Saturday, December 06, 2008

In Defense of Insite

Stephen McBean of Black Mountain (photo by Femke van Delft). Black Mountain perform in front of Insite on East Hastings today as part of a free concert, also featuring Bedouin Soundclash.

First off, for clarity’s sake: heroin revolts me. The idea of shooting up revolts me. I am not writing this as someone who sympathizes with junkiedom as a "lifestyle choice" or somesuch. I admit that I’m speaking from a fairly middleclass space, but I have a hard time conceiving of anyone decadent, na├»ve, desperate, immature, ill-informed or self-destructive enough to violate the sanctity of their own skin by stabbing themselves in the arm for the sake of a high; I’ve seen people I knew and liked go down that road and felt disgust and horror at the sheer fucking stupidity of their choices - it’s not like the destructive nature of heroin was a secret to them. The social contract, by me, is such that if anyone is so blind to basic self-care as to allow themselves to become addicted to such substances as heroin (or cocaine or meth or whatever - “the harder drugs,” or maybe we should say “the dumber drugs”), they become a liability to society, and by making fundamentally antisocial lifestyle choices - whatever compassion we might otherwise show to them for the miseries and demons that have driven them there - they deserve to lose many of their rights and privileges as “members of society.” The question then becomes how to “manage” such people so that their fucked-up choices have the least impact on the rest of the population.

Case in point: ever gone to St. Paul’s Emergency Room at night? Ever sat in line with a real health complaint behind half a dozen junkies, three of whom have injured themselves in the course of getting high, and three of whom are feigning pain in the hopes that they’ll get opiated - while the doctors, who know exactly what is happening, engage in the charade of investigating their complaint, drawing out the process and forcing the junkies into complete self-debasement and whimpering protestations of agony? It happens that I live right around the corner from St. Paul’s, and have had maybe five occasions to go there over the years; it’s shocked me how routine the above scenario is, and how drawn-out these exchanges can be. At such times, invariably, I’ve thought: Jesus, just shoot them up and shut them up so people who are really sick can get treated! Why draw out the process? To what end do we play this game of denial and delay, pretending that something other than the obvious is going on? Who exactly benefits from organizing our society this way? Not the hospital system; not the junkies; not the people waiting to be looked at by a doctor. It’s insane, and all the players in the game must surely know this.

So though I strongly disapprove of the use of drugs like heroin, I’d go a step farther than safe-injection sites and needle exchanges and such, into dispensing free heroin to hardcore addicts. I’d go even further, to the step of providing them housing and food. To sound vaguely fascist about it, I’d suggest that this housing be somewhat at a remove from the general population, and have a somewhat of an institutional nature: part jail, part hospital, part “retreat” - but if people cannot manage their own lives, such that society is forced to step in, it makes sense that we manage their lives to our maximum comfort, and to theirs. Of course, I’d also support rehabilitation, Life Skills programs, work training, and other government initiatives to help people who wanted to get off drugs and re-enter society to do so. “Punishment” has nothing to do with this picture, however; the idea of “punishing” people for the crime of indulging in self-destructive behaviour is prima facie ridiculous. It’s rather like executing people for trying to commit suicide.

The Conservative government of Canada - here’s hope that we’re soon rid of the fuckers - seem to have a far more Darwinistic/ free market approach in mind to the problem of drugs, where we simply close our eyes and hope that these same people disappear - that they overdose, die of any of a number of diseases, or kill themselves in misery. The belief seems to be that any other approach than sticking our heads in the sand would express “sanction” of the use of these drugs, and remove “disincentives” to their use (as if for the majority of the population a life of addiction, shame and stigma itself isn’t a disincentive). The very rich, among whose echelons politicians normally dwell, can, of course, afford to insulate themselves from the effects of such policies: they can build big enough fences around their backyards that junkies don’t end up shooting up in them. To them, there is no need for a further solution to the problem, since it doesn’t impact them. For the rest of the population - especially if you're middle-or-working class and living in Vancouver - a somewhat more thought-out approach is called for.

Here are five arguments in favour of Insite - off the top of my head:

a) Insite is a first rational step towards managing the problem of addiction in a socially responsible way - to admitting that it exists and that criminalization alone is not a solution, and that something more needs to be done.

b) Insite provides junkies, many of whom are radically disenfranchised, with an avenue back into “normal” society, by putting them in contact with nurses, mental health workers, and others who would be more than happy to help them seek out rehabilitation. It provides a glimmer of normalcy and dignity to people who in many cases are deeply miserable and damaged - and would otherwise have little hope of re-enfranchisement; it provides a basis for change, should they choose to seek it out.

c) Insite, by giving addicts a place to go, keeps junkies from shooting up in doorways and alleys (like the one behind the building where you live, say: the ultimate NIMBY solution is to give people their OWN goddamn backyard to do what they gotta do in). Of course, our drug problem is so huge that even WITH the existence of Insite, I see discarded syringes on the street at the rate of one every couple of months (and I’m sure I’d see a lot more if I lived anywhere in East Van) - but I’d hate to think what Vancouver would be like if Insite were shut down.

d) Insite reduces the spread of disease, deaths by overdose, and other forms of self-harm that junkies inflict on themselves in the pursuit of their highs. It thereby also takes some of the stress off our health care system and reduces the health risks to the rest of us of maintaining a system where HIV, hepatitis and other diseases run unchecked among a portion of the population

e) And whatever my vaguely fascist side says - howevermuch disapproval I feel for drugs like heroin - I believe that every segment of our society has the right to a certain base level of dignity and comfort, even if it has to be provided to them. There is something intolerably degrading and shameful for all of us about maintaining a system where a portion of our society spends their time panhandling for money, rooting through garbage, or ripping stuff off, so that they can buy adulterated and damaging drugs with which to shoot up (with dirty needles?) in alleys or roach-and-bedbug infested rooms with bloodstains on the walls. Maybe it’s just my Christian upbringing, but I think we ARE our brothers (and sisters) keepers, to some extent, and for Vancouverites to allow any among us to live in such squalor reflects very poorly on us. It is not a system that it is in any of our long-term best interests to maintain. We should be ashamed to do so little about a problem that is so obvious - and we should be deeply embarrassed that it will probably take the disapproving eyes of outsiders, come 2010, for real steps to be taken (which may well be of the most ad hoc and short termed nature - the “bus them out of the city” approach; but perhaps not). Our denial is so entrenched that any steps taken to open our eyes and see what is really going on seem like a really good idea, or at least worth a try.

Given all this, the maintenance of Insite seems to be unquestionably in this city’s long term best interests. People with far more knowledge in these matters than myself have said so. It’s not a solution unto itself, but at least it provides us a starting place, a first step. Here’s hoping the doors stay open.
See you at the rally/concert today.
Postscript: more on the concert to be added - it was an impressive event indeed - but the banners around the stage and everywhere on the block reminded me of one other argument for keeping Insite open, that really should be added to the above (since I seem to have missed it): closing Insite will lead to the hundreds of preventable, unnecessary deaths in the very near future. As I believe one of the slogans put it: "In death there is no hope."

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