Vancouver’s Downtown East Side Drug User Community Fights for Supervised Injection Site 1990 - 2003


The creation of a government-approved, supervised injection site for intraveneous drug users.



Location City/State/Province

Vancouver, British Columbia
Jump to case narrative


Bud Osborn, VANDU, Anne Livingston, Megan Olson,


Cop Watch, PIVOT,

External allies

Gil Puder (Police officer)

Involvement of social elites

Larry Campbell (Coroner, Mayor), MP Libby Davis, UN,


City government, federal police, federal law makers and federal and provincial health care policy makers.

Nonviolent responses of opponent

Not known

Campaigner violence

1997 demonstration at Vancouver Police Station - protesters broke some wooden police barriers; some protesters carried these like weapons and were perceived as dangerous. This resulted in all activists and protesters being demonized in the next day's newspapers.

Repressive Violence

Not known.


Human Rights



Group characterization

social justice organisations
Drug Users

Groups in 1st Segment

Street Nurses - Liz James

Groups in 3rd Segment

City Coroner office

Groups in 4th Segment

Street Nurses
MP Libby Davis

Groups in 5th Segment

Gil Puder (Police Constable)
Federal Health Minister Allan Rock

Groups in 6th Segment

Larry Campbell (Mayor)
DR. Peter Center
Cop Watch

Segment Length

2 years each

Success in achieving specific demands/goals

6 out of 6 points


0.5 out of 1 points


2 out of 3 points

Total points

8.5 out of 10 points

Notes on outcomes

As a direct result of the campaign waged by the protesters and activists of Vancouver's Downtown East Side, the creation and implementation of North Americas first supervised injection site (Insite) was launched in 2003. Insite remains the only approved supervised injection site in North America. With over 2 million users and zero deaths in 10 years Insite has proven its worth in human costs. Additionally, original opponents of Insite (mainly the Chinese Businessmen's Association) were among the first to praise Insite for helping reduce visible street drug use and create a 'safer' downtown.

Database Narrative

In the city of Vancouver, British Columbia, many activists and organizers in the neighborhood of East Side (DTES) initiated a campaign in 1990 to change policies regarding intraveneous drug use. Intravenous drug use was rampant – the spread of HIV/AIDS, drug overdoses and deaths were reaching epidemic proportions.  From 1988 – 1993 illicit drug deaths in British Columbia increased 800% and 60% of these cases took place in Vancouver.  

The government’s law and order approach to dealing with drug users was not stemming the tide, and every year the death toll rose.  The war of drugs was being challenged by waves of actions that call for an aggressive harm reduction campaign that included the creation of a supervised injection site and the legalization of hard drugs.

In 1990 the first direct action took place when several of the AIDS Prevention Street Nurses personally undertook the implementation of a needle exchange program and purchased hypodermics from a pharmacist.  

In 1995-1996 an unofficial supervised injection site opened – The Back Ally.  The Back Ally was operated by user volunteers and several of the street nurses.  The Back Ally acted as a day center and relaxation spot as well as a supervised injection site. Some of those who accessed the services of the Back Ally placed artwork and poems on the walls.  

Some of the police pushed back against this act of defiance by periodically searching the center to see if there were people there who were wanted by the police. Some individual police tolerated the center’s existence, but in 1996 the decision taken was to shut it down.  

In the summer of 1997 Downtown East Side (DTES) activist immobilized motorists by wrapping chains around lamp posts, ultimately blocking traffic.  They handed out pamphlets outlining the death toll of HIV / AIDS and overdose deaths in the DTES.  They utilized banners that demarked the “killing fields” and marched, gathering public support to Oppenhiemer park were they spoke, sang, drummed and planted 1,000 crosses – marking the lives lost due to government inaction to the drug and HIV problem.

Throughout 1997 there were news stories addressing the issues of HIV / AIDS, drug overdoses, and the need for a more aggressive harm reduction action plan.  Some newspapers even broached a harm reduction approach based on European models.  The campaigners gained the support a federal Member of Parliament, Libby Davis, who had meetings with the protesters and took their concerns to the national capital of Ottawa. 

In 1998 campaigners built an organization, the Vancouver Area Network of Drug Users (VANDU).  Its mission was to improve the lives of people who use illicit drugs through user-based support and discussion groups. VANDU was able to mobilize those living in the margins, the voiceless and the hopeless.  Their meetings became more active and better attended as a main focus emerged – the need for another Back Ally-type supervised injection site (SIS). MP Libby Davies met with VANDU members at one of their meetings.

Cracks also start to form within law enforcement.  Constable Gil Puber spoke out publicly against the law and order approach used by the police and in government policy to deal with IDU’s and promotes the idea of a supervised injection site (SIS) based on successful European models.  In addition to gaining some police allies, campaigners used an open letter that was published in the NY Times newspaper denouncing the war on drugs stating that it was ‘causing more harm than good.’  This letter was signed by hundreds of notable supporters including 80 Canadians (politicians activists and lawyers).

Poster art and graffiti was disseminated through out the campaign.  

In October of 1998 another large demonstration was held at the Carnegie Center (in the heart of the DTES) proving a platform for activist, drug users and community members to speak – denouncing overdose deaths and calling for the creation of a SIS. They organized a news conference in the same month in Ottawa at the national parliament buildings.  Bud Osbourn (VANDU) and Libby Davis co-hosted this news conference and highlighted the 37% increase in overdose deaths in the past year, 3,000 deaths in the last 10 years and again call for the need of a SIS.  

Later in 1998 back in British Columbia over 700 people gathered in Oppenheimer Park armed with a banner that said ‘out of harms way.’  They held speeches, stories, sharing of food and open community discussion of the need to address the issues of addiction, HIV, IDU and ideas on how to make the community better.  This mass mobilization of the community was another call to rally around the solution of a harm reduction model that encourages a SIS (supervised injection site).

Activists continued to gather momentum and victories in other countries were seen as victories in Vancouver.  In 1999 Australia opened up its first SIS and mass media in Vancouver gave the idea more attention – story headlines in 2000 carry a stronger message ‘act now to save lives.’ Not all media joined this effort but the tide was starting to shift.

In July 2000 VANDU and other campaigners erected 2000 crosses in Oppenheimer Park as a memorial to those who have died as a result of overdose or HIV/AIDS.  In 2001 VANDI presented a coffin to the Vancouver city mayor and a cheque payable to the city of Vancouver in the amount of 90 lives, representing the 1-person-per-day who was dying in the Downtown East Side due to a government moratorium on services to drug users.  

Public pressure mounted and within 3 weeks of the action the city went back to providing services.

VANDU set up a needle exchange table at the street corner of Main and Hastings, in the heart of the open air drug market which itself was in the center of the Downtown East Side neighborhood (DTES). 

Vancouver police harassed VANDU’s needle exchange and charged those running it with drug trafficking. The charges were ultimately dropped. 

In 2002 Larry Campbell was elected Vancouver City Mayor and set out to work on his ‘four pillars approach to harm reduction,’ including the need to implement a supervised injection site (SIS) in the DTES.  The Dr. Peter Center opened up a day health program, showers, counseling, and nurse care. Controversially, it provided a harm reduction room, a supervised injection site.  This was still an unapproved site that could be raided by the police.


In 2003 despite Vancouver City Council’s being an ally of the ‘four pillars’ – incorporating a plan for an approved SIS -- the Vancouver Police cracked down on the open-air drug traffic and use area. More officers were brought in to sweep the problem away, back into unsafe alleys and abandoned buildings.  

VANDU and other activist groups responded by declaring their own SIS as a direct act of defiance and community action.

327 Carroll Street was the new location for the unapproved SIS. Health care nurses Anne Livingston and Dave Diewer personally funded the space, which was staffed by both user volunteers, and street nurses.  The registered nurses onsite gathered data on the drug users as well as documented police activities and badge numbers of officers who harassed people who came into the center. The site also acted as a gathering place, support group and drop in center.

VANDU took the offensive by organizing a march to city hall protesting the additional police presence in the neighborhood, and a month later a SIS coalition issued a press release demanding the immediate opening of an approved SIS and the immediate reassignment of extra police officers that had been assigned to the DTES as part of the crack down.

2003 police continually harassed and put pressure on the 327 Carroll SIS, including parking police cars in front of the center for intimidation. Police entered the facility to question and detain some of those who were there.  

The nurses where able to remove the officers but lead nurse Megan Olsen sounded the call for more volunteers for safety and security shifts.   This call was answered by Copwatch Vancouver and PIVOT legal society, who patrolled the area around the Carroll location to provide ‘know your rights’ cards to people on the street while Copwatch recorded and documented police interaction with people in the area.  

This form of push-back and counter-push-back ended in the police closing the Carroll Street location only three days after the opening of the SIS.

In Sept 2003 Insite, North America’s first official Safe Injection Site, opened its doors. Daily reports indicated that this SIS had 700-800 visitors a day, with zero overdoses.  

Insite operated under an exclusion of the Canadian Criminal Code that enabled it to supervise the injection of illegal drugs. It bars police from entering the premise to arrest people who have drugs in their possession.  It also unofficially marked a buffer zone were police will not arrest people for possession of drugs if they are in and around Insite – heading there or just coming from there.  

Although not all the original goals were met, specifically the goal of legalizing hard drugs such as opiates, the creation of the approved SIS was monumental. Its ten-year record since 2003 has been two million users and zero deaths. With additional services such as treatment, detox, medical services etc, the SIS offered real life options to all who came through its doors.  Vancouver's Chinatown is located in the Downtown East Side, and the Chinese Businessmen's Association was a major opponent of the proposed center; it became one of the first to praise Insite for helping reduce visible street drug use and create a safer downtown.


Susan Boyd, Donald MacPherson, Bud Osborn, Raise Shit, Fernwood Publishing, Winnipeg, 2009.

Ann Livingston, The Process of Empowerment of People Who Use Illicit Drugs in Vancouver’s DownTown East Side, accessed online on Nov. 10, 2013,

Larry Campell, Neil Boyd et al. A Thousand Dreams: Vancouver’s Downtown East Side and the Fight for its Future, (Vancouver, BC: Greystone Books, 2009.) 136.

Brenda Jones, Minister Rock “open and understanding” about safe injection”, The Echo, October 07, 1998., Timeline, Accessed Nov. 13, 2013,

Thomas Kerr, Megan Oleson, Mark W. Tyndall, Julio Montaner, and Evan Wood. “A description of a peer-run supervised injection site for injection drug users”, Journal of Urban Health, 2005; 82(2): 267- 269

Canadian HIV/AIDS Policy and Law Review, Kerr, Thomas, Olesen, Megan and Evan Wood, Harm Reduction Activism: A Case Study, ( Vol. 9: 2, Aug, 2004) 14. Accessed online at accessed on Nov. 11, 20013,

Victoria Independent Media Center. “Indiemedia”, Police Raid Safe Injection Site at 327 Caroll St., accessed on Nov. 13, 2013 at

Canadian HIV/AIDS Policy and Law Review, Harm Reduction Activism: A Case Study, ( Vol. 9: 2, Aug, 2004) 15. Accessed online at

BC Centre for Disease Control, “Street Outreach Nurse History”, Accessed on Nov 09, 2013,

Name of researcher, and date dd/mm/yyyy

Stacy Clark 25/11/2013