hair Salon
Hall, Nichola, 207
HaRAS. See Harm Reduction Action Society
Hari, Johann, 25, 107, 134
harm reduction, 16–18, 143, 165, 220–21, 230, 235. See also Four Pillars; drug overdose, prevention and reversal
and Portland Hotel Society, 140, 143, 149, 156, 159, 165
defined, 16–17
HaRAS proposal, 211–13
in California, 341–44
in Florida, 101–03
in Frankfurt, 142–44, 225–26
in Massachusetts, 239–41
in North Carolina, 174–75
in Seattle, 285–89
in Switzlerland and Germany, 225–26
in Vancouver, 16–18, 54–55, 107, 122, 124 127–28, 127–28, 138, 140, 154, 194–95, 198, 200, 206–07, 227–31 (see also Insite; Keeping the Door Open; Out of Harm’s Way; Vancouver Area Network of Drug Users)
opposition to, 189–93, 243–45
Harm Reduction Action Society, 210–13
Harper, Stephen, 299–300, 317–18
Harrison, Scott, 352
Hay, Heather, 128–29, 250, 257, 264, 267, 269, 271, 309–10, 367
Health Canada, 305, 356
Health Quest, 254–56
Helsinki Declaration, 351
hepatitis C, 53, 102, 128, 165, 174, 211, 246, 263, 278
heroin, 15–17, 22–23, 34, 53, 59, 65–67, 70–71, 91, 96, 168, 346, 374
prescription, 348, 350, 355–59, 384–86
and methadone, 346–48, 352
Heroin and Prescription Opiate Addiction Task Force, 288
Herrman, Hannes, 143
Higgon, Duncan, 380
Hildebrandt, Mikel, 391–92
Hinkson, Chief Justice Christopher, 356
Hirsh, Dr Alana, 198–99
HIV/AIDS. See also BC Centre for Excellence in HIV/AIDS
in Canada, 108–09
in Vancouver, 33, 53, 95, 97, 109, 116–17, 207–08
in Florida, 101
in North Carolina, 174
HIV/AIDS Care Coordinating Committee, 207–08
homeless people, 30, 92, 136, 150–51, 237, 272, 291, 293–95, 328–30. See also Portland Hotel (Pennsylvania)
Homeless World Cup, 329
housing first policy, 139–40
Hudlin, Ron “Spanky,” 92–93, 98
Hundred Block Rock, 29, 251. See also Osborn, Bud
hydromorphone. See Dilaudid
IDEA (Infectious Diseases Elimination Act) Exchange, 101–03
impulse-regulation apparatus, 167–69. See also addiction, and brain chemistry
In the Realm of Hungry Ghosts: Close Encounters with Addiction, 166, 177. See also Maté, Gabor
Indigenous peoples, 69–70, 72–73, 77–78
injection sites. See supervised-injection sites and specific names, e.g., Insite
Innovative Empowerment Society, 82–84
Insite, 17, 273, 299–303, 306–07. See also supervised-injection sites
and Portland Hotel Society, 250–79
and Vancouver Area Network of Drug Users, 269–70
benefits, 278–79
design, 266–68
exemption from Controlled Drugs and Substances Act, 299–300, 304–16, 319–26. (see also Canadian Charter of Rights and Freedoms, Section 7)
opening, 271–77
origins, 213, 256–66
International AIDS conference 2006, 299–300
International Harm Reduction conference, 225
intravenous drug use. See opioid epidemic; names of specific drugs, e.g., cocaine, heroin
IV Feed, 85–90, 93, 95, 97–98. See also Back Alley
Jack, Mary, 15, 387–93
Jack, Molly. See Gaeta-Hildebrandt, Angel (Molly)
Jaffe, Dr Jerome, 70–71
James, Liz, 95
Jardine, Angela, 144–45
Kay, William, 82–84, 85–90, 93–94, 97–98, 106
Keeping the Door Open conference, 208–09
Kerr, Thomas, 211–13, 265–66, 312–13
“Killing Fields” protest. See protests
Kinghaven Treatment Centre, 120
KPMG, 361, 365, 367
Kral, Alex, 341–43
Kwan, Jenny, 228–29, 271–72, 321
Lake, Terry, 381–82
Lam, Phong, 153, 185, 255–56, 300, 318
Lampkin, Hugh, 379
Laviolette, Tom, 140–41, 186, 362–63, 366–67
Lee, Kwan, 252–54
Lee, Richard, 244–45
Lewis, Marc, 217–21
life, liberty, and security of person. See Canadian Charter of Rights and Freedoms, Section 7
LivingRoom Drop-In, 125, 132. See also Lookout Society
Livingston, Ann, 75–80, 83, 133, 193, 211–12, 233, 320–21, 376, 381
and Alleyne, Bryan, 130–34
and Back Alley/IV Feed, 85–90, 95, 97–98
and Eror, Melissa, 82, 85
and Evans, Liz, 84
and From Grief to Action, 205–07
and Insite, 269, 272, 324
; and Kay, William, 82–84
and Keeping the Door Open conference, 208–09
and NAOMI and SALOME trials, 345, 349
and Osborn, Bud, 83, 105–06, 109–10, 116–17, 119–20, 122, 131–33, 182–83, 200–01, 205–06, 231–32, 369–70
and Overdose Prevention Society, 377–78
and Pivot Legal Society, 291–92, 296
and Roe, Gordon, 195–96
and Townsend, Mark, 84
and Vancouver Area Network of Drug Users, 119–24, 151, 189, 246–49, 269
and Wild, Nettie, 231–32
and Wilson, Dean, 184, 209–12, 235
Livingston, Dorothy, 77–80
Livingston, Ed, 77
Livingston, Joey, 233, 235, 246, 249
Lock, Kurt, 346, 353
Lonesome Monsters, 34. See also Bud Osborn
Longhurst, Grant, 190
Lookout Society, 56, 125–26. See also LivingRoom Drop–In
Lowe, Karen, 174–75
Lux, Steffen, 143
MacDonald, Dr Scott, 352, 355–57, 359
Mackenzie, Brian, 124–26
MacPherson, Donald, 120, 224–27, 229–31, 322, 350, 385
Martin, Leah, 317–18
Maté, Dr Gabor, 163–64, 217
and Portland Hotel (Pennsylvania), 161–66
and theories of addiction, 163–72, 220
Mathis, Michelle, 173–76
McCurdy, Ed, 150, 156, 159
McEwan, Sean, 260–61, 266–68
Medlock, Harold, 176
mental illness. See persons with mental health issues
methadone, 15, 23, 65, 165, 173, 189, 225, 227, 233, 237
and heroin, prescription, 346–348, 352
methamphetamine, crystal, 220, 246, 249, 329, 344
Miloscia, Mark, 288
moratorium on services for drug users. See harm reduction, in Vancouver, opposition to
Murphy, Shilo, 285–87
Murray, David, 258, 345–46, 348–51, 354
Murray, Ed, 288
naloxone. See Narcan
NAOMI (North American Opiate Medication Initiative), 346–49, 354, 358–59. See also SALOME; Crosstown Clinic
NAOMI Patients Association, 349–51.
Narcan, 23, 173, 238–39, 374–75, 378–79, 383
Narcotic Addiction Foundation of BC, 65
Fighting for Space Page 41