The Addict Next Door

Junkies are alive and living next door (to your West Village condo)

Addiction is a painful, overwhelming secret for a lot of people, and I think that the world finally has a chance to clue in on the fact that there are dudes, successful, family men and women, housewives, teenagers…that drift away quietly, unseen, towards a point of no return. Who shoot drugs or take pills and die facedown in the bathroom.

There needs to be another tier to the whole recovery/harm reduction system – one that catches people who haven’t hit rock bottom, yet.

Waiting to hit rock bottom

Rock bottom is a pretty harsh, life-and-death place to be, yet there isn’t anything besides AA meetings and t’ai chi for addicts with jobs, mortgages, kids, sunny dispositions, brushes with happiness, anything to suggest a comfortable life.


In the end, unfortunately, junkies are all the same. They live and die and use drugs and whether or not it’s a secret or an obvious truth, whether it exists in a piss-stained alley or cozy West Village apartment – it’s all the same. Until you enter the weird, weird world of recovery.

Recovery: bottom out or die trying

The process of getting clean is a strange beast, that has yet to evolve from ye olde lock-up rehab clinics and ‘i feel’ statements in group therapy, to something inclusive, or at least familiar with people that don’t fit into the ‘junkie’ stereotype, physically, mentally, in terms of lifestyle, whatever the situation may be.

Nobody really needs the rehab spas and the Dr.Drew crowd hugging it out until probation ends. And not everybody needs the intensive, 72 day hospital-style rehabs and detox clinics. There is little in between, at least in Vancouver, and at least if you are looking to get well within the public healthcare system.


Sadly, aside from a few street detoxes and shelter-cum-sober living operations in the DTES, an addict’s health concerns must fall in the ‘post-treatment, group meetings and therapists’ category or the ‘intensive, long-term rehabilitation’ one. There is no grey area.

Rehabs wait for you to hit rock bottom, but some people don’t want to, or can’t wait to bottom out. There is a lot at stake for many people, too much to risk losing. Treatment almost seems like a jail sentence, one that you must impose upon yourself. That’s a lot to ask from anyone, nevermind the commitment-phobic, constantly running, drug addict tiptoing around the rocks beneath them.

 Rehab isn’t real life

Even when you get in, most inpatient rehab/treatment centres do little more than tossing as many addicts as possible into the temporary, mindless bliss of AA/NA meetings, breakfast, activities, lunch, one-on-one, meds, dinner, bedtime.What the fuck is that? Senior living? Summer camp?

Recovery often means another role, illusion, faking-it-till-you-make-it as a clean, happy person.

There needs to be a place to get help, get sorted, in a way that will be somewhat applicable to real, stressful, chaotic as fuck, life.



SALOME patients prepare for a legal battle against Rona Ambrose, the health minister who effectively ended an opiate-based treatment that saved their lives.


A rain-soaked man sits, sweating, eyes watering, clothes soaked, in an alley somewhere in downtown Vancouver. He wraps a tourniquet tightly above the crook of his elbow, clenches his fist, and pushes a needle up and inward, plunger pulled back. A flash of blood appears and he knows he’s hit a vein. Success. He pushes the plunger down, sweating, shaking, then bites down on the loose end of the tourniquet, snapping it off with his teeth. The body that was wracked with pain just moments ago falls away in one fall swoop – like a heavy coat, down the shoulders and onto the ground. This is heroin.

And that was the life that Larry Love lived for twenty years. For him, the constant struggle to find and use drugs was as close to a living hell as you can get. Heroin withdrawal felt like an agonizing, itching death – you feel it the bones, the tendons in your back. When you throw up it pulls at the inside of your stomach so violently you feel as though you’re being turned inside out, stomach first. It wraps itself in the roots of your teeth. You don’t sleep.

The site of SALOME's clinical trials administering legal heroin to high risk addicts in downtown Vancouver.

The site of SALOME’s clinical trials, where opiate-based treatment – including “synthetic heroin” was tested as a harm reduction and recovery strategy for high risk addicts in downtown Vancouver. (Providence Healthcare)

For people like Love, whose long history of failed attempts at recovery had made him an unsuitable candidate for rehab  – where spots are limited and even then, only become available after 2 weeks of clean urine tests – there was no middleground.

It was a choice between using heroin or getting sick, really sick – and then, inevitably, using heroin anyway.

Love, like many other high-risk, street-involved heroin addicts, had the odds stacked against him – whether he continued using or not.

The retention rate for heroin addicts who enter treatment is dismal on all counts, and the risk of overdose doubles if an addict relapses.

In Canada, the only legally viable heroin substitutes are methadone and suboxone, and both are long-term, extremely structured regimens that require refrigeration, carefully measured doses, and close contact with a prescribing doctor at all times. Those that need it the most, are often unable to maintain a methadone-based program until they find housing and adequate stability both mentally and physically.

A New Treatment Option

The SALOME project and it’s predecessor, NAOMI, attempted to fill the gap and catch the at-risk, street-involved heroin addicts that methadone and suboxone had not helped. The average SALOME client had around 11 attempts at treatment under their belt before entering the program and were the most costly individuals: requiring countless tax dollars as they routinely encountered hospitals, police, and income assistance.

Diactylmorphine, one of the opiate-based compounds tested during the SALOME clinical trials in Vancouver. (Nick Procalyo/Vancouver Sun)

The SALOME project, with it’s high success rate and retention of patients beats methadone, suboxone, and all other currently available treatment options in terms of lowering crime involvement, dependency on hospitals, jails, and quality of life. Most importantly, it works, dramatically, at giving the most hard to treat addicts a path out of addiction and street life.

The catch? SALOME’s treatment involves administering heroin, to heroin addicts. And is now tied up in moral red-tape, most recently from health minister Rona Ambrose, who effectively shut the SALOME clinical trials down in November of 2013.

In an effort to save the program, SALOME clients and doctors, backed by Providence Healthcare, have taken Ambrose to court over a charter violation. If they succeed, clinical trials of heroin-assisted-treatment will continue in Vancouver for the next two years.

Canada is currently the only first world country without a heroin-assisted-treatment (H.A.T.) program in place for at-risk addicts.