CANADA

The deadly streets

Seattle warns its addicts to stay away from Vancouver

JENNIFER HUNTER December 8 1997
CANADA

The deadly streets

Seattle warns its addicts to stay away from Vancouver

JENNIFER HUNTER December 8 1997

The deadly streets

CANADA

FOCUS B.C.

Seattle warns its addicts to stay away from Vancouver

JENNIFER HUNTER

Blood Alley is a laneway in the gentrified Gastown area of Vancouver, just half a block north of East Hastings Street. One of the saddest streets in the Downtown Eastside, East Hastings is a ragged, unfettered market of drugs, drink and despair. And considering its present use, Blood Alley is aptly named. At one end is the Gastown Medical Clinic, where heroin and cocaine addicts can seek help. At the other is Food For Thought, a drop-in centre where intravenous drug users who are HIV-positive can get a free cup of coffee, a muffin and sensible advice. Food For Thought was started last spring by two altruists, Norman Edwards, 38, and Russell Conley, 32, who had been running a free-lunch club in West End Vancouver for people—most of them gay men—with HIV. But then “we began to notice a change in the type of people who were coming for the lunch and how much they were eating,” says Conley. “People were coming back for fifth plates of food. Many were from the Downtown Eastside—they were spend-

ing their money on drugs so they had nothing to buy food.” Conley and Edwards decided to open a space on the east side to provide food and information about HIV. ‘We had no idea it was this desperate,” says Edwards. ‘We thought it was bad—but oooh.”

Bad is putting it mildly. The Downtown

Eastside is being gutted by an AIDS epidemic, spread by drug addicts who are shooting into every part of their body—necks, arms, legs, even groins—then sharing their used hypodermics with others. According to AIDS researchers, this area of Vancouver has the highest rate of new HIV infection in North America. In the first six months of 1997, it stood at 17 per cent, meaning that out of every 100 uninfected intravenous drug users

here, 17 will become infected with HIV every year. The final, shattering statistic is this: over 40 per cent of the 8,000 or so intravenous heroin and cocaine users in the Downtown Eastside are HIV-positive. “HIV is becoming more and more a disease of the poor,” says Steffanie Strathdee, one of the scientists studying the spread of the disease for the B.C. Centre for Excellence in HIV/AIDS.

The problem is so bad that in late October, the Vancouver/Richmond Health Board declared the HIV and AIDS epidemic to be a public health emergency. The B.C. situation has also sounded alarm bells south of the border. Health authorities in Seattle, Wash., where the rate of infection among drug users is only three per cent, have handed out 12,000 flyers to local addicts warning about the dangers of visiting Vancouver. The federal and provincial governments, meanwhile, have promised $4 million, topped off with $700,000 from the health board, to arrest the spread of the disease through outreach programs, stepped-up staff training and increased access to health services.

Doctors first noticed a big jump in the

rate of infection in the Downtown Eastside in early 1996—but were initially at a loss to explain it. They soon learned that drug users were beginning to inject cocaine— exacerbating the problem of shared needles. Heroin users generally need three hits a day to maintain their stuporous high. Cocaine addicts, on the other hand, need at least 20 daily fixes. That means that even with a well-established needle exchange program in place, there can never be enough clean needles to meet the incessant demand. In fact, according to Strathdee, about 10 million needles would be needed each year in the Downtown Eastside to stem the widespread practice of sharing hypodermics.

That is the scenario that met Edwards—who is himself HIVpositive—and Conley when they arrived on the Eastside.

Food for Thought received $100,000 in funding from the B.C. ministry of health. Starbucks provides free coffee and day-old buns and muffins, furniture and equipment. Hemp B.C., an organization that promotes the legalization of marijuana, provides $1,000 a month for juice and fruit. “We wanted to open up a dialogue about HIV and AIDS,” says Conley, an artist who does not have HIV.

“In the drug-using community down here, if you identify yourself as being HIV-positive you | are seen as a threat, you could ¿ get beaten up.” As a result, he S adds, few on the street tell oth2 ers they are HIV-positive—or take precautions to prevent the spread of their illness.

The Food For Thought space at 52 Blood Alley—in what was once an old jail—is tiny, enough for a desk and three tables, a coffeemaker and an array of pastries. On the walls are posters promoting the use of condoms, information about free lunches, advice about coping with AIDS. During one recent morning, Royce Contois, Albert Sutton and Mel Evenson, all denizens of the Downtown Eastside and all HIV-positive, had taken advantage of the drop-in centre, knowing they could sit for a while and be treated like human beings. “This is a good place,” said Sutton, who has been off heroin for two years. “People here aren’t afraid to talk.”

Contois, a 36-year-old aboriginal man from Manitoba, is homeless—and says he has been clean for two months. His wife, Esther, who is also HIV-positive, is in the hospital, recovering from necrotizing fasciitis— the so-called flesh-eating disease. Until he met Edwards and Conley, Contois spent his time getting high on rice wine, $1 pops of

Valium, 50-cent tabs of Tylenol 3, fixes of heroin and cocaine for $10 each. Sutton, 53, whose tattooed arms—complete with schooners and the requisite naked lady— betray his years as a sailor, used to shoplift and prostitute himself. “Anything to get a fix,” says Sutton, who is now on methadone, a prescription substitute for heroin. Evenson, 28, says: “Sometimes, I don’t want to talk about my disease—sometimes, I just want to die.” And sometimes, he can’t stay away from the ubiquitous drugs. “I see a syringe just lying there or people see me and hand it to me, saying there’s no strings attached, it’s free,” Evenson adds.

Edwards and Conley feed them and offer

advice. ‘You drive down Hastings Street and you want to lock your car and roll up your windows,” says Edwards, who is now on disability because he can no longer work as a graphic artist. “But then you start hearing the stories and you want to cry.” And if people need medical help, they send them a few doors down to Dr. Stanley de Vlaming at the Gastown Medical Centre.

De Vlaming is an intense young man, one of the few doctors who practises in the Downtown Eastside and is licensed to dispense methadone. Outside his office one day last week, Andrea, a dark-haired woman in her 20s, did what is called the funky chicken walk, bobbing up and down, weaving like a punch-drunk boxer—a sign that she was high on cocaine. Andrea had not slept for four days; signs of her addiction were also evident in the bloody track marks scarring her legs. Heroin and cocaine are so easy to

get in the area, says de Vlaming, that “you can get them delivered to your door faster than Chinese food.”

De Vlaming has 160 patients who are HIV-positive, most addicted to both heroin and cocaine. His method of treating them is to try first to stabilize them with methadone to ease their heroin addiction and then tackle their cocaine addiction by putting them into recovery programs that will get them off the street and teach them life skills, before turning to their HIV. His practice is run on a drop-in basis—de Vlaming knows better than to expect addicts to keep appointments. But, he says, “a lot of my patients want out of their addiction. Most of them come to me seeking an exit. They don’t want to live like this

anymore—their drug use stopped being fun a long time ago.”

He believes Edwards and Conley “have been a godsend.” Nobody, he explains, “was talking here about AIDS openly. What Norman and Russell did was to start dialoguing with the drug-using community.” And, since Edwards is HIV-positive himself, de Vlaming adds, “he has shown them you can live positively with the disease. He has dispelled the myth that HIV means instant death.” Edwards believes the answer to the AIDS epidemic lies in more education and addiction recovery programs. “What I see here keeps me angry,” he says. Angry enough that even though his doctor has told him he is dying, he will stay here, handing out muffins, dispensing information about AIDS, filling coffee cups until he can no longer even pour. Trying to salvage a few lives. □