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I remember the first time that I saw people injecting drugs. I had just arrived in Vancouver to lead a research project in HIV prevention in the infamous Downtown East Side. It was in the lobby of the Portland Hotel, a supportive housing project that gave rooms to the most marginalized people in the city, the so-called amp;quot;difficult to house.amp;quot; Iamp;#39;ll never forget the young woman standing on the stairs repeatedly jabbing herself with a needle, and screaming, amp;quot;I canamp;#39;t find a vein,amp;quot; as blood splattered on the wall. In response to the desperate state of affairs, the drug use, the poverty, the violence, the soaring rates of HIV, Vancouver declared a public health emergency in 1997. This opened the door to expanding harm reduction services, distributing more needles, increasing access to methadone, and, finally, opening a supervised injection site. Things that make injecting drugs less hazardous. But today, 20 years later, harm reduction is stil
