The stories outlined in these animations are fictional, but they are based on real situations faced by thousands of drug users in Vancouver. The characters’ stories also illustrate some of the harm-reduction services typically offered to drug users in Vancouver.

The three animations show drug users who inject and smoke their drugs. According to Vancouver Coastal Health (2007 statistics) there are about 14,000 intravenous drug users (IDUs) in Vancouver. Sharing needles puts drug users at risk of contracting HIV or Hepatitis C. The lifetime cost of treatment for HIV is $250,000: among injection drug users, 17- to 31-per-cent (depending on the cohort studied) are HIV positive. Vancouver has the highest rate of HIV infection among drug users in Canada. The cost of treatment for Hepatitis C is about $30,000 annually but successful treatment rates are low for IDUs, around 40 percent. The rate of Hepatitis C infection among Vancouver IDUs has been reported from 63 – 92 percent in different cohorts. Regardless, Vancouver’s rate is higher than BC’s or Canada’s.

In the animation, the character Martin visits a needle exchange. From April 1, 2006-February 15, 2007 (10.5 months) 2,416,900 sterile needles were distributed in Vancouver (Vancouver Drug Use Epidemiology, June 2007). In Vancouver, clean needles are available through Community Health Centres, Vancouver’s Supervised Injection Site Insite, the Mobile Access Project van, and from street nurses. Users may turn in their used needles at all of those sites, or they may drop them into one of the 27 needle return boxes located in the Downtown Eastside. There is also an emergency number residents may call, if they find a needle, to request a needle pick-up.

In the animation showing Carmen’s story, Carmen dies of a drug overdose. In Metro Vancouver in 2007, there were 30 illicit drug overdose deaths (Emergency Management BC, June, 2008). Carmen’s friend works at Insite, Vancouver’s Supervised injection site. At Insite, which opened in 2003, drug users are offered supplies such as clean needles, sterile water and alcohol wipes to inject their own drugs, while being observed by nurses. Between April 1, 2004 and March 31, 2008, there were 865 overdoses at the site, with no fatalities (Vancouver Coastal Health). Insite nurses also provide healthcare, such as abscess care, to users.

(Abscess care helps users to avoid developing serious infections that could require a course of antibiotics that could last six weeks and require an extended hospital stay.) For many drug users, this is their only connection with the healthcare system. After injecting, users wait for about 15 minutes in the “chill out” room, where counsellors talk to users about their drug use. This has resulted in an approximately 30-per-cent increase in references to addiction treatment in Vancouver.

In the animation, the character Alan is a crack smoker. This puts him at risk for contracting infections (such as Hepatitis C) from sharing pipes, and severely weakens his immune system and overall health. Some cities offer safer crack-use kits, which include materials such as plastic tubing for mouthpieces, glass stems, metal screens and push sticks. Such kits are believed to cut disease transfer and help users avoid cuts and burns, which can become seriously infected.

The City of Vancouver’s Drug Strategy is based upon a four-pillar approach to drug problems, including treatment, prevention, enforcement and harm reduction. The principles of harm reduction require that we do no harm to those suffering from substance addiction and that we focus on the harms caused by problematic substance use, rather than substance use per se. It involves establishing a hierarchy of achievable goals which, when taken step by step, can lead to a healthier life for drug users and a healthier community for everyone. It accepts that abstinence may not be a realistic goal for some drug users, particularly in the short term. Harm reduction involves an achievable, pragmatic approach to drug issues.