This TED Talk features drug addiction epidemiologist Mark Tyndall, recorded live at TEDmed 2017.

I remember the first time that I saw people injecting drugs.

I had just arrived in Vancouver to lead a research project in HIV prevention,

in the infamous downtown east side.

It was in the lobby of the Portland Hotel,

a supportive housing project that gave rooms

to the most marginalized people in the city,

the so-called difficult to house.

I'll never forget the young woman standing on the stairs, repeatedly jabbing herself

with a needle and screaming, I can't find a vein as blood splattered on the wall. In response to the

desperate state of affairs, the drug use, the poverty, the violence, the soaring rates of HIV,

Vancouver declared a public health emergency in 1997. This opened the door to expanding harm

reduction services, distributing more needles, increasing access to methadone, and finally opening a

supervised injection site, things that make

injecting drugs less hazardous. But today, 20 years later, harm reduction is still viewed as some

sort of radical concept. In some places, it's still illegal to carry a clean needle.

Drug users are far more likely to be arrested than to be offered methadone therapy.

Recent proposals for supervised injection sites in cities like Seattle, Baltimore, and New York

have been met with stiff opposition.

Opposition that goes against everything we know about addiction.

Why is that?

Why are we still stuck on the idea that the only option is to stop using,

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