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Is this what we're doing now?

First, it was "give them needles, it will solve the problem". Well, it did help with some amount of harm reduction, but the Vancouver Downtown East Side (DTES) is still riddled with needles every day despite the painstaking work of volunteers to clean it on a continuous basis.

Turning a blind eye toward the actual opiate consumption in terms of de-facto decriminalization similarly "helped" people not have legal issues, but it didn't help them to not be addicts, or to not be a net drain on the system.

Now don't get me wrong - I don't think time in court or in jail helps these people, or the neighbourhood they inhabit. However, we need to think in terms of impact to the city and to what should otherwise be a beautiful, safe place.

Source: worked in the DTES for years.

> Vancouver’s Downtown Eastside, defined as a de facto colony for people who inject or smoke hard drugs, is smaller than it used to be—maybe half the 20 blocks it used to cover, with condo developments looming on all sides.

Thank God. Really, if you're in Vancouver, go and visit the suburbs of the DTES, just east of Chinatown - if you squint your eyes just right on a nice day, you can see the beautiful Kitsilano-like suburb that it's supposed to be. Close to downtown, livable, this should be a wonderful place to raise a family, except for the fact that anything that isn't nailed down is stolen and you can't let your kids go outside for fear they'll get pricked by a needle and get AIDS.

(OK, maybe it's not that bad on every street, but the sketchy people are everywhere and your bike better have a huge chain or it's gone.)

> On the warm January day when I visited, a lot of people are out, lining the sidewalks of East Hastings Street, a few side streets and many wide alleys off the main artery. Many are openly smoking or injecting drugs. It’s a shocking sight the first time you visit. You get used to it pretty quickly

No, you don't get used to it, not if you actually care about the area, or about your own safety. Meth users are worse than opiate addicts, of course; you never know what a meth user is going to do, they're incredibly unpredictable. Junkies are easier to deal with because they have very little energy, but when they run out of junk they can be problematic, and it's always going to be at the worst time....

So here's the next step toward "solving the problem"

> Tyndall’s plan is for the hydromorphone to be distributed to far more people with far less supervision. He has a $1.4-million, three-year Health Canada grant to test his machines.

Free needles and a place where they can freely be an addict wasn't enough; people walking around with Narcan isn't enough; so now we need to give them the drugs too. What happens when hydromorphone isn't enough, though?

Here's my question. All of these free services are done under the auspices of "harm reduction" - but only to the individual. There's no harm reduction for the neighbourhood, nor for the normal, non-drug-using, non-addict folks just trying to eke out a living there. There's no harm reduction for the city as a whole being impacted by this, by the tax burden of continuing to enable it, and so forth. When does this come into play?

Why must we be so atomized as to focus only on the individual and mitigating their bad decisions, while not really doing anything to focus on the greater societal issue that enabling more and more opiate addicts causes? Tent cities, theft and property crimes, and a general blight upon the city - for what? What the hell do we get out of it?

Might it not be reasonable to say "okay, you can have your heroin, but you can't live here and do it, you have to come to our big facility out in the boonies where the land is cheap and you won't be impacting any locals". Is that so wrong?