Underground Safe-Injection Site Forced to Close: Vancouver health authority shuts down unsanctioned drug user-run site in the Downtown Eastside
By William Damon and Scott Neufeld
On a rainy day last December, a delegation from Vancouver Coastal Health (VCH) delivered a letter to the Vancouver Area Network of Drug Users (VANDU) ordering the organization to “cease and desist” fromoperating an unsanctioned supervised-injection site in the Downtown Eastside, where members of the drug user group assisted other people to inject illicit drugs. It was a harm reduction service that was widely known and used by hundreds in the Downtown Eastside and had been operating for four years, but flew under the radar of many in the city, and did not have government approval.
VANDU started its unsanctioned, unfunded, peer-run supervised injection service out of a repurposed office room in their Hastings Street storefront “at least four years”, says its president Hugh Lampkin. Unlike the other safe injection sites in the city, Insite and the Dr. Peter Centre, no nurses were present.
VANDU—a grassroots organization of current and former injection drug users—began operating the site as a “humanitarian response to an unmet need,” according to Lampkin, specifically the needs of the approximately 40 per cent of IV drug users who sometimes require assistance injecting, a service that Insite and other supervised injection services cannot legally provide.
For four years VANDU quietly offered a safe space, clean supplies, and the watchful eye and occasional assistance of a trained peer support worker (current and former drug users) for an estimated 50 to 100 injections a day.
In an interview with Megaphone, VCH Chief Medical Health Officer Dr. Patricia Daly explained that, as VANDU’s funder, “VCH could not support an operation that was not run according to VCH best practices and that might put clients at some risk.” She did not expand on how long VCH had known about the peer-run injection service, or why the health authority ordered it to close when it did. “We found out about it—we were advised about it by City of Vancouver staff,” she says.
Daly added that VANDU’s supervised injection site could “jeopardize [VCH’s] application with Insite [Vancouver’s supervised injection facility in the Downtown Eastside] and the Dr. Peter Centre [a residential care and treatment facility for people with HIV/AIDS in the West End],” referring to ongoing efforts to obtain legal recognition from the federal government for existing supervised injection services.
VCH’s decision to close VANDU’s unsanctioned supervised injection site is the latest chapter in long-running tensions between controversial, but research-tested, peer-run models and more professionally driven approaches to harm reduction. A peer-run site improves outreach, but increases other risks. However, unlike past episodes of this ongoing debate, VCH is in uncertain and politically fraught negotiations with the federal government to protect the legal standing of existing harm reduction infrastructure in the city, which puts the future of any such a program in prolonged purgatory.