In the heart of Downtown Eastside, where the back alleys are shooting galleries for heroin junkies using dirty needles, a long-abandoned storefront recently reopened with a handmade sign out front showing a clenched fist clutching a syringe and the words "Safer Injection Site."
In the last three weeks, up to 25 drug users have come here every night to shoot heroin and cocaine into their veins. They are supervised by a registered nurse, who dispenses fresh needles, swabs, sterile water to cook the drugs and advice on how to maintain veins.
The operation is technically illegal but is condoned by the new mayor, Larry Campbell. He was elected in November by a landslide on a platform of more treatment for addicts, more thorough law enforcement and regulated injection sites. He has not yet received federal approval to open the centers, but this privately financed center has opened to fill the gap.
The injection site, modeled after similar facilities in Australia, Germany, Switzerland and the Netherlands, is the only one to operate openly in North America. Its presence is just one sign that Canada's drug policies are moving in a direction that diverges sharply from those in the US -- to treat addiction more as a medical issue and less as one of law enforcement.
Prime Minister Jean Chretien, in his waning months in office, has said he plans to introduce legislation to decriminalize possession of small amounts of marijuana despite strong opposition from the Bush administration. The government is also planning a research project among small groups of heroin addicts in Toronto, Vancouver and Montreal to see whether crime and health problems can be reduced among hard-core addicts by giving them prescriptions to maintain their habit, as has been done in Switzerland.
"Canadians see things differently from Americans," Campbell, a former police officer and city coroner, said in an interview last week. "The philosophy here is that the drug problem that we have is a medical problem, an addiction no different from gambling."
John Walters, the White House national drug control policy director, has called the Vancouver proposal for regulated injection sites "immoral" and "state-sponsored suicide," but he conceded that it is a matter Canadians must decide for themselves.
US Attorney General John Ashcroft and the US Homeland Security Secretary, Tom Ridge, have told Canadian officials in recent weeks they were worried that a partial decriminalization of marijuana in Canada could increase supplies of the drug and smuggling into the US. Walters has said the US might be forced to increase border security, for protection.
"Nobody wants to punish Canada, but we have to take reasonable security measures as the threat increases," he said in a phone interview last week.
""No country anywhere has reduced penalties without getting more drug addiction and more trafficking and all the consequences of that." he said.
Walters said he learned from Canadian law enforcement officials that 95 percent of the high-potency marijuana produced in British Columbia, valued at US$4 billion to US$6 billion annually, was being illegally shipped to the US.
Senior Canadian officials appear to be taking some of the US' concerns into account as they move gradually in a direction that several Western European countries have taken in dealing with drug addiction.