Why do we still believe that letting drug addicts "hit rock bottom" is a good thing?

Our densely populated, low-income neighbourhood of the Downtown Eastside in Vancouver has 16,000 residents and about 6,000 injection drug users. Day after day, I’ve seen kind, funny and gentle people lose their families, get sicker, become more isolated a

Including people living with addiction into society should not be revolutionary thinking in 2013. However, in many ways the addict is the modern-day “nigger”, a term used to dehumanise, alienate, torture and abuse a group of other human beings. Today, people who use drugs – “junkies” – are expected to suffer, then blamed when they do, and if they die there is almost a collective sigh of relief.

Understanding the work that my organisation, PHS, does with addicts on the streets in Vancouver can best be explained by introducing you to one of my teachers. Tilly was a waif-like, 40-year-old aboriginal woman who I met in my early twenties. Her hollow cheeks and deep-set dark eyes were childlike, imploring and innocent – in spite of her “experience”. Locked in a room and malnourished as a child, Tilly was addicted to prescription pills by the age of 11. By the time she was 15 she had tried to end her life by slitting her throat with a kitchen knife.

When I met Tilly she was working in the sex trade, injecting heroin and cocaine, and drinking. One night she was raped and beaten, and as I held her in my lap, bloodied and broken, I rocked her like a tiny bird. She told me through her sobs that it was her fault. I felt her emptiness and I understood her cries. Hers were not the cries of a criminal but of a wounded soul who felt her life was worthless.

Our densely populated, low-income neighbourhood of the Downtown Eastside in Vancouver has 16,000 residents and about 6,000 injection drug users. Here, I started running a 70-room housing project in 1991, and for 23 years I have seen the human fallout of our collective ignorance. Day after day, I’ve seen kind, funny and gentle people lose their families, get sicker, become more isolated and die.

The people I have come to know and grown to love have helped me heal myself. My own white, privileged family was not unfamiliar with tragedy. My mother suffered her own pain and left us when I was a child. I knew what it was like to feel empty and alone.

We hear all the time how addicts are selfish liars who steal from their families, cause pain, smash car windows to steal things and get into fights. We have created brutalising conditions that result in addicts being vilified and that cause enormous harm. However, I have also experienced a unique window into the resilience, humanity and strength of people trying to survive while actively addicted.

Throughout the 1990s, alongside my partner and my colleagues, I had to go against the common logic of the day as we wrestled over how to help. We intuitively gravitated to the belief that people might be able to do better if survival wasn’t so hard, and over the years we have succeeded in creating spaces that are tolerant, respectful and inclusive – where people struggling with addiction can live, find social membership, a sense of belonging and the basics.

This flew in the face of the received wisdom that said people had to “hit rock bottom” or society was somehow “encouraging them”.

As the death toll from drugs mounted in 1997, we rebranded our community “the Killing Fields”. The number of drug users developing HIV was on a par with Botswana; meanwhile, more than 400 drug overdoses happened in our province in just one year. The level of grief was profound, so we flew in experts from around the world to talk about things that we could try: supervised injection sites, heroin maintenance, harm reduction.

Drug users themselves used their voices and parent groups spoke out. Brave politicians stood up and some lost their careers. Gradually the public became educated through extensive media coverage and community debates. By 2003, the tide had shifted and on 21 September we opened North America’s first legally sanctioned supervised injection site, or “Insite”, as a partnership between our non-profit organisation and our local health authority. We saw people come in to what felt like a sanctuary – out of the back alleys to indoors, where users could inject their drugs under the supervision of a nurse.

Over these past ten years almost two million injections have happened here, and 14,000 individuals have come in. Each year, 400 referrals are made into treatment. The staff revive, on average, 40 people a month who overdose and not one person has died.

Today, we have a more sophisticated understanding that an individual, while addicted, still has the right to live. We have created places like our dental clinic, art gallery and bank, and social enterprises that are reshaping the landscape. For example, with over 4,500 members, our community bank (a partnership with Vancity Credit Union) offers savings and checking accounts to people who are unwelcome, banned or followed by security guards in conventional financial institutions. New units of housing have been funded by our provincial government, targeting the most vulnerable homeless and addicted.

Health-care services have been established that are relevant to people actively using drugs. Social enterprises have been created to give people – addicted or not – jobs, at the vintage clothing store, chocolate and coffee roasters, art studio and retail store, commercial laundry and pest-control company.

For those of us who remember how dark it felt 20 years ago, there is much to celebrate in Vancouver in 2013. People in our community are living ten years longer.

Tilly was kind, sensitive, gentle and generous, but in the end she died of Aids because no one had cared enough to make sure she had access to a clean syringe. As a society, we told her that her life didn’t matter and she believed us.

It’s time to stop punishing and start creating solutions to the walls of intolerance and hatred we’ve built. These steps, though seemingly small, can create a new social context, one that redefines the addict from a non-person to a person, a criminal to a citizen, someone “diseased” to someone who just needs love, belonging and a community, just like me.

Liz Evans is the founder and executive director of PHS Community Services Society, which helps drug users in Vancouver

Drug users at Insite, a legal supervised injection site in Vancouver. Image: Getty

This article first appeared in the 23 October 2013 issue of the New Statesman, Russell Brand Guest Edit

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The 8 bits of good news about integration buried in the Casey Review

It's not all Trojan Horses.

The government-commissioned Casey Review on integration tackles serious subjects, from honour crimes to discrimination and hate crime.

It outlines how deprivation, discrimination, segregated schools and unenlightened traditions can drag certain British-Pakistani and Bangladeshi communities into isolation. 

It shines a light on nepotistic local politics, which only entrench religious and gender segregation. It also charts the hurdles faced by ethnic minorities from school, to university and the workplace. There is no doubt it makes uncomfortable reading. 

But at a time when the negative consequences of immigration are dominating headlines, it’s easy to miss some of the more optimistic trends the Casey Report uncovered:

1. You can always have more friends

For all the talk of segregation, 82 per cent of us socialise at least once a month with people from a different ethnic and religious background, according to the Citizenship Survey 2010-11.

More than half of first generation migrants had friends of a different ethnicity. As for their children, nearly three quarters were friends with people from other ethnic backgrounds. Younger people with higher levels of education and better wages are most likely to have close inter-ethnic friendships. 

Brits from Black African and Mixed ethnic backgrounds are the most sociable it seems, as they are most likely to have friends from outside their neighbourhood. White British and Irish ethnic groups, on the other hand, are least likely to have ethnically-mixed social networks. 

Moving away from home seemed to be a key factor in diversifying your friendship group –18 to 34s were the most ethnically integrated age group. 

2. Integrated schools help

The Casey Review tells the story of how schools can distort a community’s view of the world, such as the mostly Asian high school where pupils thought 90 per cent of Brits were Asian (the actual figure is 7 per cent), and the Trojan Horse affair, where hardline Muslims were accused of dominating the curriculum of a state school (the exact facts have never come to light). 

But on the other hand, schools that are integrated, can change a whole community’s perspective. A study in Oldham found that when two schools were merged to create a more balanced pupil population between White Brits and British Asians, the level of anxiety both groups felt diminished. 

3. And kids are doing better at school

The Casey Report notes: “In recent years there has been a general improvement in educational attainment in schools, with a narrowing in the gap between White pupils and pupils from Pakistani, Bangladeshi and African/Caribbean/Black ethnic backgrounds.”

A number of ethnic minority groups, including pupils of Chinese, Indian, Irish and Bangladeshi ethnicity, outperformed White British pupils (but not White Gypsy and Roma pupils, who had the lowest attainment levels of all). 

4. Most people feel part of a community

Despite the talk of a divided society, in 2015-16, 89 per cent of people thought their community was cohesive, according to the Community Life Survey, and agreed their local area is a place where people from different backgrounds get on well together. This feeling of cohesiveness is actually higher than in 2003, at the height of New Labour multiculturalism, when the figure stood at 80 per cent. 

5. Muslims are sticklers for the law

Much of the Casey Report dealt with the divisions between British Muslims and other communities, on matters of culture, religious extremism and equality. It also looked at the Islamophobia and discrimination Muslims face in the UK. 

However, while the cultural and ideological clashes may be real, a ComRes/BBC poll in 2015 found that 95 per cent of British Muslims felt loyal to Britain and 93 per cent believed Muslims in Britain should always obey British laws. 

6. Employment prospects are improving

The Casey Review rightly notes the discrimination faced by jobseekers, such as study which found CVs with white-sounding names had a better rate of reply. Brits from Black, Pakistani or Bangladeshi backgrounds are more likely to be unemployed than Whites. 

However, the employment gap between ethnic minorities and White Brits has narrowed over the last decade, from 15.6 per cent in 2004 to 12.8 per cent in 2015. 

In October 2015, public and private sector employers responsible for employing 1.8m people signed a pledge to operate recruitment on a “name blind” basis. 

7. Pretty much everyone understand this

According to the 2011 census, 91.6 per cent of adults in England and Wales had English as their main language. And 98.2 per cent of them could speak English. 

Since 2008-2009, most non-European migrants coming to the UK have to meet English requirements as part of the immigration process. 

8. Oh, and there’s a British Muslim Mayor ready to tackle integration head on

The Casey Review criticised British Asian community leaders in northern towns for preventing proper discussion of equality and in some cases preventing women from launching rival bids for a council seat.

But it also quoted Sadiq Khan, the Mayor of London, and a British Muslim. Khan criticised religious families that force children to adopt a certain lifestyle, and he concluded:

"There is no other city in the world where I would want to raise my daughters than London.

"They have rights, they have protection, the right to wear what they like, think what they like, to meet who they like, to study what they like, more than they would in any other country.”

 

Julia Rampen is the editor of The Staggers, The New Statesman's online rolling politics blog. She was previously deputy editor at Mirror Money Online and has worked as a financial journalist for several trade magazines.