WHERE THE DRUGS ARE

Think of the Downtown Eastside as a giant shopping mall for users and
dealers. At the end of the day, many of the shoppers and retailers head
home to the suburbs.

Vancouver's Downtown Eastside may be the region's most notorious retail
centre for injection drug users of heroin and cocaine, but most of those
addicts live in someone else's neighbourhood. A study published in the B.C.
Medical Journal estimates there are 4,700 injection drug users in the
Downtown Eastside and a total of 12,000 to 15,000 injection drug users
throughout the Lower Mainland.

No one seems to have precise figures, but the available statistics -- and
anecdotal evidence -- indicate every community in the region has been
touched to some extent. Drug overdose deaths in different communities are
one way to measure the impact. The fatal diseases spread through hypodermic
needles and blood-to-blood contact are another. A 1999 study found about 70
per cent of Fraser Valley residents newly diagnosed as having HIV infection
were injection drug users. For the last several years, about 2,000 cases of
Hepatitis C have been reported annually in the Vancouver/Richmond health
region. Yet another indicator are the calls for more drug-treatment
facilities and needle exchange centres in the suburbs. Even a small town
like Port Moody (pop: 25,000) has about 50 youths who use heroin, according
to the city's police department.

Another snapshot: Almost 40 per cent of the 400 people now getting
substance counselling from the West Coast Alternatives in North Vancouver
are cocaine users. Fifteen years ago, the non-profit substance abuse
counselling service saw no cocaine users.

Alan Podsadowski, executive director of West Coast Alternatives, says drug
use isn't limited to the Downtown Eastside. "That's just what gets all the
hype and attention, because it looks like a war zone and makes for nice
sound bites on television."

He says drug use in the suburbs is simply less visible, and injection drug
use isn't the only drug problem.

"There are a lot of people out there who are free-basing and snorting
cocaine who are very addicted, so using needles isn't the only problem we
have."

North Vancouver district Councillor Doug MacKay-Dunn is a Vancouver police
inspector who used to be in charge of police services in the Downtown
Eastside. MacKay-Dunn says injection drug users are very mobile and often
use the SkyTrain system without paying fares to travel to the Downtown
Eastside, where they fence stolen goods, buy their drugs and return home to
inject and sleep it off.

MacKay-Dunn says he used to tell visiting reporters to watch a kid get off
a bus, score some drugs, then get on the bus again. "That bus goes
everywhere," he would tell them. "If you think the drug problem is
localized to just the Downtown Eastside, then you are on drugs."

As a parent, a former school board chair and a veteran cop, MacKay-Dunn
wants to see more services in his community, like a North Shore
detoxification facility or a residential treatment centre for youths, so
local residents don't have to go to the Downtown Eastside and get exposed
to the street scene. But as a municipal politician, MacKay-Dunn knows what
kind of local reaction to expect if a site is proposed: a Not in My Back
Yard protest.

Staff-Sergeant Chuck Doucette, the provincial coordinator of the RCMP's
drug awareness unit, says only a small percentage of the people who use
social services in the Downtown Eastside actually come from that Vancouver
neighborhood. "That's a big bone of contention. If they had the same
services in other municipalities, they wouldn't necessarily have to go to
the Downtown Eastside."

Statistics collected by the attorney-general's ministry show Vancouver city
police make the most arrests in the province for narcotics possession and
trafficking. There were 348 heroin and 1,225 cocaine charges in Vancouver
in 1998. But there were also 547 heroin and 910 cocaine charges elsewhere
in Greater Vancouver, mostly in Abbotsford, Burnaby, the Coquitlams,
Langley, New Westminster, North Vancouver and Surrey.

However, Doucette said those statistics don't reflect how many injection
drug users live in different communities, because police try to target
higher-level traffickers and arrest numbers vary according to how many
officers a police department assigns to drug law enforcement. "It's more of
an indication of what our priorities are in policing."

And even the injection drug population estimates published in the B.C.
Medical Journal in March are admittedly fuzzy numbers.

The article was written by Dr. Martin Schechter of the B.C. Centre for
Excellence in HIV/AIDS at St. Paul's Hospital and Dr. Michael O'Shaughnessy
of the health care and epidemiology department at the University of B.C.
Their estimates are based, in part, on a Vancouver Injection Drug Users
study that began in 1996. The study surveyed about 1,350 users, mostly
through a storefront office in the Downtown Eastside. Of that group, 57 per
cent said they have lived in the Downtown Eastside for most of the last six
months, but another 22 per cent cent lived elsewhere in Vancouver, and
another 15 per cent lived elsewhere in the Lower Mainland, mostly in
Surrey, New Westminster, Burnaby, Maple Ridge, Coquitlam, the North Shore
and elsewhere in the Fraser Valley.

However, the writers concede, they recruited the most high-risk and active
injection drug users and likely over-sampled users who spend a lot of time
in that neighbourhood.

"This is clearly not a group of middle-class people with stable residency
in apartments or homes," the doctors noted. "Many have no fixed address;
many cycle between shelters, [single-room-occupancy] hotels, 'crashing'
with family/friends, and prison."

In other words, injection drug users trying to hang on to their jobs and
live seemingly normal lives in the suburbs, weren't likely to show up on
their rolls.

DEADLY ECONOMICS

Within Vancouver, drug-induced deaths are concentrated in the Downtown
Eastside and adjacent areas. Nevertheless, drugs account for only a small
proportion of the disparity in life expectancy between wealthy and poor
neighbourhoods.

Area Deaths Life Exp. Low Income

Area 1: 30 70/82 32%
Area 2: 62 57/81 52%
Area 3: 17 78/84 30%
Area 4: 7 80/84 20%
Area 5: 18 75/81 34%
Area 6: 13 78/83 31%

Column 1: Average number of drug-induced deaths by Vancouver
neighbourhoods, 1991-98.

Column 2: Life expectancy of men/women.

Column 3: Percentage of population below Statistics Canada's Low-Income Cutoff.