Safer injection facilities provide critical resources for people who have been systematically marginalized. In Canada, organizing efforts in Vancouver’s Downtown Eastside have been at the forefront of drug user advocacy. David Hugill and Michael C.K. Ma interviewed Ann Livingston in the summer of 2017 and discussed her organizing career and the contemporary overdose crisis.

Ann Livingston is a Vancouver-based activist who has been organizing against the criminalization of drug users and poor people for decades. She was at the centre of a number of efforts to build drug user organizations in British Columbia, including the well-known Vancouver Area Network of Drug Users (vandu). Ann grew up in Victoria with five siblings. She is currently interested in organizing poor people so that they can survive their terrible social conditions.

How did you become politicized?

My mother was a social worker and my dad was a geologist, and they were ahead of their time in rejecting what was happening in the us in the postwar period. We ended up living in Canada. I was born in Nelson, bc and we moved around a lot. My mother was an organizer, and she did a lot of community work while having six children in 10 years. She was the first social worker ever hired at Vancouver General Hospital. She had a constant stream of people coming through our house, and I met lots of Aboriginal people from the North. I saw how she did things.

During my young life, my father was part of a street corner vigil held by the Quakers. He wasn’t a Quaker, but he was protesting the Vietnam War, and the only other people who stood at that corner vigil were the Quakers. My dad was from a once wealthy family, but he had insight into how the system really worked. He was a socialist.

In 1982, I had a child who has cerebral palsy. It was a shocking experience to see just how odd the world was. I couldn’t get a bus pass while my child could have a bus pass. I started to understand how services worked versus how communities work. I mean, you’re way better off with a political movement than lobbying to get a new hospital or a new bunch of services or an institution where you can send your child.

When did you move to Vancouver and how did you start organizing on the Downtown Eastside?

I moved to Vancouver when my son was about 12. I had two other little kids at the time, and I landed at Four Sisters Housing Co-op on welfare. It was 1993, and it was a bad year. The overdose rate was about the same as in 2016. It was just siren after siren. The busiest needle exchange in all of North America was in Vancouver at that time. It was on Main Street between Powell and Cordova. The streets were filled with people using drugs and overdosing. There were about 10 police assigned to our neighbourhood. Now there are 400.

Like my mom, I thought there must be something that I don’t understand here. I could see what needed to be done. I started doing volunteer work. I was on the board of the Downtown Eastside Resident’s Association (dera), which appointed a member to the board of the Downtown Eastside Youth Activities Society (deyas) for the needle exchange. This is how I met John Turvey [the organization’s founder and Executive Director]. Pretty much right away I got in trouble with everyone in the Downtown Eastside. dera had taken the stance that if people were drinking, then let’s shut down the liquor store; if there are drug users in the neighbourhood, they need to leave. I was saying, “No, you don’t understand, this is a huge health issue, and dera should get involved with this!”

Where did you go from there?

I understood that the next thing we should do was get going with drug user organizing. I started working with William Kay, David Goodwin, and Melissa Eror. They were unemployed and put on organizing meetings at La Quena for unemployed people on welfare.¹ They were first sponsored by End Legislated Poverty (elp). They weren’t paid for the work they were doing but were motivated to build a social movement. Paid agency advocacy is something completely different than a group of welfare recipients getting together and gathering information from other welfare recipients. The thing that was so remarkable at La Quena—we’d have meetings with 40 people—was that we’d do a go-round, and every single person would speak, crying and disclosing sexual abuse, saying, “I’ve never told my parents I’m on welfare, they hate people on welfare, and here I am unemployed.” Pretty quickly they pissed off elp, which didn’t like the idea of doing this mass organizing, where you get these huge numbers of people turning up for meetings.

Right around that time I took a course that was put on by a group called Tools for Peace, taught by Nicaraguan organizers using the book To Change This House. It was about how to organize by building a foundation, the same as a house. They lined up all the aspects of organizing. I sat there weeping at certain points, saying, “Who knew there was a way to do organizing?” At the time, I saw so much sloppy organizing. We didn’t have enough people doing it in a disciplined way. Anyway, the things I learned from that course saved me as we started setting up the Vancouver Area Network of Drug Users (vandu).

vandu’s first meeting was in 1997, and it was held in Oppenheimer Park. Most of the drug users that came to the meeting I knew from iv Feed [a drug user advocacy group started in 1994], but once Bud Osborn was involved, we gained access to meeting spaces.

When did you start thinking about establishing an injection site?

William Kay was a good researcher. He’d come back and tell us, “Oh Europe has these injection sites and heroin prescriptions,” and so on. So, we started to hold meetings.

In 1995, our first meeting was held on the day of the Oklahoma City bombing, in the boardroom of Vancouver Native Health. We invited the press and sent out faxes. Reporters were going to write something much bigger, but the bombing wiped out all the coverage. The headline was something like “On the Nod”—I guess the writer was so impressed that people in the room were on the nod, we didn’t have any fake drug addicts at that meeting! Although, eventually everyone started coming because it had such caché. We were good looking, young, and had warm cookies. The other thing is, people with addiction never got invited anywhere. They were always told to come back when they had been clean for six months, or two years clean at that point. There was this myth that still occurs that the crueler you are to people who are addicted, the more likely they will stop using drugs. It simply isn’t true. We had the same thing going on in the Downtown Eastside. They couldn’t sleep in the shelters. They couldn’t eat in the food places. Of course, these were the ones that couldn’t pass. If you could pass as a non-user, you could sneak around.

It was William who decided we needed a place for iv Feed to meet. He did the work and found the first storefront. We found one for $650 a month. I signed the lease and put the phone in my name. It was 356 Powell Street.

What did the early days of this place on Powell Street look like?

When we moved in the place was in disrepair. Punk rockers or somebody had been there. I kind of missed all that because I was so busy with little kids. Two rooms had been used as photography darkrooms. We thought, “Oh well, this is weird, this could be an injection site.” My kids used to rollerblade around the front room. That’s where we’d hold the meetings because you could see in through the front glass.

The funding for the iv Feed storefront came from very teensy grants dispersed by Central City Mission Foundation and the Vancouver Foundation. vandu came later, in the fall of 1997.

At first, we just held the meetings. Then we started running the injection site. The organizing principle that I used—and still encourage people to use—is that if you’re doing something risky you need to have a lot of meetings.

At the iv Feed meetings, you were welcome if you were a drug user. It was like a drug users union. There were two meetings a week: one to schedule the injection site volunteers who supervised the storefront, and another that was the regular drug user meeting where it would open with, “Hi, my name is Ann” then we’d go around the room. We’d discuss questions like, “What do you think this group should be doing? What do you think is the most pressing issue for drug users in the Downtown Eastside?” People were dying like flies, and they were getting beaten by cops, they were getting maced in the face with a needle in their arm in an alley. And the women were disappearing.

How did people know where to find you?

We were very strong on the idea that it would be word of mouth; we only did posters to say that there was a meeting somewhere. Initially, this was the model that the drug users wanted because they were very cautious of police.

At first, we got everybody who should not have been at the meetings. We got all the guys who wanted to start dealing in there. We got every kind of trouble you could imagine. Then we started getting opinion leaders. Then word got out that we were doing something pure, that is wasn’t a shooting gallery, and that it was a selfless voluntary thing that was for the community—a real sense of saving lives.

At first, we had people saying, “No one can use any drugs in here; this isn’t an injection site.” Then we had people coming to the meetings and saying, “We’re getting maced in the face, this is nuts, we gotta do this.”

The real art of organizing, in my opinion, is to put things through the group constantly. So you get this sense of consensus. It works well because this was a foreign land to some of us; we weren’t heroin addicts, although a couple of the people we were working with ended up using drugs in there. It was their lives, and I didn’t meddle.

So, at this point, you started to provide equipment and a place for people to shoot up in relative safety?

We were having hundreds of people a night come in there. It was an open space with a lot of people in it.

The deyas needle exchange refused to give us needles. This is how you fuel an aids epidemic. The needle exchange felt that if they withheld needles, they could get more funding. What a stupid idea. They also wouldn’t listen to us when we were saying, “People are shooting cocaine!” The amount of needles people were using was just phenomenal because they would shoot cocaine multiple times an hour. They’d need like 20 needles. You could get eight needles three times a week. Otherwise, you would have to buy them or send somebody in. But if you sent somebody in, they might say, “You don’t have track marks!” One of the first things we ever did as a drug users group was going to deyas and say, “Look, this guy is a drug user and you won’t give him needles! He doesn’t get track marks!” I always thought somebody should sue those motherfuckers. It was a terrible aids epidemic, and they were never held accountable!

It’s a myth that if you have harm reduction services, then you don’t need a user group because of the false assumption that they are well-run and accountable. The first people you’re going to end up going to and saying, “There have been complaints,” or “We’d like to have a discussion with you about this policy or that one,” are the ngos providing needle exchanges and the methadone clinics. But they are not in a position to be flexible or responsive. That’s why users need user groups! It’s life and death if you’re cut off from methadone or denied needles.

So our big effort was to try and get needles. deyas wasn’t supplying us. The needle exchange van would pull up and everybody would take dirties out of our dirty container—which you’re never supposed to do, because it’s hazardous waste—and each person would get eight of them and then go stand in a lineup. deyas had this idea that there was this magical healing offer of recovery for people who came in and saw them to get their needles. It was a deyas policy to maximize contact because they believed it was therapeutic. We couldn’t get the supply. So we purchased our own while on welfare. I mean it was nuts, no conversation with Turvey, the ed of deyas, would make any difference. He would not give us the needles.

Eventually, a group of street nurses found out about our dilemma and just started delivering needles. They were watching the epidemic blossom, and they were freaking out. It was happening in slow-motion because people were starting to share needles more than they ever had before.

I had to keep them at my house with these little kids. People would walk down to my place and buzz me, and I’d hand them a box of needles. You could not leave the needles at 356 Powell because we had foxes in charge of the hen house. We even had to keep the dirty ones secure because people would steal the dirty ones and sell them. This is the problem when you restrict needles.

Was the Powell Street site—the Back Alley as it came to be called—set up with tables and chairs, the way we imagine injection sites today?

Yeah. I think it was William Kay who said that this is a social thing. It’s like a bar. The big issue was to set it up so people could walk in and not have people stare at them, so we used these funny little cubicles. People needed to be observing. We had two phones.

I was there a lot, so I got to know drug addicts. You’re sort of friends with them. We were open from three in the afternoon to three in the morning. You’ve already had a meeting to decide who is on the schedule for next week. You look up and say, “Is Fred here?” and Fred is. You hand him money—we were working with stipends of 10 or 20 dollars for like 12 hours, which is shocking—but it was for their drugs. They would often go score and then come back to be okay for their shift. We had to have coffee, cream, sugar, and then tobacco. Because otherwise, whoever has cigarettes would just get hounded and then they’d never come back. And you want to keep your good volunteers. That’s how we did things with that tiny little amount of money.

Did you have any nurses or was it all peers?

Oh, hell no. That’s real politics. The Vancouver Coastal Health Authority told the nurses they were not allowed to enter, ever. I was like, “Oh, fuck off.”

So how did the Powell Street facility meet its end?

We had it for almost two years. The police aren’t legally supposed to get in touch with your landlord and tell them to kick you out. Our landlord would just raise the rent. That was his way of dealing with it. Eventually, though, the police blocked off both ends of the block and went in. They busted a guy with 300 flaps of dope in his front pocket. Which didn’t mean he was dealing, necessarily.

Bud Osborn tells the funniest story. The police had come in a number of times and didn’t shut us down. They were different in those days. Anyway, Bud was there one day transcribing all these poems that were written on the wall because we were going to paint over them. The cops came in, and somebody just continued to use their drugs right in front of the cops. The cops took his drugs away, and the guy started demanding his drugs back. Bud was like, “Holy shit! Talk about empowering drug users, and they are demanding their drugs back from police officers!” Then the cops turn to Bud and say, “What are you doing?” I’m writing down the poems on the wall. And they were like, “Yeah, sure you are.”

It was a pretty murky place. People thought it was awful. But you should have seen it before we fixed it and painted all the walls!

So it was the cops who shut it down?

Well, they claim so. But what happened was that Carol Brown, who was the ed of the Ray-Cam Cooperative Center, said that she knew a mother who had just got her child back, but she happened to come to our place and use drugs there. So we were responsible for her relapse. We were like, “Are you fucking kidding?” Once she decided that place is going down, she told the rest of the people on that interlocking bunch of boards (i.e., dera, deyas, Ray-Cam, and Vancouver Native Health).

We were dealing with this interlocking power structure. No new funding to new groups. Part of the reason was they were fending off all the aids organizations from the West End. There is a creepy thing that goes on between ngos. In my lifetime, I’ve seen ngos turn from real community groups into these fucking corporations, where the ed appoints her board and then answers to them. This is going on all the time. I used to go back to the government and say, “I don’t know why you are saying this is a community group, they don’t hold an annual general meeting (agm), they don’t have anyone from the neighbourhood, and you’re claiming that this is a community group?” I gave up on that soapbox pretty early.

At vandu, we have the big agm—with a hundred people attending—but we try not to discourage people that don’t get elected to serve on the board. Why would you do that? It’s shattering to them. This is the first time they’ve taken a risk like this, and they often come from backgrounds where everybody is always mean to them. We also try to make it so members can tip the board. If you get a certain number of signatures and you want to say, “Fuck this board, they are not doing anything for us,” you can petition the board to hold an agm early. And they’ll do it.

In all the associations we have formed—vandu, the bc Association of People on Methadone, and others—we have tried to create a structure where a marginalized, oppressed person can see what’s coming up. Nothing is done with trickery. I think the most important thing is to make sure that as many people as possible get access to “Citizenship 101.” How do these things work? What is a motion? What is a budget? Even early on, we were trying to make the running of the Back Alley as fair as possible.

So what happened after the Back Alley project was shut down?

There was a delay of almost nine months, and it was awful. There was still tons of hiv spreading, lots and lots of overdoses. That was probably the second peak year, and it was just heartbreaking because we knew lots and lots of people who were dying. aids was a real death sentence. People died within two years. I got involved with Bud Osborn at that point, sometime in late 1996 or early 1997.

The earliest meetings were with Ken Quail, Brian Mackenzie, and Theo Rosenfeld—who made up the name vandu. They were part of an illegal rave dance scene. The rave movement had this civil disobedience thing going on, and they came to me and said: “You had this Back Alley thing going, we’ve been there, we know what you did, that was very impressive, can you do the Downtown Eastside?” And we did. I mean “I” did. Anyway, the vandu were successful in getting some initial funding.

How did you get vandu off the ground?

There were a few community grants available because people like me had made the point that if you just let the ngos apply for funding, then you’re never going to get anything innovative. You need to let groups apply that only have members.

The first grant that vandu got was a little formative grant. Ken, Brian, and Theo gave me a little bit of money, and I used it to give people three dollars for attending a vandu meeting. I knew a ton of users because I had been up to my eyeballs in them at the Back Alley. They knew I was nice, that I was a friendly neighbourhood lady person, and that I was on welfare, which made it a lot easier.

Eventually, we got funding because they were panicking about the overdose rate and hiv. The first real grant we got was to prevent hospitalizations. We got $50,000 in January of 1998, and we continued to use the same techniques. We started to hold the big meetings at the Hot Dog church. We’d give people three dollars—which goes a long way—and I made sandwiches at my house. I’d make like a hundred sandwiches and take them over to the church. Bud was the emcee, and I took notes on chart paper.

What kinds of things were being talked about at the meetings?

The police and not being treated fairly came up a lot. And they were talking about the hotel rooms a lot.² People would say, “You know in jail I got my toilet, and actually, the jail cell is bigger than the room I’m in.” The hotels were awful and just full of dead people. No one was checking the rooms.

And at this point did you start working full time for vandu?

The others insisted that I take the job. I was very wary about it because I’m white, I had social housing with little kids, and I was on the champagne end of social welfare. Single mothers are treated worse now. Ken Quail had left for Australia by then, but he insisted that it wasn’t going to be a shitty job. He didn’t want user organizing to be an underpaid job. He said, “You’re running a user group, you need to get $23 an hour” and he just fought for it. When we first started, it was like starting from scratch. We had an office with a leaky roof, a landline, and a computer. We were at the top part of the Living Room Drop In, which is now called the Powell Street Getaway. “Getaway” because they believe that no one likes the Downtown Eastside and that they want to get away. They get all the harm reduction funding now, those pricks. They hated drug users and treated them like shit all through that period.

What was happening with the struggle to set up safer consumption sites at this point?

Eventually, we had a second injection site. At this point, we were all being good sports and going to millions of meetings. Bud went to Ottawa with [Vancouver East mp] Libby Davies and met with the Minister of Health. Bud is terrific with this kind of thing, and he did so well. We were sure we would get some money. We were going to do a drug user resource centre, and it was to be a self-help model which would build on the work of vandu. Instead, when the money came in, it went to the Vancouver Health Authority, and they did nothing.

We walked past this place at 213 Dunlevy Avenue, and I noticed a “for rent” sign. I had overdraft protection so I just went in and paid for it out of my pocket because it couldn’t be done with vandu money. At some point, I just realized that, you know, we got abortions by people doing illegal abortions. We’re going to get injection sites by people doing illegal injection sites. So 213 Dunlevy became the next injection site. It didn’t last very long, it went from November to February.

The last injection site was at 327 Carrall Street. It was the one that ran the longest. And we even had help from Chris Owen—[Vancouver Mayor] Phillip Owen’s son—who is the straightest fucking guy you’ll ever meet. You know, he fundraises for the rotten government we just got rid of, a totally conservative guy.³ But his neighbour’s daughter had died of an overdose, so, oddly, he was our ally. We refused to close down 327 even after they opened up insite [a legally-sanctioned safe injection site on Hastings Street in East Vancouver], in case people didn’t like it there.

So, eventually the Portland Hotel Society (phs) came to run the insite injection facility, which had an exemption from Health Canada and could be run legally. Did you support this initiative?

Well, we supported them to run the resource centre that drug users did get, which has now been shut down. We thought we were allies with the phs and I didn’t realize we weren’t allies at all. They treated me like shit, taking credit for every bit of work that we did. Working me harder and harder. They were empire building; they have a very different idea of what works and what doesn’t. We said that vandu fully supported the phs to run the injection site. In the last minute negotiations, they asked us to shut down the illegal site. We said no, and we kept it open. I can’t remember when they opened, and I think there were three months of overlap before we shut down 327. The other point of negotiation was that they would not hire any drug users. We had to tell them that we would picket insite if they didn’t hire some peer workers.

So was it significant for you when the Supreme Court effectively legalized safe consumption sites? Do you remember that day?

No. I remember the day that we went over to picket insite because they wouldn’t allow people to assist other people with injections and they were coming to our office to do this. We knew then that the aids rate was super high among this group that had to ask for help and lots of women. Really vulnerable people. vandu got a Canadian Institutes for Health Research (cihr) grant, which lasted for two years and let us do an injection support team. Then we got a “knowledge transfer” grant—you know whatever you can get—and that’s how vandu ended up doing an injection room. The injection support team were going around saying, “Do you need help with that injection?” During the training of the team, I said, “Where are you? Look around, are you safe? And if you’re not, if you’re in a bad situation, bring them to the vandu office, and I’ll let you guys use my office to inject drugs.” Pretty soon there was blood spraying on the walls and a whole bunch of loaded people wandering around with needles with no caps on them. So we formed a little glass injection room on the main floor.

I kept saying, it doesn’t matter if the Supreme Court gives us this, we’re not going to get more injection sites. Everyone disagreed with me and said, “No, we’ll win this site at the Supreme Court, and then there will be injection sites.” But there wasn’t. I was right. Any new injection sites we ever got, we had to get by doing an illegal one first.

What are your thoughts about the current overdose crisis?

I don’t think it’s going to end until they do the key work. When people look at vandu, they think that we do injection sites. What we do at vandu is help people become human beings. If they don’t think they’re human, they don’t even try to save their own lives. What they really need is care. They need to be viewed as people who have been cut off by welfare and now live in an alley, not just as people to administer Narcan to. That may make you look like a fucking hero, but I’m just like, “Fuck off!” If it was your kid would you go, “Yeah you head back out there, we’ll save you tomorrow too”? No, you’d say, “Hey buddy, we are wondering if living in an alley and shooting dope and overdosing frequently is your best option in life.”

I’m glad they’re doing the other overdose prevention sites; these are things that are long overdue. I think the Fentanyl crisis has pointed to the problem of poison in illegal drugs, and the fact that they’ve just arbitrarily decided this drug is illegal.

You know what kills people? Poverty. You know what makes people discouraged? Poverty. You know what makes people “crazy”? Poverty. And I know it because I’m actually living it, which probably makes me a little more grouchy. But the beauty of the situation that I find myself in is that it makes me have so much insight into poor people’s lives. I’ve now mystery shopped the welfare system three times, in the 1980s, the 1990s, and now again. I can actually compare those experiences.

You’ve talked about these terrible years for overdose deaths—1993, 1998, 2016, 2017. What lessons can we learn from the earlier crises that can instruct us about what needs to be done in the current context?

You get exactly what you get organized to fight for and nothing more. Start early, work late, be direct. One of the reasons that our overdose prevention site in the alley worked so well is because we had been running a minimally-funded purely volunteer-run street market with the same people who were at-risk of overdose. And it was those people that we were able to empower and get them to volunteer at the Overdose Prevention Site and use the site. •

Notes

1 La Quena was a non-profit coffee shop and political meeting space on Commercial Drive in East Vancouver.

2 In Vancouver, single room occupancy rentals are often housed in old hotels.

3 At the time this interview was recorded, the bc Liberals had just lost an election and ceded control of the provincial legislature for the first time since 2001.