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The Shooting Gallery
progressive poverty pimping of the DTES
This place. It feels like death and it reminds me of death. The worst kind of death—the kind that comes too soon after a small eternity of torment + bondage and too little self-actualised joy. Once my stomping grounds for a brief time at a low point in my life when very vulnerable, I now avoid the DTES, Canada’s poorest postal code and a neighbourhood world famous for it’s open drug scene. The beginning of the end of my happy married life happened here. The beginning of the end so many lives happens here. So much life ends here, the landscape has so many tales of human torment and death to tell you. And yet, joy lives here too—you need to look past the veil of ugly worldliness, and into the human beings themselves, you need to see human spirit, you need to see that this is you there as sure it you are you right here.
The pandemic took far too much, from a community that has already given more than its share to Vancouver City. As time passes I believe more than ever that we lack the political and moral will to address the addiction suffering problem in our society because it serves a purpose in the materialist structure of our world here. As long as the payoff exceeds the pain, then no reason exists to change the behaviour.
Let me rephrase that to increase your discomfort level. As long as the payoff of drug addiction to the ruling elite exceeds the cost of suffering to the poor society will make no real evidence-based effort to address addiction. The lower classes always act as a currency for the ruling class. No, I am not a Marxian, whatever that means, just a logical human who sees how the world works.
What is the payoff? Figure that out and you have the answer to a real solution. Because currently the present delusion that drug users entirely cause their own suffering doesn’t represent reality on the ground. No, it is not a lifestyle choice. People turn to illegal drugs that could kill them, knowing they could die from it, because they have nowhere else to turn, they would risk death because they have hit a wall. That’s not a choice, that’s an escape from suffering.
The most egregious abuse I have ever received was a Christian woman who called herself an addiction counsellor telling me your best thinking got you here, she read that in a fcuking book published in the 1950s and she thought it sounded cute. I thought it sounded and felt like an insult. The worst pain you cannot imagine got me there. And so the recovery community can fcuking bite me for it’s spiritual abuse and blaming me for my own suffering. No compassion happening there. You cannot embrace someone when you perch yourself on a pedestal 10 feet above them.
I’m not writing this about me though—not this time. I’m writing this about the contempt that seems to ooze out of everything addiction-relief in this society. We have a collective of patronising pedantic assholes who have so much baggage about sh1t that they cannot handle human suffering. Everything is about these emotionally stunted people who think they are helping anyone with a drug use compulsion that’s draining their life from them, from within. It feels like some kind of classist arrogance at play.
No one would rather end addiction more than any of those poor souls who are right now shuffling around the DTES looking for their next crack rock and hoping not to get bunked. No one wants to end that bondage more than those humans do, I promise you. Slaves don’t choose. This is slavery. Don’t judge what you don’t know. If the social + attachment conditions of your life shifted just so, you could find yourself there too, pushing your steel wool through a narrow glass tube with the long metal shaft of a fondue fork, salivating over your next crack rock that will make you feel like a wild tormented animal within 5 minutes of insufflating it and wondering why you keep doing this to yourself. I imagine it can only feel worse that I have described when you have to jam a needle into you arm or your foot or wherever you can to get your fix. No one wishes for this life. No one chooses this life. You find yourself there.
Overdose deaths exceeded Covid-19 deaths in Vancouver throughout the pandemic. The disproportionate response tells you about the moral judgement which society places on those struggling with compulsive drug use. We congratulate ourselves with a progressive pat on the back, in western elite self congratulatory style, because muh harm reduction. Ok, well I happen to see it as a variant of poverty pimping, but I suppose most elite saviours gravitate toward euphemisms because they provide safety from the ugly + cold reality.
This story will tell you about my experience as a nursing hire at Insite in its inauguration. I have carried this story around for nearly 20 years and I feel like it’s time to just speak my truth. The story I have to tell already exists out there in various forms. Looking back, I can say I have learned a great deal about myself over the past two decades. I cringe for the naïveté of that young woman I was back then, for the blunted and immature compassion that you can so easily revel in, as a helping professional raised in a society founded on saviourism culture. The number of people willing to overlook the blatant corruption and misuse of funds baffles me. Particularly because we were meant to help the poorest and most vulnerable in our country.
On September 21, 2003, Vancouver opened North America’s first legal safe injection facility (SIF) for IV drug users. The Portland Hotel Society had begun lobbying for SIFs in the 1990s and planned to open their own in 2003. All three levels of government supported the concept of SIFs, and the required exemption was given under Section 56 of The Controlled Drugs and Substances Act. The mood was celebratory—Insite was victory for the grassroots movement that lobbied for reforms to improve the lives of drug addicts and reduce overdose deaths.
Disillusioned with the way hospital staff shortages and inadequate health care funding compromised care, I embraced the idea of nursing at Insite. I had high hopes, believing the knowledge and experienced for which I was hired would help me effect positive change. I wanted to make a real difference in the lives of IV drug users by teaching them the techniques I learned as a nurse to keep them safe until they decided to stop. I had a million ideas. And no will at all existed to take the opportunity to actually do anything crazy genius good with this endeavour. Nope. Instead I spent my days wipe down countertops and watching people perform venipuncture on themselves with a fixed needle syringe meant for subcutaneous injections of Insulin.
The 28 gauge, 1/2 inch needle has low dead space, meaning all of the drug leaves the syringe and there is a smaller flash of blood when you puncture the vein, so the logic goes that the risk of disease transmission is lessened when the client re-uses the needle. I’m puzzled. Overall, needle reuse is still associated with disease transmission, fixed needle syringes mean that clients can and will break the needle from the syringe, and any needle shorted than 3/4 inch will not reach the vein—the non-sterile drugs will only reach the subcutaneous layer and this leads to abscesses and cellulitis. Again, I questioned the logic of having a nurse (ie, me) supervise a procedure that did not meet clinical standards. “That’s the way we’ve always done it,” was the reply from the non-clinical person in charge. Well, not in my world it isn’t, I think to myself, Why do you need a hospital nurse, with a clinical focus, if the procedure won’t be done to clinical standards?
Clinical guidelines require a minimum 24 gauge, 3/4 length needle with detachable syringe for venipuncture/IV insertion. Clients inject with a larger, longer clinically appropriate needles at Crosstown Clinic, why the difference? It seems discriminatory, offering clinically appropriate needles to one set of clients and while offering fixed-needle syringes meant for subcutaneous injections to other clients. Insite is based on the Swiss injection facilities, which provide appropriate-sized needles with detachable syringes, have time limits and strict rules for orderliness. Even venipuncture on a feline, where the vein is near the surface of the ear, is performed with a 5/8 needle. Why not offer users the proper equipment? What kind of cost saving does it really add up to, to offer IV drug users subpar clinical equipment in your harm reduction programme? Who is all this for? Don’t answer, I already know.
The injection room at Insite had 12 injection booths, each with a stainless steel countertop, a giant mirror, and a sharps container. Clients checked in upon entering the room and were given a tray with a syringe, a tourniquet, sterile water, cotton filters a tiny cooker and a tea light. Insite was low barrier, to capture as many clients as possible: no time limits and few rules. Saving lives was the manipulative line from PHS bleeding hearts whenever the topic of time limits and more structured facility setting arose. Having the lowest barrier possible supposedly would be the only way to save lives—sacrifice long term gain for short term bandaid solution.
One of the regular clients would bath himself in the sink after injecting himself. Another client would use the injection stall to put on her makeup after injecting. And yet another client would spend hours crawling around on the floor, tweaking. To have a SIF seemed enough for everyone—the alleys were nearly empty back them and everyone just wanted to wallow in the self-congratulatory arrogance. We all preferred to embrace the delusion that we fixed the thing. I ought to have felt grateful that it existed at all—I mistakingly demanded more and better, something I’d always done, particularly as nurse. Thinking had become offensive. I became the problematic one, always demanding better for my patients. Do no harm.
Keeping the addicted alive and then refusing to relieve their suffering felt inhumane—we were like doctors in a MASH unit patching up soldiers and sending them back into battle to sustain another injury or die. The mood felt ghoulishly self-congratulatory, like the victory parties at the end of WW2. Only the war raged on, people continue to suffer and die. From the first day of the three-week training, Insite felt lavish yet toothless—they could have achieved as much or more with far less. It was a spectacle that distracted everyone from the real issue. It seemed to be about celebrating the virtue of the PHS executive. Insite is necessary and meets effective its objective of keeping addicts alive—is that good enough? We’ve slowed the flow of blood from that gunshot wound, we still have to repair it. Imagine if we thought this was enough, that we didn’t have to repair the wound.
I received media training, I’m not certain why a nurse needs to receive media training when she’s preparing to work at a SIF. Insite was very political—we were not permitted to attend the official opening—it seemed like a party for the elite saviours and the odd celebrity. Some notable actors from the CBC show Da Vinci’s Inquest received the privilege of attending the opening hoo-ha. Staff did not. What’s my first clue about this being a show for woke muppets?
I saw so much extravagance and self-indulgence even before Insite opened and, having come from a hospital, it enraged me. On my last shift at the hospital a patient coded—she had an unstable airway and had recently and prematurely transferred from the ICU. I had a patient load of 8 patients and charge nurse duties. The nursing office had refused to provide me with a bedside constant because they wouldn’t bring in extra staff on overtime, the patient broke free from her wrist restraints and dislodged her breathing tube. The crash team resuscitated the patient and my request for a bedside constant was granted. This seemed unnecessary and cruel, to deny proper care in the name of a bottom line.
Yet, there seemed to be funding for an extravagant training program. A posh lunch was provided every day of training, with the occasional Crantini lunch. I could not juxtapose the two scenes in my mind, I didn’t want to. When I asked for additional resources for teaching purposes—one of the roles in the nurse job description—I was told there was no funding. There was no funding for further harm reduction in a harm reduction program. The people that decided there was enough money for Crantinis also decided there wasn’t enough money for actual harm reduction other than policing a shooting gallery.
Also I had just watched someone nearly die in a hospital setting for lack of funds and I was being paid to work as a licensed nurse and being given alcoholic beverages for doing so, paid by this government-funded non-profit organisation. Yeah, I felt fcuking angry I watched my hospital patients suffer an inadequately funded care at the end of their hard working and long lives. And then I come to the DTES where there’s a band of self-serving hipster muppets building castles in the air, giving themselves free alcoholic gourmet-catered lunches and other fringe benefits because they worked so hard. Yeah I felt fcuking gaslit by these woke bleeding heart muppet assholes pimping modern day enslavement to drug dealers for their fcuking CVs and LinkedIn profiles! You bet I did.
This felt disingenuous and more political than anything else. This had always been about averting a crisis, never about addressing the suffering and experience of addiction, which, in the long term, makes true economic + compassionate sense. When I pointed out the extravagance of the training, the derision I encountered confirmed my suspicions. A decade later an audit of the Portland Hotel Society revealed many irregularities in the society’s operation. The province made their continued funding contingent upon the resignation of the entire executive—the same responsible for opening and operating Insite.
How angry do you think I felt reading about the $9K stay at the New York City Plaza Hotel, a $632/night stay that Townsend + Evans made for PHS business? Or the $3.8K Steuzebecher made for a brand new computer and printer whilst visiting Germany? Because it’s totes okay to be a staff of a publicly-funded non-profit travelling and buy yourself new electronic equipment. Or the whole bullsh1t with the basement of their fcuking house? Or the trip to Disney? Like, dude y’all are supposed to be serving the most vulnerable humans in the country’s poorest postal code, and you’re acting like high end executives??
It would seem some people make a career out of feeding their own need for glory by pimping suffering to the vulnerable. Poverty enterprises don’t really help the poor as much as they help the drama triangle muppets which seem to cluster around activism work like flies on honey. After being forced to leave PHS, Liz Evans + Mark Townsend moved to NYC to work in that city’s poverty industry. Did the people of NYC seriously not do a background check? AYFKM?
You see how we actually DGAF about the poor and suffering, how we use them as currency to line our pockets and build our very cool CVs? Fcuk this. This kind of behaviour resembles a kind of predation. The plight of the drug addicted and homeless serve the egos and pocketbooks of middle and upper class elites. What’s the payoff? How much money has exchanged hands and through what channels?
Don’t for one minute believe the harm reduction cult wants to eliminate suffering. That sh1t was never on the table for real. Nah, it wasn’t. Suffering that happens now happens because it serves an interest. Facts. We have the capacity to fix this if we had the will. We lack the will. Classism is the real monster no one wants to acknowledge.
I laughed out loud when I read a quote published after the Townsend-Evans departure from PHS—describing the incoming BOD as the foxes are in the henhouse. LOL, I’m pretty sure a cabal of self-interested poverty pimping entrepreneurs buying themselves fancy trips and new computers whilst pretending to help the people of the poorest postal code in Canada were the foxes in the henhouse! But okay. The incredible thing to me remains the lingering reluctance to call the Townsend-Evans et al thing what is was—corrupt and self serving. Oh they did so much good. They spend $9000 at the fcuking Plaza Hotel in NYC, setting the standards for luxury for over a century. They purchased computer equipment for themselves. They leased out the basement of their fcuking house to the non-profit because sometimes they had meetings there? AYFKM?? How is that good? And, for whom?
I remember attending a very posh party at the Townsend-Evans home, hundreds of people in attendance, in a massive rented tent, food, alcohol, music, the whole deal—did the PHS, ie the taxpayers, pay for that fancy party? How does anyone serving the poor and homeless have such an arrogant, entitled + wasteful demeanour toward their work? My 90 pound, severely post-TB sequelae elderly auntie refused a $10 cab in a Winnipeg January to go feed the sick + elderly because she felt it too extravagant but one of the most aggressive poverty advocates in Canada drops $9K at one of the most expensive hotels in NYC on PHS business because his job is hard and he deserves treats? Oh, okay, muppet.
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I remember leaving my position at Insite feeling gaslit as hell. When people show you who they are, believe them. We see the signs all around us. We see what the actual slow genocide is — it’s allowing people to die and doing nothing to prevent it. Harm reduction with no treatment to back it up and a low threshold facilities to feed the vulnerable drugs is a slow poison. We choose this approach. What purpose does it serve?