This is the Cato Daily Podcast for Thursday, April 4th, 2019.

I'm Caleb Brown.

Heroin users have often been burned by the clinical system, the criminal justice system, and others who are supposed to help.

Darwin Fisher is program manager and coordinator of the Insight Clinic, a supervised injection

facility in Vancouver, British Columbia.

Much of his work focuses on meeting drug users where they are,

and he says it makes all the difference.

We spoke at the Cato Institute's Harm Reduction Conference last month.

Describe the kind of people who come to your facility.

The sort of people that attend insight are, I think, some of Canada's poorest citizens. Most of them are

unhoused or under-housed. They tend to be entrenched substance users who have been injecting substances for multiple years.

Most of them, many of them, are going to struggle to access any other societal services, i.e. they are often barred from clinical services,

struggle to access housing, any community centers often don't want to see them.

They are just people who are completely ostracized from society.

And they are almost to a person coming from backgrounds of extraordinary privation, poverty, and trauma.

And I feel as though their drug use, their opiate use, their stimulant use and things like that are kind of survival reactions to mitigate what can feel like an unbearable existence.

That's what some of the users relate to me when we just talk about things like that.

So Insight, fundamentally, outside of keeping people alive and preventing disease

transmission and all these things it recognizes that this population

exists because this population exists I think in every major city and yet

we consign them to the margins and the alleys and most of us don't even know that they exist. It's like that movie

Alien in space no one can hear you scream. The pain that people have endured

...