The Canadian Press
Camille Bains
VANCOUVER–The smell of rubbing alcohol permeates a tiny room where chronic heroin users inject a pharmaceutical-grade version of the drug three times a day to just feel normal.
Justin Hall, 48, exits the freshly-cleaned injection room at the Crosstown Clinic in Vancouver’s Downtown Eastside after his second visit of the day.
He plans to return in the evening for his third “shift,” the same routine he has followed for two-and-a-half years.
“A lot of people just muscle it, they don’t bother with the veins,” Hall says as the next group of people line up outside the room containing eight orange chairs in front of a counter and a mirrored wall.
Nurses behind a glass wall slide doses of heroin through an opening, dispensing an average of 200 mg of heroin.
Patients must inject the opioid and leave the room within seven minutes before it’s cleaned for the next group.
“It just levels me out,” Hall said five minutes after the shot.
“For most addicts, the use of getting high is a thing of the past,” he added.
“It’s just to keep a person level, just normal.”
About 94 participants come into Crosstown two or three times a day, rotating through a schedule starting at 7:30 a.m. and ending at 10:05 p.m. at the only clinic in North America that provides treatment with supervised medicinal heroin, or diacetylmorphine.
“It’s clean, it’s safe, it’s what I need to get through the day,” Hall said.
“And I’m not being a burden to anybody else,” he noted. “I’m not committing crimes or abusing anybody.
“I’m not hustling for money.”
Hall said he began using marijuana, cocaine, and other drugs at age 18, then became addicted to heroin for 15 years before getting into treatment at Crosstown.
“A lot of people would be dead if it wasn’t for this place, that’s guaranteed, not just because of the fentanyl,” the former construction worker said of the potentially deadly pain-killer that’s often cut into heroin.
The BC Coroners Office says 914 people died of overdoses in British Columbia in 2016–the highest number of annual fatalities in a Canadian jurisdiction ever attributed to illicit drugs, including fentanyl.
Hall said that besides the pure heroin he receives at Crosstown, support services at the clinic have allowed him to leave a single-room occupancy hotel and move into stable housing so his four daughters can visit him.
“There were quite a few years there when I didn’t have much contact with them,” he noted.
“They see that my life has stabilized and I’m able to see them when they come for visits.”
Most people who chronically use heroin don’t take it for the high but to avoid becoming “dope sick” with withdrawal symptoms, such as vomiting, sweating, and diarrhea, Hall said.
“I definitely see myself having a job, working somewhere, making money,” he remarked.
“I may still be going to the program, maybe not going three times a day, maybe twice a day,” he said, adding some Crosstown patients go to work between injections.
Dr. Scott MacDonald, lead physician at Crosstown, said the program was modelled after supervised heroin assistance treatment that started in Switzerland in the 1990s.
“They are now closing clinics,” MacDonald said of the successful outcomes in that country. “They’ve solved their opioid problem.
“With adequate treatment, they basically have stopped recruiting new people into the program.”
MacDonald noted about 15 patients at Crosstown have transitioned to other less intensive treatments, such as methadone or suboxone, as their lives stabilized.
