Susan Boyd, Donald MacPherson, and Bud Osborn, Raise Shit: Social Action Saving Lives.

Hyshka, Elaine

Susan Boyd, Donald MacPherson, and Bud Osborn, Raise Shit: Social Action Saving Lives (Halifax: Fernwood Publishing 2009)

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 detail VANDU'S actions, including a number of effective protests and demonstrations, the operation of an unsanctioned, user-run support centre and injection room, and the work of Bud Osborn to convince the federal health minister Allan Rock of Vancouver's urgent need for a sanctioned supervised injection facility. The authors also include additional context regarding international harm reduction advocacy and highlight the dedication of other high-profile advocates working in the DTES, in particular Gil Puder, outspoken advocate for harm reduction and member of the vancouver Police Force who died prematurely of cancer in 1999.

In the end, the book makes clear that VANDU offered users an effective means to advocate and speak for themselves and that these efforts played a significant role in the establishment of North America's first supervised injection facility. If anything is missing from this engrossing story, it is documentation and discussion of users' perspectives and experiences of Insite and the extent to which they informed the development and operation of the facility. Additionally, drug policy enthusiasts can only hope that Osborn is keeping meticulous archives of the ongoing legal challenge launched in part by VANDU members that questions the constitutionality of the federal government's rejection of Insite's continued exemption under the Controlled Drug and Substances Act.

Raising Shit: Social Action Saving Lives is an important contribution to the literature surrounding Canadian harm reduction efforts and illegal drug policy. Its emphasis on secondary source material, with measured interpretation, makes this book a brisk and enjoyable read. Its inclusion of striking photographs and personal accounts brings home the pain, destruction, and death associated with addiction and the war on illegal drugs that Still mars the DTES today. However, its texts also offer salient reminders to readers that Canada's most notorious postal code still has community, strength, and passion for finding solutions to its myriad social problems.

Though at times its historical account can be disjointed, overall the book provides an excellent perspective on illegal drug users' experiences living in Vancouver's DTES from the mid-1990s to the early 2000s, and the community organizing which ultimately helped shift municipal, provincial, and (at the time) federal policy to support the establishment of Insite. Indeed, the book helps to re-humanize drug users as individuals with opinions, hopes, solutions, and agency who can act on their own behalf and contribute to their community. This is not an easy task considering our deeply ingrained predilection to conceive of people with substance use problems as empty shells, or as Dr. Gabor Mate (physician and harm reduction advocate working in the OTES) eloquently puts it, "hungry ghosts." Raising Shit counters some of this stigma and leaves a sense of hope for those fighting to ameliorate the worst harms associated with illegal drug use and the war on drugs.

ELAINE HYSHKA

University of Alberta