THE FIX A new way of thinking about the intractable problem of injection drug use

published on September 1, 2013 in The Walrus

MATT SLUMPS DOWN in the faded leather chair across from me, his eyes barely open.* We are in a small office at the headquarters of the Vancouver Area Network of Drug Users (VANDU), in the Downtown Eastside, a neighbourhood that serves as a kind of open-air market for as many as 5,000 injection drug users. Matt apologizes: he shot heroin moments before the interview, and he hopes he can keep his nodding off to a minimum, which he does. In his uniform of baggy pants and a straight-brimmed baseball cap, he looks the part of a street-level dealer; the deep lines that score his thirty-six-year-old face suggest that he has also been battling addiction for a long time.

I begin by telling him that I work as an epidemiologist, researching HIV and addictions, up the road at St. Paul’s Hospital. “They know me quite well at St. Paul’s,” he says. He spent almost five months there being treated for endocarditis, an infection of the heart often caused by injecting with dirty needles, which led to a couple of heart attacks and culminated in open-heart surgery. “I dealt with the addictions people quite a bit, and the methadone guy. I had quite the team that worked on me there.” He says it with a sort of pride, as if being treated in a hospital were a luxury.

He grew up in a small town in British Columbia’s Rocky Mountains known for its wildly expensive ski resorts. While he describes his upbringing as good (“Mom and dad. Two sisters, two brothers. Dog. Cat. All my siblings, they work, and they’re married and have kids”), it is clear that from a young age he suffered from severe depression. By thirteen, he had dropped out of school and was smoking and dealing drugs. “It was just for the escape—and the popularity. I liked the idea of going down the street and everybody knowing who I was,” he says.

Dan Werb
The Walrus
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BC Centre for Excellence in HIV/AIDS

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THE FIX A new way of thinking about the intractable problem of injection drug use

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