The devastation visible on Vancouver's downtown streets leaves little doubt that the war on drugs has failed here. But working with an inherently unstable clientele of street junkies, there are no guarantees harm-reduction measures will succeed. Coaxing marginalized addicts to embrace an official safe-injection site could prove difficult -- let alone making the site an effective stepping stone to detox and rehabilitation.

"I used to break into cars all the time, anything to get another fix," says Robert, a jittery 37-year-old junkie in shorts and a tattered T-shirt who asks me for 15 cents at the corner of Abbot and West Pender. It's early afternoon and a couple of businessmen in suits whisk by; normal commercial activity and the hardcore street hustle blend with a strange ease on this block. Robert's fingertips are blackened, and scabby holes pock the backs of his hands, his forearms and the sides of his neck. He says he's heard about the coming safe-injection site, but quickly adds, "I don't shoot no more." We go into the McDonald's on the corner, where he pays the few extra cents he needed for his order: two strawberry sundaes, with extra peanuts. "I think that site is a foolish idea," he says, repeating unconvincingly that he's been clean for three months.

Back outside at the bus stop, Robert greets a young addict named Jasmine, then sits down to eat. He keeps glancing across the street, where a couple of prostitutes work the corner in broad daylight, a pimp-dealer type lurking close behind. "You don't think I'm going to be on heroin do you?" he says, jiggling on the bus stop seat. "I'm not ever going to be a junkie again. Never."

Angelic-faced Jasmine says the site wouldn't get her off the street. "When you have to fix, you do it wherever you want. You won't wait to go to some other place."

"Yeah, you just go around the corner," Robert exclaims.

"Think about it, people that fix coke get so retarded," Jasmine chimes. "You think they'll really stay inside there? They're gonna boogie straight out the door all jacked up!" she laughs.

"Yeah, tear up ... start ripping the carpets up!" laughs Robert. His face goes flat again. "It's like a stupid joke," he says, shaking his head.

But the site is a grave matter for Ann Livingston of Vancouver Area Network of Drug Users, an activist group working out of a ragtag office just down the block at 50 East Hastings St. The city's harm-reduction plan has wound through six years of study and debate, with the new safe-injection site promised over a year ago. "Just what really is a public health emergency?" implores Livingston, who helped set up the guerilla site at 327 Carrall. "It's a really vicious, violent thing to leave in place, while people diddle around and argue about protocols and funding. It verges on criminal negligence to stand by and watch a group of people year after year when you can predict extremely accurately how many will get HIV/AIDS, and how many will die."

The activist group, made up of hundreds of current and former addicts (Livingston herself is not a drug user), hasn't waited around. It runs nightly "alley patrols," and now distributes 1.5 million clean needles per year, according to Livingston -- that's roughly half the 3 million given out annually in Vancouver, which has the largest needle exchange in North America.

"We have a really long way to go," agrees Fiona Gold, a "street" nurse at the nearby office of the B.C. Center for Disease Control. Gold oversees CDC outreach in the Eastside. "I've told far too many people here they've tested positive for HIV. It's just nuts. We really have to do something different." According to the latest Vancouver drug use epidemiology report, injection drug use was the predominant mode of HIV transmission in B.C. from 1994 to 2000. A 1997 study of more than 1,400 Vancouver needle users revealed an HIV infection rate of 18 percent -- the highest level anywhere in the developed world. Since 1997 the number of new cases in the city has dropped significantly, but the report suggests that decline may be due to a "near saturation" of the addict population considered most prone to infection.

Conservatives, Gold also points out, should be equally invested in the harm-reduction strategy -- especially those who are fiscally conservative. Every HIV-infected addict dropped into the healthcare system costs the Canadian government an average of $150,000 in long-term care; the cost of 12 such patients would pay for the new site to run for a year, she says.

Gold introduces me to Earl Crow, a middle-aged ex-rocker from southern California with stringy blonde hair, dark brown eyes and a humble smile. He tells me how he came to Vancouver four years ago hooked on speedballs, a potent mixture of heroin and cocaine. "I was really wired, I was shooting a gram a day," he says. But he made the decision to clean up, joined Vancouver Area Network of Drug Users in 2000 and became its president for the next year and a half. He now works outreach for the CDC in the Eastside, giving out information and clean needles, and watching for medical emergencies in the back alleys -- sometimes putting in 12-hour days.

But he also knows the daunting odds harm-reduction tactics must overcome. "When I was using there wasn't a fucking person in the world who was going to come and save my life," he says. "It had to come from my own heart and head."

Crow agrees to take me around with him, and we head up Powell Street to nearby Oppenheimer Park. The mild afternoon and oasis of grass belie the park's reputation as a drug-dealing hub; at night, Crow says, it's one of the city's most dangerous spots. We run into a young addict named Michelle who says she's been in the neighborhood for 15 years, and we talk as she hurries us down the block. We reach the local welfare office and she darts inside. "She's all jumpy like that because she's been up for a few days," says Crow. "The beginning of the month is tough. It gets busy for us out here because people binge." He adds that some healthcare workers are worried the new safe-injection site could become a "revolving door" for addicts who inject coke, a much more fleeting fix than heroin. "Some of them whack 20 or 30 times a day," he says.

Michelle comes back out, check in hand, and as we hustle back toward Oppenheimer Park, I ask her what she thinks about the coming site.

"Maybe it'll work, but not if you have to go through all the nurses and a bunch of forms and shit. You'll be withdrawn by the time you can get a fix," she says, skipping along. "And it won't work if it's all super-clean and they're gonna freak out if there's one little drop of blood on the floor." At the corner of Jackson Street, she spots who she's looking for and flits off across the block.

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