B.C. clinic's free heroin enables addicts to 'have a meaningful life again,' co-ordinator says

Providence Crosstown Clinic in Vancouver's Downtown Eastside gives free heroin to longtime addicts. It's a controversial program, and the clinic's research co-ordinator admits they're enabling addicts. "We are enabling them to have a meaningful life again."

Goal is to give addicts just enough heroin to take away their desire to seek out street drugs

Lisa James, left, 48, shoots free heroin twice a day at Providence Crosstown Clinic in Vancouver's Downtown Eastside. The longtime addict says the controversial harm-reduction program has helped her get her life together. 'My relationship with my daughter is better than it's ever been.' (Leonardo Palleja/CBC)

If you met Lisa James, chances are you'd never guess she injects herself with heroin twice a day.

She's a devoted mom to her daughter Tia, 24, who has a rare neurological disorder that causes tumours to grow on her spine and brain.

She comforts Tia when she's overcome with nausea. She's by her side when she visits doctors.

"My relationship with my daughter is better than it's ever been," says James, 48.

But James says it wasn't so long ago, her days were spent doing absolutely anything to score heroin.

She used to steal hundreds of dollars' worth of meat from grocery stores and sell it on the streets.

She even stole from Tia.

"I took $500 out of her account and because of the lovely girl that she is, she never wanted to make me feel bad," James says. "If someone had told me I would do something so despicable — I never would have believed it."

How I got my heroin

7 years ago
Duration 1:04
Lisa James describes how she supported her habit by pawning her belongings and stealing meat

She says that all changed when she was accepted to the Providence Crosstown Clinic in Vancouver's Downtown Eastside, where she's buzzed in every morning at 9 a.m.

She sits down in a sterile room and injects a syringe full of free heroin into her arm.

"Nobody knows I am an addict," James says. "I share with some people and they are always shocked. 'You're an addict? Really? A heroin addict?' They would just never know. And that's a nice feeling."
Lisa James shoots heroin at Providence Crosstown Clinic in Vancouver. (Leonardo Palleja/CBC)

Crosstown has been operating for seven years and is the only harm-reduction treatment centre in North America where addicts get actual heroin.

The program is for longtime addicts who've been unable to get off opioids using other treatments, including methadone.

Each participant goes through a titration process, supervised by a physician, to determine their tolerance level. The idea is to give addicts just enough heroin to take away their desire to acquire street drugs.

The clinic is at capacity and serves 130 addicts. Research co-ordinator Kurt Lock estimates there are at least 500 opioid addicts in the Downtown Eastside alone who could benefit from the program.
Research co-ordinator Kurt Lock says Crosstown's goal is to stabilize the lives of addicts rather than push them to quit. (Leonardo Palleja/CBC)

He says addicts approach him every day to see if they can get into the clinic.

"I see desperation," Lock says. "When they come and see me, this is their last straw."

Decades of addiction

James got high for the first time when she was 12.

"My grandma, who was actually an opiate addict and probably wasn't aware of that, gave me some Tylenol with codeine in it just to help because I had a terrible headache," James says.

"I just remember the warmth coming over me. I loved it and I wanted more."

After that, James started stealing pills from pharmacies and friends' houses.

"I crushed them up and snorted them, trying to get that feeling again."

In her 20s, she tried heroin.

"I was in heaven, absolute heaven."

Then one night, heaven turned to hell.

She and two friends overdosed.

"I couldn't see for about 20 minutes or so," she says.

Her friend Otis died in the middle of the night.

"It was horrific. I still think about him."

The reality is death is never very far away if you're an opioid addict.

Statistics from B.C.'s coroner service reveal there were 433 overdose deaths across the province in the first seven months of 2016.

Fentanyl, an extremely powerful opioid, was detected in 238 of those cases.

Controversial harm reduction

Conservative Health Minister Rona Ambrose tried to shut down Crosstown in 2013. Her government argued the clinic enables addicts and that the goal should be to get heroin out of the hands of drug users.

It took an order from B.C.'s Supreme Court to keep the clinic open.

Lock agrees that Crosstown enables addicts.

"We are enabling them," he says, "but we are not enabling them to continue doing evil in that simplistic sense. We are enabling them to have a meaningful life again."
These days, Lisa James and her daughter Tia, 24, spend as much time together as they can. (Leonardo Palleja/CBC)

Lock says the clinic's goal is to stabilize the lives of addicts rather than push them to quit.

He says the negative health effects of heroin addiction have nothing to do with the drug itself, but rather what it takes for a user to feed the habit.

He says most addicts forego food, sleep and medical attention in their search for drugs.

"A lot of people, they think that there's something intrinsic within the heroin that's harming people and that's just not the case," Lock says.

"We've been brought up to think of heroin as the killer drug, but heroin itself, if you take it in proper conditions, and you are eating food, and you are getting sleep, there's no reason you couldn't get to live to 100 years old on the drug."

Where does the heroin come from?

7 years ago
Duration 0:19
Kurt Lock explains how the clinic's heroin is sourced and safely brought into the country

These days, James and Tia spend as much time together as they can. They make dinner and go to movies.

"We appreciate the little things together," James says.

Usually when people talk about the "little things," it's because they're trying to savour life. And that's exactly what mother and daughter are doing.

Tia has had several surgeries, but her prognosis is still uncertain.

"She has an army of doctors," James says, "and basically I try to be there for her."

James gets her second shot of heroin in the mid-afternoon.

She insists the treatment has brought stability to her life and without it she wouldn't be able to look for a job. "I did my shot an hour ago," James says. "Do I look high? I am just normal."

It costs British Columbia taxpayers $27,000 for the clinic to supply a year's worth of heroin to a single addict.

The societal benefits are harder to calculate, but James insists, for her, they are crystal clear.

"We all need our moms," she says. "I am able to be her mom."

Controversial Clinic Gives Heroin to Addicts

7 years ago
Duration 11:36
A Vancouver clinic offers heroin to addicts, arguing that it's the best way to help them.


Nick Purdon

Current Affairs Correspondent

Nick Purdon is a Current Affairs Correspondent with CBC News' The National. You can follow him on Twitter at @nickpurdoncbc