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ABOUT THIS EPISODE

At Crosstown Clinic, doctors are turning addiction treatment on its head: they’re prescribing heroin-users the very drug they’re addicted to. This is the story of one clinic’s quest to remove the harms of addiction, without removing the addiction itself.
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00:00:00broadcasting from the University of British Columbia this is cited
00:00:08I'm seven and I'm Gordon Katic and we have some new listeners I think at thanks to piece that you did Jordan last week with the excellent podcast 99percentinvisible yeah that was funny if if you haven't already listened to it give it a listen to the latest episode of cited but Abbott tube is new listeners welcome I guess salmon I just wanted to tell you a little bit about what we're about what we're going to try to retain you not put you off you know immediately so we've been making the show for a long time and the story that you heard from Gordon which was his kind of quixotic story about this research are right who's got a idea manage Retreat and it is struggling to implement it and and having to adapt that's what that's like a classic kind of excited story we're really interested not just how people generate ideas right but like then what happens once they've got their idea right to cite it is a show about research but it's not a show about
00:01:08lots of revealing the flashiest coolest new ideas coming into Academia as much as it is a show about the politics of research and expertise what what actually happens how do ideas get like you said generated and then what happens when people butt up against them there's a few kind of stories stories about bad ideas and how they got kind of turned into policy and we were going to have another episode that's kind of along those lines coming out soon about criminal justice and we also tell stories about ideas that confront some deeply entrenched assumption or conflict with like the status quo politics and that's what we have for you today it's one of our favorite episodes that we've ever made the story that we're going to share this week is about a clinic in Vancouver downtown Eastside a clinic where they prescribe medical legal prescription heroin to be
00:02:08letter addicted to heroin heroin as a treatment for heroin addiction
00:02:20we're in an empty lot off of back alley in downtown Vancouver Christmas lights are strung up outside of Mobile Trailer and it doesn't people are hanging around smoking and chatting this is one of five overdose prevention sites that has popped up in the past year
00:02:37down 529 crack cocaine at 5:30 for clipboard of people check in with her when they arrived at the trailer and then she writes down the time and the drug that they're using down means heroin and rock means crack rock 66 Rock 657 658 Rock 60s woman with no teeth and Bernadette says she comes to this trailer in case she overdoses dealers in Vancouver have been selling drugs laced with fentanyl a powerful synthetic opiate and nobody really knows what's in there drugs anymore I've heard rumors about being it in the Rock right so I'm not sure right you guys hear that
00:03:37no you haven't had no Bernadette sits at a steel table inside the trailer she pulls out a compact mirror and a syringe and she injects into the jugular vein in her neck
00:03:54Let It Go beautiful
00:04:01okay now I'm high right now his head is hung low a staff member named Dakota looks over at him and then
00:04:19dualism breathing he's turning blue
00:04:31another staff member jams and needle full of a drug called Narcan into his leg right through his jeans and overdose
00:04:41do you know how to hook get a proper seal okay to go to hear we got you 6568 big big brothers Interstate 68 74 76 79 8412 starts moving around again he says he's okay
00:05:10where is the delivery guy didn't like goes on at the site just like it never happened
00:05:28in 2016 nearly a thousand people died of drug overdoses in British Columbia over half were linked to fentanyl at one point the corner of service admitted the Vancouver's more words were quote frequently fall so they had to start storing bodies in local funeral homes this isn't just a Vancouver problem there been overdose spikes in Massachusetts New Hampshire Ohio Rhode Island West Virginia all linked to fentanyl but there's one place in North America were drug users legally avoid this game of Russian Roulette it's here in Vancouver just two blocks from where Doyle overdosed
00:06:17it's 10 in the morning we're outside and unremarkable looking concrete building right next to a country music bar this used to be a bank now it's Crosstown Clinic
00:06:33a nurse sits behind a thick glass window looking into a room with stainless steel tables along the walls one by one eight patients approach the glass they met her to the nurse through a baby monitor High
00:06:46birthday January 16th tall guy with a gaunt face in a baseball cap takes his turn at the front of the line this is Kevin Thompson the nurse passes Kevin needle through the slot in the glass just like it's a pack of cigarettes at a gas station what does it say on the nurses called by its scientific name diacetyl morphine but yeah it's heroin
00:07:17Kevin takes his syringe and walks away from the window he leans against one of the stainless steel tables and he pulls his jeans and boxers down a couple of inches I just go right in
00:07:33cabins on the highest possible dose he says if he shoots up that much into a vein to go through the roof so he doesn't in a muscle
00:07:45because your dad takes you out so much
00:07:51I love you :-) from be dead
00:08:18Kevin goes to Crosstown three times a day everyday the heroin is produced by small Swiss pharmaceutical company it's prescribed by doctor and a minister by nurse is paid for by the Canadian tax Kevin's part of the very select group the only 91 people in all of North America who get prescription heroin
00:08:48here's how this happened back in 2005 before they're even was across town Clinic Kevin is homeless he's living in Vancouver in the area known as the downtown Eastside it's one of North America's largest open air drug markets and you fall asleep on this street before if you fell asleep you know not it off you were done your pant Pockets were cut out people's name that's how bad is your shoes are off your feet your jacket and I don't care if it's raining when there's no you were robbed Kevin frequently wakes up Dope Sick it feels like a horrible fever his body aches his muscles are tight and the only way to make the pain stop is to go get more heroin but to do that Kevin needs money so he steals things and he has one simple philosophy don't be sneaky and just take it right
00:09:48UTV's in 2 skill saws and put them on stack them in and then employee come running out the other door and open the door for me and take it to an inspection weighted balls to do that really yeah they just assume they paid for it right and this is pretty much Kevin's life wake up Dope Sick steal something by heroin hide from the cops until one day A guy walks up to him and says I'm recruiting for a clinical trial we're going to give out free heroin do you want to sign up and so what are you what do you think yeah I better set up for so that's just the way they can keep an eye on us right what's going on here trying to get us Corral they're down into all of us in one little section and then just going to ruin
00:10:42erase all RV on you never know
00:10:45art is called Nyomi North American opioid medication initiative of population and Public Health at the University of British Columbia Martin says that since the late 1990s he's wanted to know the answer to one question what do you do with someone with Heroin addiction or opiate addiction who has tried the therapies that we have available
00:11:14and they haven't been successful those therapies so for example methadone treatment for heroin addiction but it doesn't work for a lot of people and when somebody has tried it twice three times 4 times and they keep failing what are you do should we try another attempt of methadone which was the only thing we could offer or should we try on alternative like heroin at that time so it's the very is the early 2000 late 90s by the way this is our producer Alexander cam how crazy did the idea of giving heroin to people who are addicted to heroin sound
00:11:58it was yes people very early were incredulous at the idea what was the argument you would make them well I would make the argument to what you have to offer but these people are currently injecting heroin in Alleyways are facing overdose and risk of disease and causing all kinds of problems for the public why wouldn't you want them to be getting the heroin from a doctor to bring them in off the street and in contact with the health care system and someone decides to start an experiment it's the first of its kind in North America a randomized control trial to see what happens when you give heroin to heroin users
00:12:43a million hurdles each one of which could have been a deal breaker in 8 million dollar Grant he holds meetings with neighborhood groups he gets ethics board approval he passed her permit from City Hall he asked the United Nations for special permission to import heroin from Switzerland and if the government's request he makes a staff go through hostage training very afraid this heroin would Escape into the community so we had armored car deliveries and we had maglock panic buttons and alarms and we actually had it in the bank and will use the Vault that was still there ironically the amount of of drugs we had on site was probably less than your average Pharmacy so my name is Kenya or whether you can I was working in Spain in another Chronicle trial testing injectable pharmaceutical grade heroin
00:13:43and I join the team of Martin Schecter and year of your mucus is an associate professor in the school of population and Public Health at the University of British Columbia deck the walls have a very small but very important role in the addiction treatment system but this is the statement this is a statement on how do you want to treat your most vulnerable individuals that are right now injecting in the street and put in their life address
00:14:18Martin Andrew Henrik Route 192 people from the downtown Eastside these are people they call Haile and trench drug users they've all used heroin for years some for decades and they repeatedly failed conventional treatments
00:14:33the 3-year Naomi trial begins at Crosstown clinic in March of 2005 each participant will be on the trial for 15 months and they split up into two groups of methadone group and a heroin group
00:14:53can you remember the first time that you actually like walked into the clinic and got heroin the taxpayers paid for
00:15:03kerastraight cuz you thinking how I can take any mail here on there going to give me how many take it they sit there and say that don't worry about the dog and we've got more you can do it's all pharmaceutically done so there's no infection just here in a sterile area and I don't have to go rob or steal a bum all I have to do is wake up and Kevin's Life Changes immediately he doesn't have to hustle to get drugs anymore so he has a lot of extra time and it doesn't know what to do with it started going for walks. You know she and stuff and realizing a lot I haven't been to live on the ocean a block away and I haven't even been down to the ocean basically and paid attention to it in the 20 years I've been here 25 years if you've been struggling everyday to get your fix up to three or four times a day and all of a sudden you don't need to do that at all.
00:16:03centramatic change this is Scott McDonald the lead doctor at Crosstown Clinic he's a guy that actually writes the heroin prescriptions and Doctor McDonald's says he sees the participants improve really quickly their sex workers who stopped going on dates drug dealers who stopped working the corners you can be dramatic now I remember one patient who is probably not showered in months and Melissa's living in a box under some steps in the downtown Eastside and within a within a week reconnect with his family was living with his uncle and was showered and clean that say that's pretty quick
00:16:49what did you say to him next time you saw him I didn't say anything he said haydock that things are going better and I said I'm glad to hear it and the results were awesome this is Diane Tobin another Nyomi participant Diane is also the leader of a drug user activist group crime rate went down there hospitalizations went down there overdoses went down and they are starting to think about a future and pausing had a girlfriend had a job had one since you haven't been arrested no contact please say don't mess with me no more
00:17:28oh yeah it was great
00:17:36the participants are only legally cleared to receive the heroin for 15 months but the early results look good and so Marvin and a hannya and all of the participants they're hopeful they think that this tiny study might become something much bigger a fully-funded prescription heroin program something that drug users across the country can access well that's what we all hope when we do research you show that is affected you show that is cost-effective and it's going to be considered to be implemented
00:18:16you know I'm a medical Anthropologist and I always tell my students that medicine is much more than science Dan small is an Adjunct professor at the University of British Columbia he's travel throughout Europe to research other heroin trials and he says that all the randomized control trial have shown good results but in many cases it never leaves the randomized controlled round it never gets its medical exemption because certain controversial things like supervised injection facilities and heroin assisted therapy Steve forever in a kind of a liminal zone of the temporary exemption provide to them and this is largely what's happened in the wider world it's politically easier to start controversial treatments in the context of a study but studies end and we got someone in a study who is doing well what do you do next and so this is really one of the conundrums and research of this type is how do you get a randomizer
00:19:16study around heroin from the peer reviewed research Roman into medical practice this is the final mile
00:19:28dad said some about the politics in the ethics of Naomi he meets with Martin and tells him if you want to keep Crosstown open after Naomi end you're going to have to fight for it and that research your looked at me and said that's not my job my job is to essentially Lee the data at the feet of policymakers and I'm a scientist
00:19:58was quite taken aback when I heard that from him and I was disappointed not going to be hard on Martin Schechter because he was a little first-rate researcher but the idea hypothetically is it when the science speaks then presumably the policymakers will listen the skies will open and they will allow this to be a medical project but that's not what happens Martin thought this was you know this is a tea party and we were eating cucumber sandwiches with the crust cut off but it wasn't it was an all-out metaphoric Ballroom brawl
00:20:50all right Wendy thanks very much the latest report on what's happening in Quebec well we can tell you we have seen enough we've been checking the numbers checking the figures and are we can let it go bra begins in January 2006 Stephen Harper the leader of the federal conservative party wins the election and becomes Canada's 22nd prime minister Harper ran on a law-and-order platform and promise to quote not use taxpayer money to fund drug use
00:21:19thank you
00:21:21what's what's mean
00:21:25we will reform our justice system to make it stronger and to ensure we turn back the growing play of guns gangs and drugs in our cities and communities
00:21:40we did as much as I think we could have to convince
00:21:48decision makers that the clinic should continue with the local health authority they send letters to the government they defend their work in the press and they apply for compassionate access to heroin all of these attempts fall flat the participants will have to transition to methadone a treatment that they've all failed multiple times
00:22:15oh I was panicked it was horrible and everybody there just felt so discouraged so lost they finally had to wait to they were doing well they were gaining weight their house was good they weren't stealing and all of a sudden she was right on the coals basically three months later she coming out for yourself again that's basically what he did to us
00:22:46will fermented meant returning to the street returning to listen to Opie ideas and 1/2
00:22:54how many I can count at least 15 it was just
00:23:01bang bang bang bang dying and it was all because of what happened with Naomi dropping us
00:23:13we can't confirm exactly how many Naomi participants died no one really knows the researchers simply lost track of a number of them after the study but they say they have no reason to doubt Scott McDonald's number
00:23:32things are going a lot better for the researchers when all the data is in they have some exciting results the heroin group did significantly better than the methadone group they were more likely to stay in treatment and less likely to turn to street drugs Martin gets an international drug policy award and no henya presents our findings in the most cited medical journal in the world we used to say I told Martin that is saying in Spanish is La cirugia I see the next it'll burn paciente
00:24:06the surgery has been a success but the patient is dead
00:24:14that's how I felt
00:24:18there's no joy of publishing in the New England Journal of Medicine
00:24:27but there's one obscure finding any owe me that offers the researchers hope of the people receiving injectable medication most of them were getting heroin diacetyl morphine but a number of them 25 of them we're receiving Hydromorphone the drug name that you, because Dilaudid
00:24:56Dilaudid is chemically similar to heroin but it doesn't have the same kind of bad brand Association that she legal in Canada it's already used as a painkiller Martin put a small group of the Naomi participants on Dilaudid because he wanted to see if drug users could tell the difference he thought of course they're going to that we couldn't believe it but the people didn't really seem to know that was really unexpected the 25 people who receive Dilaudid their outcomes were exactly the same as the people who had facet on morphe
00:25:34so that said to us wow
00:25:37here's a drug that's a licensed medication Hydromorphone and it seems to work as well as heroin if we could find that Hydromorphone get as well as heroin that could make it available in a lot of countries where heroin is essentially a political non-starter
00:26:01and that's when I are the sign Solomon and Solomon came just because you know we don't have to pay for ghost everybody's closed and I went or so why don't you it's going to be off for the policy makers that are committed to make this happen needy evidence as fast as I can get the evidence out you know this can roll into a treatment if I am still
00:26:35no fucking shit so one day in the summer of 2011 Ohanian meets up with drug users at van do she wants to tell them about her new idea to compare heroin and hydromorphone but she knows that many of the people in the community are still mad about how Naomi ended expecting 6 people and they were 68 people using drugs that came and then someone asks the million-dollar question what's going to happen to the participants of this new study when the trial is over tell you the truth cuz I don't know I wouldn't work very hard with everybody for this to continue but I am not in the position to make any guarantees and I said this to them
00:27:26I have two options in front of me knowing that is 6 months I need to tell you to go back to the street or not doing the study
00:27:40and I decided to do the study this way I have no idea right now is that it's the right decision for the room it's full of people who have used heroin for decades people have had to sell their bodies to get their fix people who have lost their families and people have seen their friends die on the street has to tell them I'd love to help all of you but most of you are going to make it into my trial that I can only do the show number of people
00:28:13because this is super expensive I want the minimum number that I need to have power for my calculations not because I have a demonic agenda is because we don't have money and we need to get it done and get results as soon as possible and they're tremendously supportive instead of being pissed off at me they weren't you know don't worry we will support you you you are doing the right thing I was kind of like I'm amazed of how generous they are so generous
00:28:52a few months later Ohanian begins recruiting for Salome many of the old Naomi patients join Kevin signs up but Dan is still bitter so she has a taste because I didn't know if the same thing would happen is Naomi I wasn't positive that it wasn't going to go to the same routine so I was kind of leery the researchers open the phone line on the very last day of recruitment Diana's with a drug user who is on the phone with the Salome researchers as he's about to set the phone down Diane says wait and I said don't hang up I want to talk and I said I'd be on the study in the next thing I know they were telling me I was the first one on the study what what made you decide that you know what I am going to go on it I don't know it was just a spur-of-the-moment I'm going to try it again
00:29:45Diane wants back into Crosstown clinic this time as a participant in the Salome trial Salome is run by a new health authority Providence Health Care and it has an entirely new nursing staff I walked into the injection room and about 8 nurses and students in wherever they were that were working there came and they were right in front of my face just hanging over my head to watch me do it kind of funny cuz all of us nurses were you know interested in really like watching her and jacked for most of us and luckily she was a good sport about it I told him back off get away you know like you can't do that it was always a private thing for me so then when there were eight people watching me do what I said I can't do it go away and then we're all waiting for something to happen nothing really happened she didn't really change she was just cheering woman alert and vibrant when she walked in and she was alert and vibrant when she
00:30:45he left here like oh okay and stands up and walks away from the table the nurses are excited that Salome is underway so they start clapping when everybody started clapping nothing it was there their time to clap it had nothing to do with me the number of the drug users are worried they don't want Salome to end just like Naomi did but that is the researchers plan all they can promise is to transition everyone to methadone when Salome ends you can't just sue the government to say give us a medical treatment you know that there's not that bases to do it and unfortunately this is Scott Bernstein that represents homeless people drug users and sex workers in the downtown Eastside Veterinary patients take Scott on as their attorney and they asked him to make sure that after Salome that don't lose their hair
00:31:45Scott sends a forceful letter to Providence Health Care so this is June 14th 2012 the memo line says regarding the legal and ethical issues of human opiate trials and so I'm writing can you imagine UBC Providence Health Care in Vancouver Coastal Health in the researchers randomizing patients who had failed available therapies for breast cancer to to experimental treatments that would be halted after one year even if proven effective Scott basis the letter on an international agreement something called the Helsinki declaration the medicine away if I study drug works for a person the government cat taken away from them but Helsinki declaration is basically the Magna Carta a medical research ethics it says that if researchers can't continue an effective treatment after the trial has ended I need to provide another appropriate treatment option but Scott says that methadone is an appropriate Providence response
00:32:45Scott's letter and they say legally the best we can do is methadone so the participants think if they do that maybe we should sue them and that's the only option we had to sum it up like what the hell what are we doing what are we doing here folks like how is this being remedied
00:33:05I was happy to have that that pressure in those ideas from them in the community dr. McDonald has an idea but it's a long shot it's something the researchers originally tried with Naomi we started applying to have Canada for through the sap special access program for compassion access at Tennessee to Morphine unlicensed drugs to patients with life-threatening conditions McDonald's begins riding up just over 20 requests they're thick files over a hundred and fifty Pages any faxes them all over to health Canada include the Naomi study results the Swiss studies and a detailed description of the patients
00:33:50baby past history of that of the patient with whether they've had that overdoses requiring resuscitation with Narcan have been in jail like charges how many related infections hep C h i v a l all of those things is just like a Litany of personal tragedies like that sounds like a difficult document to write
00:34:13and that is what every single imma be like
00:34:17so I'll make sure I understand like it's not that your boss is breathing down your neck saying put in put all this work together put these sap as in that's your job right now this is like your leadership is that is that a fair characterization
00:34:30I'm an advocate for my patients and they are participants in a study if this is working they need to have access to it the only way to access it is to the sap so it was my it was it was my apparently my idea and Forest that made that happen but I've worked in research studies before this is just what you do somebody needs to believe it how did you show Health Canada that you and your team really believe in this
00:35:02but we kept sending I say peas and chicken stock
00:35:06on September 20th 2013 Health Canada calls and asks is your fax machine broken and I was going to put paper in the machine or something like breaking them with sandwiches they didn't say anything interesting
00:35:33one by one the letters buzzing through the fax machine accept it accepted accepted every request is approved this is the first time in North America that heroin is approved as a treatment for heroin addiction not just in the context of a research study but as a medical treatment that was a bit was a big deal for us we were very very excited cuz it's acknowledgement that this is how Canada has put their stamp on an injectable treatment option diacetyl Morphine at that yes Health Canada proves that but then not much longer. Very morning
00:36:13we are today to begin a much-needed conversation about the need to focus on the treatment and recovery of those who are addicted to drugs minister of Health the same day the special requests are approved Ronald write a statement to announce she is reversing the decision made by Health Canada her own department and I do not believe we are serving the best interest of those addicted to drugs and those who need our help the most by giving them the very drugs they are addicted to the answer of course is not to treat heroin addiction with Heroin that's I hope obvious to all of you so today I'm announcing that our government has taken action to close this loophole that we found in the special access program my Ambrose for an interview but she declined our request
00:37:05I really don't understand why they didn't just government procedure or whatever whatever I don't know their stupidity that's what it was stupidity this is honestly, pure and simple there are very few treatments on the diction addiction field that have provided evidence like the Solomon study has done
00:37:29Ohanian says conservatives like Rana Ambrose and Stephen Harper they like to say we shouldn't give people drugs we should get them to stop taking drugs we need to treat the root causes of their addiction but the politicians don't actually have a plan how would you do that for me to drink the root cause of the 202 Solomon participants I need a budget for public health Canada for two generations to heal for the cause of genocides to heal for the child abuse that we see to hear for the people that has been incarcerated over and over because they cannot stop using Jackson Street so give me to generational pageant and then maybe we can do the root cause
00:38:23dr. Scott McDonald Scott Bernstein and a number of the drug users hold a press conference they're going to sue the federal government to reverse Ambrose his decision dr. McDonald speaks to the pool of reporters I need this tool in the addiction tool kit
00:38:40to help the people with this severe life-threatening illness
00:38:45as a human being as a Canadian as a doctor
00:38:49I want to be able to offer this treatment to the people who need it is effective it is safe and it works you're fighting the federal government in a very very public battle and you're at the center of it at that press conference her right center stage talking about your patients that you're crying about this like how did you feel about being there
00:39:16I had a message to Terrell
00:39:21some of that message had is about
00:39:25hope and
00:39:28fighting Despair and that is an emotional message and I did not want to get emotional at but this is an evidence-based treatment and if without is some of my patients were going to die and even here is hope hope for these folks that have not had any any thing to give them care for years and it's taken away at that
00:40:01guide to get emotional
00:40:10the drug users the doctors and the researchers are all gearing up for a big constitutional case but it never happens
00:40:18in 2016 Justin Trudeau replace is Stephen Harper as prime minister Andrew those government quietly reverses Ambrose his decision
00:40:32this leads Crosstown Clinic exactly where it is today McDonald's really applies for exemptions for each of his 91 heroin patients every 6 months
00:40:43but the doctors researchers and drug users they all wanted something bigger they want a formal program with Heroin clinics like Crosstown all over Canada and even though salary found Hydromorphone is effective to that hasn't happened either in fact very few politicians are pushing for extending injectable treatment of any kind
00:41:09sometimes I feel right now
00:41:13I am really like at the verge of being at the verge of losing my marbles many times but at this time we are the closest we have ever been of expanding treatment with injectables
00:41:28I am so scared that somebody in a table that I don't sit
00:41:34he's going to just review piece of paper that somebody is just going to come and wipe it
00:41:48it's an unusually cold winter here in Vancouver and it's been snowing all day I'm at a pop-up injection site just like the one at the trailer that you heard at the beginning of her story there are a handful of drug users huddled in the Festival this year to warm up and they're here to shoot up needle Depot in all of North America Kevin works here full-time now his job today is to check people in as a show up at the site
00:42:23thank you very much do you usually do
00:42:30yeah I called her that purple stuff so drop yet thank you Jasmine
00:42:35Kevin sees two or three overdoses pretty much every shift sometimes more and then his lunch break walk 6 blocks over to Crosstown Clinic where he takes his shot prescription heroin in with for years and they're still playing the right game that I'm not and you know what I'm the one with saving them in
00:43:03I didn't see what that knowing that you you kind of lucked out and you don't have to be a part of all of that but then all your friends do
00:43:12disgusts me really
00:43:159News advice more friends now in this year and it's prices it's happened then I have been the whole 25 years I've been down here could you do this job if you didn't if you weren't in the crosstown clinic right now
00:43:39I've been my other statistics guarantee you that
00:43:43like me doing this interview that's for sure
00:43:47get your tables ready my friend
00:44:08down the block from Crosstown Clinic drug users hold a vigil to remember lost loved ones this crisis is hit First Nations people the hardest they light candles and place them at the base of a tall totem pole called the survivors Pole
00:44:23in April officials in British Columbia declare the overdose crisis a public health emergency over 1,000 people have died since the start of 2016 and the crisis is showing no signs of slowing down
00:44:53so I was waking up every morning going to work and I hear somebody else died somebody else died somebody else died and you didn't have time to grieve I would have been under Memorial everyday
00:45:06I just got I got finally I got tired of it and I told doc I'm his phone so I don't have to hear ambulances all day
00:45:27Diane is all the way across the country now back in Nova Scotia together again with her family and after 40 Years of heroin addiction she says she's completely heroin free shine on methadone a opiate free how to make her only one of two patients across town he's done that
00:45:59this month Crosstown Clinic is doing some Renovations there knocking down a wall and expanding the pharmacy this will let them squeeze in 30 more patients may be more it won't be hard to fill the spots doctor McDonald's says just about every day a drug user will wander up and knock on the clinics window looking to get in but for now Crosstown is still an exclusive Club
00:46:51the heroin Clinic was produced by Gordon Katic Sam Phan Alexander cam and Travis Lou pick Travis lubick is reporter and editor with the Vancouver newspaper the Georgia Straight you can follow Travis's work on Twitter he's at T Lubbock l u p i c k Travis Road companion piece to our documentary and you can find that in the Georgia straight and you can also find a link to that on our website sided podcast.com also on our website we have a bonus interview with addiction researcher Bruce Alexander so check that out a version of this documentary was also produced in partnership with life of the law check them out at life of the law. Org And subscribe to them on iTunes to hear a follow-up conversation about this piece that will come out on March 21st we would like to thank life for the law for the editorial support Dan Reese tap the University of Victoria for academic mentorship and Josh GED for editorial input thank you also to Lauren Road and Jen Lu for
00:47:51search in marketing help sided is funded by the social sciences and Humanities research Council and produced out of the University of British Columbia in Vancouver thank you as always to the world class Michael Smith Labs home 2 / 250 researchers and one podcast shut out to our listeners on terrestrial radio that citr in Vancouver cjsf in Burnaby civl in Abbotsford wvbr in Ithaca New York and CKD you in Halifax if you live somewhere else and you'd like your local campus for Community station to carry our show you should let them know and they can have our show for free if you want to send us any feedback or just say hello you can send us an email at cited. Podcast at UBC. CA we love to hear from you so just drop us a line for Gordon cat exam fun and Travis Lou pick I'm Alexander Kim thanks for listening

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