Injecting Space: a cultural history and spatial analysis of the Drug Consumption Space 10 11 12 7 Hannah Leyland Appendix C: April 2017 Research Advisor: Dr. Sara Stevens Injecting Space: a cultural history and spatial analysis of the Drug Consumption Space by Hannah Leyland Bachelor of Science (hons.) in Health Science - Simon Fraser University - Vancouver, Canada Associate of Science - Langara College - Vancouver, Canada Research Mentor: Dr. Sara Stevens Submitted in partial fulfillment of the requirements for the degree of Master of Architecture in The Faculty of Graduate Studies, School of Architecture and Landscape Architecture, Architecture programme of the University of British Columbia. table of contents: list of figures 7 preface 8 abstract 10 thesis statement 11 individuals who specifically impacted my research: 12 PART 1: INTRO 1. introduction 16 2. related terms 20 3. goals 26 PART II: INSITE 30 4. overview 42 5. programmatic elements 60 6. in Vancouver PART III: INQUIRY 68 7. finding precedents 72 8. prisons 75 9. hospitals 80 10. opium dens 82 11. harm reduction 84 12. global examples of Drug Consumption Spaces PART IV: INSIGHT 96 13. existing design related research 98 14. seeking primary research 103 15. narratives PART V: INCEPT 16. learning from Insite 108 17. design proposal: furthering Insite 109 18. design proposal: continuum of Drug Consumption Spaces 114 19. assessment tools 117 epilogue 119 bibliography 120 Figure 53: AMOC Consumption Room list of figures: Figure 28: Crosstown Clinic - (2007): looking into staff area from Pharmacy Counter and Injection Room visitor area Figure 29: VANDU - Injection Room Figure 54-55: AMOC Consumption Figure 1: Street art in the Downtown Room (2007): looking from visitor area Eastside Figure 30: Overdose Prevention Society from staff area - Injection Trailer Figure 2: Goals of a Drug Consumption Figure 56: AMOC Consumption Room Space Figure 31: Vancouver - Overdose (2007): Marmoleum Red Floor Prevention Tent Figure 3: Achieving Cultural Safety Figure 57: AMOC Consumption Room Figure 32: Vancouver - Overdose (2007): Backsplash on walls, frosted Figure 4: Street art in the Downtown Prevention Tent windows, art, and furniture Eastside Figure 33: Street art in the Downtown Figure 58: AMOC Consumption Room Figure 5: Insite from Hastings Street Eastside (2007): Storage area and wooden chairs Figure 6: The objective of Insite Figure 34: Building Typology Analysis Process Figure 59: AMOC Consumption Room Figure 7: An Average Week at Insite (2007): Furniture, floor, and windows Figure 35: Table of related precedents Figure 8: The Average Visit at Insite and building typologies Figure 60: AMOC Consumption Room (2007): Evacuation plan and Figure 9: Substances Reported at Insite Figure 36: Narcotics Farm (1935), blackboard Lexington, KY, USA Figure 10: Alley in the Downtown Figure 61: Waiting Area, Spain Eastside Figure 37: Okalla Prison Farm (1912), Burnaby, BC, Canada Figure 62: ‘Danger Zone’, Spain Figure 11: Main Components Unpacked Figure 38: Panopticon (1790), Not built Figure 63: Accessibility, Australia Figure 12: Plan of Insite Figure 39: Modulator (1954), Figure 64 – 66: Hygiene, Germany Le Corbusier Figure 13: Program diagrams of Insite Figure 67: Colour, Switzerland Figure 40: The Subway (1950), George Figure 14: Elements diagrams of Insite Tooker Figure 68: Colour, London (render) Figure 15: Waiting Area at Insite Figure 41: The Government Bureau Figure 69: Colour, Luxembourg looking out to Hastings Street (1956), George Tooker Figure 70: Injection Booths, France Figure 16: Section diagram of the pre- Figure 42: The Waiting Room (1957), injection space of Insite George Tooker Figure 71: Street art in the Downtown Eastside Figure 17: Injection Booths at Insite Figure 43: Paimio Sanatorium (1933), Alvar Aalto Figure 72: Drug Consumption Space Figure 18: View from the Nurses ‘experts’ Station at Insite Figure 44: Cure Chair at Paimio Sanatorium (1933), Alvar Aalto Figure 73: Contacts Figure 19: Nurses Station from the participant’s location at Insite Figure 45: Covered Patio, REHAB Basel Figure 73: Related Lectures (1998), Herzog and de Meuron Figure 20: View from the Nurses Figure 74: Street art in the Downtown Station looking towards the entrance Figure 46: Patient Room, REHAB Basel Eastside door at Insite (1998), Herzog and de Meuron Figure 75: Narrative before and after Figure 21: Section diagram of the Figure 47: Pool for physical therapy, Insite injection space of Insite REHAB Basel (1998), Herzog and de Meuron Figure 76: Narrative before and after Figure 22: Seating and coffee/juice bar Heroin Assisted Treatment in chill-out room at Insite Figure 48: Skylight above bed in Patient Room, REHAB Basel (1998), Herzog Figure 77: Continuum of Services Figure 23: View from the table in and de Meuron the chill-out room towards the from reception desk at Insite Figure 49: Opium Dens from around the world (late 19th century) Figure 24: Section diagram of the post- injection space of Insite Figure 50: Sex Boxes, Zürich (2013) Figure 25: Map of Drug Consumption Figure 51: Exterior of AMOC Spaces in Vancouver Consumption Room Figure 26: Table of Drug Consumption Spaces in Vancouver Figure 52: AMOC Consumption Room (2007): showing windows, art, lighting, Figure 27: Dr. Peters Center - Injection floor, and furniture Room 6 7 After describing my thesis topic I am often asked, “You could have chosen My second inspiration comes from my brother’s struggle with drug addiction. preface to research anything for your architecture thesis, where did this idea stem Throughout his recovery process I visited a number of detox facilities, from?” rehabs, sober-living houses, and saw first hand the way these facilities are structured and designed. I know the lengths an addict will go to get his Previous to pursuing a Master of Architecture degree, I completed a Bachelor drug of choice and the destruction this causes to families. I understand the of Science in Health Science. This statement is usually followed by questions societal perceptions of how these individuals are seen as undeserving of about why the 180-degree switch, as the two fields are seemingly unrelated. attention or care, and that efforts are often seen as ‘enabling’ drug use. Going back nearly four years ago to the Statement of Intent I wrote to receive admission to Architecture School, I stated: My third reason stems from my love of Vancouver. I was born and raised in Vancouver, a place that is consistently number one or at least among the “It may appear as though the paths of architecture and health sciences rarely top five cities for livability and quality of life. [1, 2] However, “No society intersect, or only do so in the construction of health care facilities. However, my can understand itself without looking at its shadow side”. [3] In Vancouver’s academic pursuit of health sciences interwoven with my experiences working at ‘shadow side’ lies some of Canada’s most marginalized citizens located in my father’s architecture firm have made it apparent that they are linked at many the Downtown Eastside neighbourhood. As a Vancouverite, this is not a integral levels. The social determinants of health and the built environment are new phenomenon, I have known about this reality my entire life. The issues tightly intertwined within architecture and should be considered in every design are largely concentrated within a 4-block radius along East Hastings Street whether institutional or domestic. An effective design has the power to promote and Main Street. It is a huge, complicated problem that attracts worldwide safety, encourage social interaction, avoid injury, foster support networks, and attention and wonder. The Vancouverite in me was curious to understand influence health decisions.” this phenomenon further. I ended my statement by saying: I truly believe that everyone has a role to play in dealing with societal issues. “I hope to one day practice architecture in Vancouver and enhance my designs I felt as though that it would be appropriate to apply the discipline and with my knowledge of health sciences in areas such as epidemiology, mental health, resources of architecture to what is a broad and disastrous community and the social determinants of health as together, they can better our lives.” problem. I will now admit that at the time I really had no idea whether this was My thesis as it stands combines my interests in health, my experiences with even true, just how I was going to achieve the statement, or if I was even my sibling, my familiarity with Vancouver, and my newly acquired training in interested in doing that at all. I was merely trying to ‘prove’ to myself and architecture to investigate ‘Drug Consumption Spaces’. others that I hadn’t abandoned the Medical School direction for something completely unrelated or irrelevant to health. “Those whom we dismiss as `junkies’ are not creatures from a different world, only men and women mired at the extreme end of a continuum on which, here or there, all of us might well locate ourselves.” “No society can understand itself without looking at its shadow side.” - Dr. Gabor Maté - Dr. Gabor Maté In the Realm of Hungry Ghosts: In the Realm of Hungry Ghosts: Close Encounters with Addiction Close Encounters with Addiction 8 9 The Downtown Eastside drug-using population of Vancouver is as deserving By exploring the primary research in this paper, I will set out to create abstract of healthcare as any population on the planet. The extensive healthcare system design principles and apply these guidelines to a continuum of design thesis statement that we have currently devised and the facilities that we have beautifully interventions, that aim to understand: designed to be efficient, work well for the average person. However, this system is failing the marginalized Downtown Eastside individuals, people who could greatly benefit from it. Healthcare settings are filled with barriers for this population.