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

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
Read More

Scroll to Top

During the Canada Post strike announced September 25, 2025, the following measures will be undertaken to minimize service disruption to BC-CfE clients and providers.

  • The BC-CfE Laboratory has transitioned to private courier for delivery of outgoing reports and documents. Results required urgently can be faxed upon request. (Lab Contact Information: Phone 604-806-8775; FAX 604-806-9463)
  • The BC-CfE Drug Treatment Program (DTP) will fax outgoing forms and documents to the provider’s office. (DTP Contact Information: Phone 604-806-8515; FAX 604-806-9044)
  • St. Paul’s Hospital Ambulatory Pharmacy has transitioned to private courier for delivery of medications. We recommend requesting medication at least 2 weeks in advance in case of delivery delays, particularly to rural/remote parts of BC. (Contact Information: Phone 1-800-547-3622; FAX 604-806-8675)

During the Canada Post strike, we recommend that documents be faxed or couriered to our sites, versus utilization of regular mail service

The BC-CfE Laboratory is streamlining reporting processes for certain tests in order to simplify distribution and record-keeping, and to ensure completeness of results. Beginning September 2, 2025, results for the ‘Resistance Analysis of HIV-1 Protease and Reverse Transcriptase’ (Protease-RT) and ‘HIV-1 Integrase Resistance Genotype’ tests will be combined into a single ‘HIV-1 Resistance Genotype Report’.
For more details and example reports, please click on the button below