by Peter Topolewski
Most of us haven’t smoked or snorted crystal meth. Not in meaningful quantities. Same goes for heroin and fentanyl.
But by now, no matter where we live, most of us have stepped over or around someone who has. Someone who is, if not dead, smoking or snorting or shooting up again right now. Or is desperate to.
Probably, as we walked by—giving the meth user his space, wondering if we check that the facedown fentanyl user is breathing—we thought we couldn’t relate to that person, that predicament. Not to the tipped over bag of worldly possessions. Not to the permanent hunch, the swollen ankles, the open sores.
With a little effort, though, we could relate. For whom among us hasn’t smoked dope? Or popped pills, or chewed mushrooms, or dropped acid, or drank too much booze? We know, in a way, a little something about chasing a feeling, getting a rush, smoothing the edges, escaping ourselves and our predicaments.
Turns out each of us have more in common with people severely addicted to drugs than not. We each had a mother and a father, some loving, some not. We all were babies once, that cooed and laughed, some more than others. None of us got to choose what era we’d be born into, nor what circumstances. We all have people that worry about us, or did once. Even if only one person. We all have basic needs for food and water and shelter, for entertainment. Sometimes, perhaps most, they’re not always met. We all have ideas and opinions, we all have hopes and dreams, some big, some small. Or used to. We all laugh and cry, rage and tune out. Sometimes not enough, sometimes too often. We all have questions. We all search, in our ways, for our reason for being here. Some find it, for a while, others don’t or can’t any longer be bothered to ask.
And yet we can’t relate?
How did we get to this spot?
This spot.
I’m not talking about a figurative time and place. I’m talking about one place, right now, a few blocks from my front door. Vancouver’s Downtown Eastside, aka the DTES. More than a century old, a roughly four square kilometer neighborhood that is home to about 8,000 people. It’s ground zero for the city’s, even the country’s, drug and homelessness problems. Home, therefore, to a non-stop fight to keep people alive.
Death is winning.
Drug deaths have fallen from a peak of 2,589 across the province in 2023. But as recently as October 2025, 150 people in BC perished that month because of drug overdoses, keeping it among the worst-hit in North America. The DTES is the sad final resting place for most of those.
The buildings, shops, and sidewalks of the DTES can be charming, but it’s long been all-too common to find benches, curbs, and doorways filled with the semi-conscious users, eyes glassy or closed. Tents, litter, feces, stolen goods, broken glass, busted suitcases, forgotten clothing, makeshift beds, discarded pipes—these are the daily leftovers of the beaten down, drug-using population of the neighborhood.
Crime funds the killer drugs and fuels violence. The stats say the violence and the theft is down, and there is a feeling that that the streets over the past year are cleaner and calmer, but its subtle. When the local firehall—the first responders for medical emergencies—gets over 14,500 calls for response in 2024, it’s tough to notice a drop.
The DTES is Vancouver’s drain. Every city has one. The place where the unwanted collect, where they cling for their lives or they get washed away for good. It’s been like this for decades, but not always.
A century ago, the now infamous intersection of Main and Hastings was the heart of the Vancouver. On one corner, city hall. Theaters, shops, banks, and neon signs lined the streets. Job seekers flocked there. But when the jobs evaporated, and city hall and the major businesses moved elsewhere, they stayed. The population became increasingly transient, incomes dropped. It became an enclave of growing hardship and sex work, hurt by decreased social services and the rising use of hard drugs.
I fell in love with the whole area east of downtown after my first real visit in the mid-1980s. My sister and her boyfriend lived in Gastown, a neighborhood adjacent to the DTES, though the borders, if they exist, are invisible. The place has a beautiful old-world look, a gritty vibe, interesting people and shops, a taste for adventure, and an openness to people from all walks.
Around 1985, when I was in junior high, I was coming back from a trip to the Eastern U.S., my younger brother from a trip to Southern California. We met in Vancouver, enroute home, and were going to spend the night at my sister’s. We each stuffed our prized purchases—things you could only find in those locales—under the seat of our dad’s pickup for the night. We were from out of town, none of us gave it another thought.
When we got to the truck the next morning, it took us a few minutes to realize that the truck had been broken into, the vent window smashed and the door unlocked. Our things were cleared out. There was a payphone in the corner of the parking lot. We called the cops. How naïve were we?
A car with two officers showed up. For an overnight break-in to a pickup truck. How naïve were they? Today, they won’t take a call for such a thing. It’s not uncommon to see three, four, five smashed car windows on a three-block walk.
Turns out that while we waited for the cops to arrive, a local walked through the parking lot, oblivious to us, seemingly oblivious to the world, wearing my brother’s jacket. He barely flinched when we pulled it off him. He kept going, wandering into an abandoned milk truck on the side of the lot. When the cops arrived, we pointed them in that direction. With zero fight, they recovered everything we thought was lost.
Thirty years later, I moved to the other edge of the DTES with my wife and kids. That was nearly a dozen year ago. At the time, injected drugs were the products of choice, perhaps by the users, more likely by the pushers. We were more than a decade into an HIV epidemic from shared needles. There were needle exchanges and giveaways all over the neighborhood, and so you’d find them everywhere. On the ground, in the trash, jabbed into wooden power poles.
Over the years, meth took over, so needle use dropped—though if all you did was read the headlines you wouldn’t know it. In 2025, a city-sponsored program collected 26,700 needles in the neighborhood. Sounds like a lot. That was down from 32,800 in 2023. Funny thing is, when you walk around you hardly see one compared to the old days of 2013.
After fentanyl moved in, the streets changed again. The meth rages disappeared, the yelling quieted. No more sex workers and johns in their own drug-fueled mental worlds going at it in front of condos in broad daylight. In place of the wild unpredictability came users knocked into silence, in the stoop or fold or whatever you want to call it, bent over in place. Or slumped over or sprawled, on a sidewalk or a bench or a patch of dirt. The relative calm was full of danger. Overdoses rose, cops and fire fighters morphed into medics. Crime to fund the addictions got more brazen.
Despite how the place sounds, I never felt unsafe. Scratch that, I did once, when, on a sunny spring morning I yelled at a shirtless man trying to break the driver’s side window of a car on my block. He started coming at me.
Was I wrong to run, to think he couldn’t be reasoned with?
How’d we get to this? To this point where I couldn’t see a person running at me, only a threat? To a place where the mental lives of so many people in one of the richest countries in the world are consumed with desperation, longing, frustration? To a neighborhood marred with ghosts of hundreds or more who died in misery, mostly alone, cut off from any semblance of what we’d consider a normal life?
Trauma is often woven into the histories people bring with them to the DTES.
Many blame the war on drugs: more casualties than victors. Maybe only casualties.
Housing, the lack of it, is always a top culprit, and more of it is always touted as the most powerful solution. When I first moved to Vancouver, my one-bedroom apartment cost $655 a month, or $1,235 in today’s dollars. The average now is $2,300, far outstripping inflation and wage growth and increases in provincial subsidies. The reasons for the city’s housing issues are complicated, but certainly exacerbate problems in the DTES, which has long been a destination for low-income housing, including single-room occupancy (SRO) hotels.
Government has continued to pour resources into concentrating this type of housing in the area. Do people come for the cheap housing and get snared in a web of drugs? Or do they come for the drugs and end up with a need for cheap housing? Let’s say both.
The list of causes goes on.
In the 1980s, the provincial government decided to close the Riverview psychiatric hospital. The move was based on advances in medication and the latest psychiatric treatment philosophies, which called for integrating patients into the community. Good intentions and faith in those theories weren’t sufficient. The implementation of this “de-institutionalization” was, and has continued to be, botched and underfunded. Many Riverview patients ended up on the DTES, and in the years since many of the people who arrive there bring with them or develop mental health problems. It’s a street level mental institution, a mental hospital without walls or a roof, without admin. With drug dealers.
These are challenges housing alone cannot solve. Cannot, in fact, deal with.
Democratically elected governments reflect our collective values. Those aren’t always—maybe they’re never—shared universally, but that doesn’t deny the fact. In Canada, those values show up in universal healthcare, peaceful transitions of power, gay marriage, the right to die with dignity, and on and on.
To suggest, then, that governments of all levels have deserted the DTES, have let it devolve into a war zone, is to suggest that as a society we’re OK with that. Many of us are. The disaster of the DTES is, after all, contained. It’s easy to walk away from and forget about.
There’s a flipside.
Hundreds of millions of dollars have been spent in this tiny part of the city. The DTES is crammed with people from government agencies and non-profits focused on housing, food, and health services. This abundance, and the inefficiencies and fog that come with it, can be counterproductive. But the effort and the intent speak to the fundamental urge to do something.
On the housing front, Vancouver has 6,500 SRO units, the majority in the DTES. Since 2017, the province’s housing agency has completed construction of over 900 affordable and middle-income units in, or within blocks of, the neighborhood. Another 500 are in progress.
This isn’t enough, clearly. But it’s not nothing. It’s a massive financial commitment that says we’re trying to do some good.
Where government often stumbles is on implementation, on changing course. To their credit, governments do “pivot”, slowly. Last year, the city cancelled its decade-old plan to limit development in the DTES. Done in the name of preserving the area’s character and saving residents from gentrification, that old plan locked the DTES into a loop of endless funding, endless grief. Given that recent evidence shows gentrification can be a force of good, we can hope change for the better is coming.
In 2023, the provincial government initiated a pilot program to decriminalize possession of small amounts of drugs. After three years, that program was ended. Whatever it’s merits, it was an attempt—and one part of a larger effort to treat the drug and housing problems in the province as a health issue, not a criminal matter. The cops agreed with the concept.
If drug use is not a crime issue, but a health one, how would we react if in another, richer neighborhood dozens of people fell to the sidewalks every day? Would we revive them then drive away? What would be the approach if they chose to induce their collapse?
Of course, for most drug users using isn’t a choice. If the problem is a health issue, the solution—at least part of the solution—is about treatment. Treatment of addiction and mental illness. Around here there are not enough such options available. Like everywhere, however, the debate over compulsory or mandated treatment goes on. If you’re having a heart attack, do you expect to give consent to the surgeon to repair your heart? If your mother, living across the country, were having a heart attack, would we expect the doctor to withhold treatment until she consented to it?
It’s not that simple with mental health and drug addiction problems. But at least some people are begging for—would be grateful for—doctors to take control and treat their loved ones. The alternative in a place like the DTES is not a choice between mandated and voluntary care. The more realistic choice right now, while people continue to suffer, is between mandated and no care. And absent care, we are stuck in a cycle of bringing people back from the dead to do it all over again. The system is in a perpetual fight to keep people alive a day, an hour longer.
In this battle, we can’t be sure of much, but we can be certain the number dying each year in BC and in the DTES far exceeds the number of addicts who are breaking free of their addictions. We have to assume that despite the moments of beauty and respect and love that do show up in glimpses, most don’t want this. They don’t want to be on the streets, they don’t want the desperation, they don’t want the addiction.
A wrinkle in this worldview comes via The Vancouver Area Network of Drug Users (VANDU), a drug user advocacy group at work in the DTES and beyond. VANDU, like many others, is of the opinion that the government and non-profit apparatus hodgepodged together over the years to deal with the DTES is full of parties most interested in self-preservation. It would be interesting to see if, in the event crime decreased precipitously in the DTES, the Vancouver Police Department would volunteer to cut its budget. What about some of the non-profits? If local drug users banded together and took control of their housing needs, would well-paid execs at non-profits walk away from their jobs, patting themselves on the back for a job well done?
How about the doctors and social workers? They are, according to VANDU, exerting soft power over drug users. Most outside observers would not assume this, but dig deeper—which is one reason for VANDU’s existence—and you can see the validity of this perspective.
For society to adopt VANDU’s goals—including ending the war on drugs and ensuring drug users’ right to “homes, a decent income, transportation, nutritious food, clean water, and healthy and safe communities”—we’d have to tackle larger systemic issues. These are worthwhile and increasingly crucial changes to pursue. But this kind of reformation doesn’t happen overnight, and presumably VANDU would not be in favor of the government and the non-profits and the doctors and the social workers walking away from the DTES tomorrow. What would the place look like then?
VANDU’s larger goals are and should be shared by a bigger swath of society, including those addressing climate change, environmental degradation, social justice, and increasing income inequality. But VANDU is above all about drug use, and the group’s goals include “the creation of a regulated drug market where people who use drugs have access to quality controlled drugs and can use them without fear or prejudice.” Drug use, the group points out, “is a pretty universal, non-deviant behavior and that drugs can bring pleasure, insight and connection without creating harms.”
In this light, the group comes across as having a yes and strategy. Yes housing, and healthcare and social supports and drugs—no strings attached. What’s an equivalent to this?
The long-term goal looks like a Mecca to drug use, but with relatively little mention of addiction—it’s a social problem to be addressed collectively, VANDU says, one that can’t be dealt with via abstinence or shame—it’s easy to imagine such a place turning to hell. Isn’t that what the DTES is now?
Drug use, like many of life’s recreations, easily veers into addiction with high costs to the addicts and the world around them. But it’s also not like alcohol, processed food, social media, and gambling. Using drugs, especially hard drugs, is walking on a razor’s edge, with a much narrower range of forgiveness. Unlike drug use, these others don’t, at any one encounter, run the risk of leaving you lying in an alley. They don’t generally require you to partake under the supervision of nurses in a specially-equipped ventilated room.
Relative to their demands, drug user advocates like VANDU seem to have a willful blindness to the tangential costs of unrestrained drug use. Why ignore the rights and feelings of non-users who live in the DTES? Anyone in an altered state of mind—from drink, drugs, or anything else—can be unnerving to a sober person. Is it wrong to be cautious or even ill at ease around them? What about when they steal from you or threaten you?
What about the cashier at Rexall the other day shivering with anticipation to finish her shift? Junkies, she said, on the verge of tears, are so hard to deal with. Do her feelings not count for anything?
What about the people who’ve opened and staffed restaurants in the area, gentrifying the DTES but bringing in money, customers, their talents, their attention? They don’t count?
The mother and son tandem who owned our local corner store finally sold. The son’s dentist told him his teeth were crumbling from the stress. He was sure he had PTSD. He never knew what the next customer that walked in would do, but he knew if there was trouble the cops were hours away from responding—even though their cars endlessly race by. I saw him more than once fighting off out-of-control shoplifters. The store, once a neighborhood go-to, is a vape shop now.
Drug possession and use need not be criminal—most other vices are not. But the fallout should be. Threats, assaults, property damage. They’re piling up and it’s costing us all, users and non-users both. The DTES and surrounding streets have lost banks, coffee shops like Starbucks, the major retailer London Drugs (which claims it lost $10 million over the life of its DTES location), and a Dollar Tree.
None of us can be surprised that other neighborhoods don’t want supportive housing for drug users and addicts. They don’t want that the trouble that comes with them, including a constant parade of police visits.
The police remain busy, a constant presence in the DTES. Dealing with ODs, violence, and small-time thieves supporting their addiction. Less seen, far less discussed in the proposals to turn the place around, are the only people truly winning in the DTES. The real criminals, the dealers.
VANDU hardly mentions them. Government proposals don’t give them much thought. Even a well-regarded challenge to all levels of government from the owner of PidGiN—a high-end DTES restaurant condemned by local residents when it opened—didn’t address the dealers.
Yet it’s the drug dealers—a group continually celebrated in pop culture—who are dropping bombs of poison into the DTES. They are preying on the mentally ill and the disadvantaged. They are directly responsible for the entire blast radius of destruction.
We can imagine the dealers favored decriminalizing small amounts of hard drugs. The same reason we can imagine they consider their customers something other than human. The money.
In this regard they’re in good company with big pharma, cigarette makers, social media platforms, among others. How else do the people at these companies prescribe oxy, hook you on doomscrolling, cut off your credit, or deny your claim except by looking at you as something other than a person. The drug dealers are more open, more heartless, but isn’t it a matter of degree?
How do we move forward without addressing them?
What about the people who recruit desperate DTES residents to steal? One couple the police arrested lived only a few blocks east of the DTES. Their greed couldn’t keep them from piling more depravity on the neighborhood.
Or the shop owner on the outskirts of the DTES who sold pipes and high-powered lighters favored by drug users—luring them with discount prices to hang out and get high further afield—because he didn’t give a shit, he didn’t live anywhere close by.
To be able to think and function like this, aren’t they the ones with mental problems?
Against people like this, against drugs this powerful, offering a smile or a gift card or to clean up the sidewalk can feel futile. Progress will take systemwide change from governments. And in spite of their faults, government and non-profit programs do help. But we’re stumbling. The DTES is getting less livable. The support system is struggling to keep addicts alive, and to bring those who OD back from the edge, back to the land of the living.
But if we can’t look at each other and see a sister or a brother, can’t see that some of us came up less fortunate, with trauma, then what are we bringing them back to?
And why?
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