10 YEARS OF TEARS

It's our 10th anniversary this year and we're feeling a little weepy‒that’s why we’ve dusted off the archives to bring you highlights from our back issues over the last 10 years. Join us as we take a look back at 10 years of SAD Magazine, revisiting the memories and the people that made SAD what it is today. We're not crying, you’re crying.

When I started working in supportive housing in the Downtown Eastside several years ago, harm reduction had long been the established attitude of major programs, both residential and otherwise. With harm reduction, there is an acceptance that certain things, such as drug use or sex work, will continue to happen regardless of legal or social sanctions. In a pragmatic sense, this approach aims to meet individuals where they are at and ensure that whatever they are engaging in is done as safely as possible. In the case of drug use, this includes distributing clean needles and other  supplies (to reduce infection and the spread of HIV, Hepatitis C, and other communicable diseases) and running safe injection sites (to reduce the risk of death by overdose). 

At my job, residents often poke their heads into the office and ask, “Can you call Needle Exchange?” The Mobile Needle exchange is a service run by Vancouver’s Portland Hotel Society (PHS), which aims to bring harm reduction materials to people wherever they are and to safely dispose of used needles across the city.

Usually within that same shift, a Mobile Needle Exchange driver would buzz at the front of the building, balancing multiple boxes of harm reduction supplies (including clean needles). They would leave with any full sharps containers we had to get rid of. The PHS started in 1993 and blazed the way for the acceptance of a harm reduction approach in the city through its mandate of low or no barrier supportive housing.

Many PHS programs and initiatives are fixtures on the Downtown Eastside, and the Mobile Needle Exchange is so widely used that some support workers have the number saved in their cellphones. However, despite their obvious presence in East Vancouver, the Mobile Needle Exchange operates far beyond that one neighbourhood, driving out as far west as the University of British Columbia campus and even as far east as Burnaby. The Mobile Needle Exchange operates from 7 am to 3 am, 356 days a year. They provide harm reduction supplies for safer injection and safer sex, as well as distributing Naloxone to community members for the reversal of opioid overdoses and supplies for safer inhalation (including screens and glass pipes). The Mobile Needle Exchange provides anybody who asks with sharps containers for areas that commonly need safe needle disposal. They also pick up hazardous waste, such as used needles. A Mobile Needle Exchange van might be called to pick up garbage bags full of sharps containers from a supportive housing program in the Downtown Eastside, or they may receive a call about a single uncapped needle in a park on Vancouver’s West Side. “Our goal is to respond in two hours depending on where we are and how many calls we have at a time,” says Susan Alexman, Director of Programs at PHS. “We do work very hard to get there as soon as we can. We always prioritize areas where there may be children or a lot of people.”

With the sheer area covered and hours of service provided, one would think that the Mobile Needle Exchange is made up of countless vehicles and employees. The reality is that for the time being, it’s one van and a handful of permanent staff operating the service for 20 hours a day. Their service is supplemented by the six-person Spikes on Bikes team, who ride around the Downtown Eastside and Oppenheimer Park area on bikes picking up used needles and handing out harm reduction supplies when necessary.

PHS took over the Mobile Needle Exchange in 2011. In 2012 alone, they had distributed 755,000 clean needles and had retrieved 1.6 million used needles. But, once that frazzled but cheery Mobile Needle Exchange driver has collected bags full of sharps containers, where does all that hazardous waste go? Where do millions of used needles end up?

“When we pick up a syringe, obviously we use special equipment, gloves that are puncture resistant, we use tongs to pick up a syringe when we find it and it goes directly in to a puncture proof safe disposal container with a lid, so once it is in there it cannot be retrieved,” explains Alexman. “Once those containers are full, they go back to our storage area and then there is a disposal service called Stericycle that comes and picks up those syringes from us…and then they dispose of them properly.”

In 1989—the same year Stericycle was founded in the US—the Canadian Council of Ministers of the Environment (CCME) began working on a set of national guidelines and uniform standards to address the irregularities and differences across provinces in biomedical waste disposal. The company grew as the regulations around medical waste disposal tightened and awareness of the environmental consequences spread to the general public. Because of the environmental repercussions of incineration, most medical waste, including used needles, is now disposed of through the use of an autoclave, which is an industrial pressure chamber that uses a combination of heat, moisture, and pressure to ensure that medical waste is safe and free of any bacteria, viruses, or communicable diseases. After that, it is disposed of through municipal waste disposal services or can be used in waste-to-energy endeavours. The waste that is incinerated is kept to a minimum because of increasingly strict air emissions regulations, but pharmaceuticals and pathological, chemotherapy, and cytotoxic waste still have to be incinerated for safety reasons. 

From the moment that a clean needle is handed to an individual until it is safely disposed of, the number of regulations, laws, organizations, and individuals that are involved is immense. In order for that clean needle to be used outside of a hospital or clinic, there has been decades of fighting to get our city where it currently stands on the issue of harm reductive approaches to drug use. In order to get those needles disposed of safely, there have been years of work on a local and organizational level. This is not time wasted; our entire city benefits from a well-regulated system for disposing of used needles and bio-hazardous waste, even if it’s not something many people care to think about.

Although it is rarely a part of the conversation regarding harm reduction, the safe disposal of used needles—not to mention the community work of the Mobile Needle Exchange—are pragmatic components of a greater fight for accessible health care and basic human dignity. When we can minimize the spread of communicable diseases, infections, and overdoses, we are doing more than saving lives; we are making a clear statement that these are lives worth saving and communities worth empowering. 

This piece was first published in 2018 for Issue No. 25: Trash.
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