Vancouver currently offers a number of harm reduction services, and a number of others are in the proposal or development stage. Millions of needles are exchanged in Vancouver each year at fixed sites and mobile outreach, by both the Vancouver/Richmond Health Board and the Downtown Eastside Youth Activities Society (DEYAS). Access to methadone has been improved in recent years, and a heroin maintenance trial, NAOMI , has recently been proposed (Schechter & O’Shaughnessy, 2000).

Fledgling peer-based programs are being developed by the Vancouver Area Network of Drug Users (VANDU), including the user-run VANDU Health Network. The Vancouver/Richmond Health Board, with funding from Health Canada, is waiting to open a resource centre, and the BC Centre for Disease Control’s street nurse and other programs provide outreach services. The Portland Hotel Society and the Dr. Peter Centre have developed innovative housing and residential projects with health care services built in. The Harm Reduction Action Society has specifically chosen to develop services that are conspicuously absent in the Vancouver context.

The goal of the Society’s first major initiative is to establish an 18-month pilot of two safe injection facilities.