The long-time activist Dianne Tobin, formerly associated with many NGOs from the Vancouver’s Downtown Eastside Women’s Action Group to Lifeskills / Drug Users Resource Center, from the British Columbia Association for People on Methadone to SALOME/NAOMI Association of Patients, is currently a board member of CAPUD (the Canadian Association of People Who Use Drugs), but also a regular member of the seminal Canadian users’ organization VANDU — the Vancouver Area Network of Drug Users. When VANDU received the 2017 National Rolleston Award, given to an individual or organization for their outstanding contributions to reducing harm from psychoactive substances at the national level, Dianne was one of the people to accept in on behalf of the Network.
“VANDU is a grassroots democratic organization of people who use drugs, founded in 1998 as a peer-driven response to the failures of conventional health policies in services to address the HIV epidemics in the Downtown Eastside of Vancouver,” said Rick Lines, the Executive Director of Harm Reduction International, at the opening ceremony of the HR17 conference in Montréal this May. “VANDU has been one of the pioneering grassroots, drug-user-led organizations in Canada, inspiring the formation of similar organizations in cities and countries around the world.” They were also fundamental in getting the InSite safe injection project initially set up and running, as well as defending its continuation and expansion in Canada, Lines pointed out.
Dianne was president of VANDU for seven years during the period when InSite was first opened. This year was already the second time in eight years that VANDU received the award. After the ceremony, Mart Kalvet of the Estonian drug users’ association LUNEST asked Dianne a couple of questions.
- Congratulations on the Rolleston Award! As the safe injection site InSite in Vancouver has shown great promise as an effective pilot project, is the same model now being expanded throughout Canada?
- Yes, we’re trying to use the same model, because it works. Why change something that works, right?
- We, drug users, like to say that drug use does not define us, while at the same time we’re unionizing under the umbrella of drug use, trying to unite people whose only common trait may be the use of illegal drugs. Do you see here a contradiction in terms? Can a balance be found between those poles?
- Yes, I believe there is a balance that can be made, just like for any group of people working towards a common goal, like musicians, for example. They’ve got their own group, and they need to work with somebody as a group to get things done. That’s why drug users have been able to survive and to change things by sticking together and self-identifying as nice people who use drugs, not just as “junkies” or something derogatory like that.
- How much is harm reduction a political or ideological movement? Is there — or should there be — a “leftist agenda” behind or around it?
- Right now, the way harm reduction is incorporated into the political paradigm, is mostly Bible-based; its adoption is seen as an ethical and moral issue. But it shouldn’t be that at all — to most people, it’s a medical problem, a health issue, clear and simple. We should not be stigmatized; instead, we should just be accepted as part of the population. There are so many drug users who are doctors, lawyers, etc., and they never come out. They’re not stigmatized, because they’ve got money to hide behind.
- The movement here seems to be much more heavily politicized than it is, for example, where I come from. I’m afraid that if the same were to happen in a post-Soviet country, it would be easy to bend the public perception against the harm reduction movement by painting us as agents of moral relativism, communism, or worse…
- Oh, yeah, and it very well could be! A lot of the mainstream would like to take advantage of our movement’s momentum in unintended ways. I think decriminalizing drugs would be a great step towards countering such inclinations. On some fronts, Canada seems to be moving in that direction — just last week we got a DIN number for heroin. That means that Canadian companies can now produce diacetylmorphine — medical-grade heroin —, and doctors can prescribe it on their own terms. That’s what I’m on now at the heroin-assisted treatment (HAT) program in Vancouver.
- The “They Talk, We Die!” protest organized by CAPUD (the Canadian Association of People Who Use Drugs) during the keynote speech by Canada’s Minister of Health Jane Philpott was really heart-wrenching. What were the reasons behind it — did the government break some promises?
- The government certainly has failed drug users on many occasions. Take, for example, the NAOMI project — the North American Opiate Medication Initiative, a randomized controlled trial evaluating the feasibility and effectiveness of heroin-assisted treatment in the Canadian context. We were put on it for 18 months, and then cut off, just like that. Declaration of Helsinki — the cornerstone document on human research ethics — says that if a study drug that a person gets from a government study program is working for them, you can’t take it away from the person. Yet the government cut us off, just like that.
A bunch of us that were in the NAOMI program started our own group and started fighting; we were going to prepare a lawsuit. And then we heard that the SALOME project — the Study to Assess Longer-term Opioid Medication — was coming up. So, instead of suing the government for scrapping NAOMI, we pulled together and brought the good stuff in to SALOME. So, yeah, they did have an exit strategy, and the exit strategy turned out to be a program which was started a month ago. That’s the program I’m in right now. Around 400 people have been taken off street drugs because of it. Every week now doctors are starting to open up new services where they can prescribe HAT. As long as they have a place and a nurse there to watch people inject, and a pharmacist, that’s all they need now in order to prescribe heroin to a heroin addict. So, things are slowly getting better, but the change is not coming soon enough for some of us.
- But how do you go about changing the general public’s stance? What’s the most effective argument for providing and expanding effective harm reduction services such as InSite and SALOME?
- Money — that’s what really got the people of Vancouver and British Columbia on our side! They compared the costs of keeping a person street-entrenched — you know, expenses on ambulance, the court system, costs resulting from crime, all of that together — with the costs of taking a person off the street and putting them on the program, and it went from 147 000 dollars a year to 47 000 dollars a year. So, right there, people’s minds changed, and they started thinking that maybe this is a little bit more cost-effective than fighting it all the time. People like to think they’re saving money on their taxes!
- I hear that drug user rights and harm reduction advocacy groups in Canada often follow a depressing pattern — they organize in abject misery to fight against abject misery, they find funders, then they start quibbling over the money, and essentially break apart, achieving very little. Can you tell me — a representative of a fledgling users’ association in a country where there have been none — how to prevent such atomization of the scene?
- I don’t think you can prevent it, but you have to learn to work around it, and push the boundaries where you can, where it’s not actually putting you into danger. Oh, yes, there may be a chance of getting arrested, but as long as it’s for a good reason... You need to always keep pushing the boundaries a little bit, because if you don’t push the boundaries, nobody will get anything. They’ll just shove it under the rug, like, “That’s last week’s news.”
For example, at one point in the late 1990s with VANDU, we just started putting up tables with injection supplies, clean syringes and needle disposal bins at the corner of Main and Hastings Streets, the ground zero of the injecting drug use related HIV epidemic in Vancouver’s Downtown Eastside. In 2003, we also opened the city’s first illegal safe injection site. The police kept putting big padlocks on the doors, but we kept taking them off, for two reasons — first, to keep giving users a safe place to inject with clean needles, and second, to see if the police would arrest us, so that we would have a reason to go public and demand safe use rights for drug users from the government.
- The divide between cannabis users and users of other drugs, especially people who inject, is evident everywhere. What do we need to do to make everyone — opioid users, potheads, speedfreaks, psychedelic hippies, club drug enthusiasts, etc. — understand that prohibition forces us all into the same boat?
- You need to keep pushing the envelope and telling the truth! Tell them our story! That’s the biggest thing Canada found: that once we really started telling our stories, things started moving in the right direction. If you don’t tell your story, someone else will, and you won’t like what they say. So, tell your own stories!
About VANDU: The Vancouver Area Network of Drug Users (VANDU) is a group of users and former users who work to improve the lives of people who use illicit drugs through user-based peer support and education.
VANDU was formed in 1998 to bring together groups of people who use drugs. VANDU is dedicated to improving the lives of drug users, their families, and our communities.
VANDU is also committed to increasing the capacity of people who use illicit drugs to live healthy and productive lives. They do this by affirming and strengthening people who use illicit drugs to reduce harms both to themselves and their communities.
They organize in their communities to save lives by promoting local, regional, and national harm reduction education and interventions.
VANDU challenges traditional client/service provider relationships and empowers drug users to design and implement harm reduction interventions.
VANDU believes in every person’s right to health and well-being. They also believe that all people are competent to protect themselves, their loved ones and their communities from drug related harm.
VANDU is committed to ensuring that drug users have a real voice in the creation of programs and policies designed to serve them.