Raise Shit: Social Action Saving Lives (review)

Raise Shit: Social Action Saving Lives tells the untold story of drug users' community organizing efforts in one of Canada's poorest neighbourhoods, Vancouver's Downtown Eastside (DTES). Using photographs, meeting notes, poetry, newspaper clippings, and government documents, the authors weave a loose history of the collective action that brought about Insite, North America's first supervised injection facility. They pool their extensive knowledge — Boyd is a drug policy scholar, MacPherson is Vancouver's drug policy coordinator, and Osborn is a former injection drug user and one of the founding members of the Vancouver Network of Drug Users (VANDU) — to order and contextualize hundreds of texts from Osborn's extensive personal archives. The resulting product is a striking collage that does justice to some of the ongoing Insite saga's most unsung heroes: illegal drug users.

The collection opens with a brief history of the DTES, and reminds readers that the neighourbood was once the vibrant and thriving heart of Vancouver. It reviews a series of structural changes, including the rerouting of major public transit services and suburban expansion beginning in the 1950s, which drew people out of the DTES and led to its decline. Adding further context to their historical account, the authors adeptly summarize the roots of modern illegal drug policy in Canada, demonstrating the law's basis in racism and moral conviction rather than scientific evidence. In one short chapter, the authors are able to capture the complexity of the situation in the DTES where poverty, racism, violence, and disorder intersect to produce conditions ripe for drug use.

By the late 1990s Vancouver had the worst illegal drug problem in the world. Rates of HIV infection were skyrocketing and overdose deaths were increasing 800 per cent year over year with hundreds dying. The situation was so bad, the Vancouver-Richmond Health Board declared a public health emergency. Unfortunately as the authors make clear by reprinting sections of an independent evaluator's report, the response to the situation was woefully inadequate. Newspaper articles are presented to suggest that the response was the product of a highly politicized environment where most politicians and police were unwilling to recognize the potential of harm reduction — a series of strategies, such as needle exchanges, that work to reduce the harms associated with drug use, rather than focusing solely on abstinence — to save lives. This type of opposition is par for the course and has been documented by other researchers writing about various Canadian illegal drug policy debates.

Fed up with authorities' inaction and sick with the sadness of losing relatives and friends to overdose or disease, a group of drug users began an advocacy campaign to promote the importance of harm reduction and argue for an increased say in their own lives. In one of the book's longest and most interesting chapters, Boyd et al. detail the initial development of VANDU. From small meetings "by the shed in the park" to large-scale protests including "1000 crosses in Oppenheimer Park," the authors lay out a blueprint of sorts explaining how VANDU was able to organize and empower some of Canada's most disenfranchised people.

The VANDU archives and discussion are particularly enlightening because they highlight user perspectives on illegal drug policy, law enforcement, addictions treatment, and social services that are often overlooked in the illegal drug policy literature. Especially of interest is evidence of the need for effective user-based peer support and advocacy efforts. Boyd et al. present facsimiles of notes from early VANDU meetings which detail users' dissatisfaction and mistrust of many DTES service providers and community organizations and suggest that users are best able to support their peers and look after each other. This is significant because conventionally, community-based service providers are seen as representative of their clients and often speak on behalf of drug users. Moreover, these notes offer evidence of drug users' concern for various sub-populations within the community (e.g. rice wine drinkers) and their respect and concern for their neighbours.

Subsequent chapters...