The Terry Project on CiTR #44: The Unlikely Heroes of Harm Reduction (the Four Pillars Revisited, part 4 of 5)

This summer, an activist named Ann Livingston signed a lease for a bubble tea cafe in the heart of the busiest drug market in suburban Vancouver. Ann has one goal: invite the drug users in, and start a political movement. The Bubble Helping Centre in Surrey is to be that movement’s headquarters. But how will the neighbourhood react to its new neighbours? This is part three of the Four Pillars Revisited, our season-opening series on Vancouver drug policy, produced in partnership with The Tyeeand syndicated at the University of British Columbia, the University of Victoria and Simon Fraser University.

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Ann Livingston has the dedicated the past 20 years to improving the lives of hard-core drug users in Surrey. She's had success in many places. But she says that Surrey might be her "biggest failure." Photo by Gordon Katic.

Ann Livingston has the dedicated the past 20 years to improving the lives of hard-core drug users in Surrey. She’s had success in many places. But she says that Surrey might be her “biggest failure.”
Photo by Gordon Katic.

Vancouver’s drug problem is shifting into its largest and fast-growing nearby city. But while Vancouver set North American standards for progressive drug policies 13 years ago, naming its approach The Four Pillars, Surrey has not followed Vancouver’s lead.

The Four Pillars called on all levels of government to treat drug users less as criminals and more as people with medical issues. Measures to cut down on disease transmission and overdoses included distributing clean needles, providing a supervised safe drug injection clinic, and setting up a drug court that could funnel chronic drug users into support agencies. Such policies fall under the heading of harm reduction — measures that don’t demand drug users quit, while providing help to lessen the harm their addictions do to themselves and society.

The people who helped create The Four Pillars with its embrace of harm reduction say it is time for Surrey to catch up. Larry Campbell, the Vancouver mayor who oversaw the opening of the Insite injection clinic, says that Vancouver benefited from a number of important alliances that do not exist in Surrey.

“Where else do you have complete support of your police, your mayor, your health authority? Where else do you have that? Sure ain’t Surrey,” says Campbell.

“Let’s face it. The municipalities around Vancouver are doing zip. Vancouver carries the whole burden,” says John Blatherwick, the former chief medical health officer who created Vancouver’s first needle exchange.

“Eventually, Surrey is going to have to come into the 21st century. And they’ll probably go through the same political evolution that happened here. You need the leader of the quality as Philip Owen or Gordon Campbell who will step forward and say, ‘These are our communities, these are our people, and we have to do something for them.'”

Bonus Interviews:

In this bonus interview, Sam Fenn speaks with Nettie Wild–the director of Fix: The Story of an Addicted City. Fix is an extraordinary documentary film about the battle for harm reduction in Vancouver’s Downtown Eastside.

You can also check out our bonus interview with Joanne Csete on the global politics of harm reduction. Joanne is one of the world’s foremost experts on health and human rights. She’s an associate professor at Columbia University’s Mailman School of Public Health; she was the founder and director of the Human Rights Watch HIV/AIDS Programme; and she has worked with the Canadian HIV/AIDS Legal Network and Open Society’s Global Drug Policy Program.

Bonus Reading:

Where does harm reduction stand in the Fraser Health Region?

A report by the BC Harm Reduction Strategies and Services Committee [PDF] took Centre for Disease Control stats and demonstrates how Fraser is significantly lagging in several measures.


An article in the journal Substance Abuse Treatment, Prevention and Policy [PDF, open source] discusses how NIMBY-ism adversely impacts the availability of harm reduction supplies and services.

“Furthermore, participants residing in Fraser Health Authority were 41% less likely to support harm reduction in comparison to participants residing in Vancouver Coastal Health Authority, after adjusting for potential confounders.”

Click here for the rest of the series.



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Sam Fenn is the Executive Producer and Host of The Terry Project on CiTR. You can follow Sam on twitter (, check out his instagram ( and read more of his writing at