B.C. injection site exempt from drug laws: Supreme Court

NationalPost.com – news
Sep 30, 2011.    Brian Hutchinson

Supporters and clients of Vancouver’s drug injection facility in the gritty Downtown Eastside are celebrating as Canada’s Supreme Court has rejected an appeal from the federal government to close down the controversial facility.

“It’s a great morning,” former Vancouver mayor Philip Owen said, as confetti swirled outside the large, publicly-funded injection site. Mr. Owen was instrumental in raising federal, provincial and municipal funds prior to its opening in 2003. “I always thought that once we got it up and running we could prove that it works. I was a little worried this morning but the Supreme Court has done the right thing. Now we can move on. I can think of five or six other cities in Canada that want something similar.”

In a unanimous ruling, the court has ordered the federal government to allow the facility — called Insite — to continue operations under a special Health Canada exemption that allows illegal street drugs to be injected under the watch of health care providers. Insite claims it saves lives and helps maintain public order in a neighbourhood where open drug use is rampant.

Insite organized an early morning street party Friday morning, outside its doors on East Hastings Street; it coincided with the release of the Supreme Court judgement. Just before seven in the morning, local time, the decision was announced. The large crowd gathered outside Insite erupted in cheers. A pancake breakfast has attracted hundreds of homeless and marginalized area residents.

Dean Wilson, who has fought drug addiction for more than 40 years and who has used the Insite facility himself, said the decision was a fitting result after the long battle first to get, and then to keep, the facility in Vancouver’s drug-ravaged Downtown Eastside.

“It’s a validation of all the stuff we worked [for],” Wilson said in the foyer of the Supreme Court minutes after the decision came down. “It’s a miracle.

“We already won, no matter what the results were, because statistically, eight or nine people a year would have died through the overdoses we’ve prevented [at Insite]. Over eight years, that’s 72 lives and that’s a win. We won the day we opened that door.”

Federal Health Minister Leona Aglukkaq said Friday the government will comply with the Supreme Court ruling, but that it will also review the decision as it considers its options.

Aglukkaq said the government believes the system should be focused on preventing Canadians from becoming drug addicts in the first place, noting a key pillar of the national drug strategy is treatment and prevention.

“Although we are disappointed with the Supreme Court’s decision today, we will comply,” she said in the House of Commons. “We will be reviewing the court decision.”

Vancouver NDP MP Libby Davies noted that fatal drug overdoses have dropped by more than one-third since the facility opened in her riding in 2003.

“This government has an opportunity here to take off their ideological blinders and support a vital public service that has saved lives and given people hope,” Davies said.

The fate of the supervised-injection site had been muddied ever since 2008, when the Conservative federal government refused to renew a Health Canada exemption that had permitted the facility to operate in contravention of criminal drug laws.

The Tories, including former health minister Tony Clement, have said that the facility and similar “harm-reduction” programs divert money from addiction-treatment programs.

In a subsequent ruling from the B.C. Court of Appeal in 2010, the court — in a 2-1 split decision — found the federal government, which has exclusive jurisdiction over criminal law, did not have the right to interfere with health care, which is covered as a provincial responsibility.

The Supreme Court found the government decision in 2008 not to renew the site’s exemption from drug laws violated the rights of Insite users under Section 7 of the charter, which protects the “life, liberty and security” of individual Canadians.

“It is arbitrary, undermining the very purposes of the CDSA, which include public health and safety,” the judges ruled.

The medical community also applauded Friday’s ruling and the president of the Canadian Medical Association said facilities such as Insite are a critical piece of the puzzle to quell the devastating effects of hard drug use.

“We’re delighted with this unanimous decision,” said Dr. John Haggie. “Insite worked to save lives and it’s a proven tool in management of addiction. We would like to see it as part of a national strategy that involves prevention, treatment, harm-reduction and enforcement. Really, this validates that tool of harm-reduction, so we’re delighted.”

“Canada’s physicians wanted to see something like this. It’s evidence-based and the decision was fairly clear that in a situation where there’s clear medical evidence of benefit, and no negative impact in terms of public safety, the federal government had to grant an exemption.”

Wilson, 55, has gone from using the facilities at Insite, to moving upstairs to Onsite — a second-floor detox centre — to the third-floor of the Vancouver building, which serves as transitional housing for people getting off drugs.

Now clean for two years, and nearing the completion of methadone treatment, Wilson said he hopes to turn that fight, and long hours of volunteering, into an income through work linked to the facility.

Although his fight to keep Insite in operation has been tough, and while he touts its benefits, Wilson said conditions have to be right for similar outfits to be successful in other Canadian centres.

“The planets aligned in Vancouver, where we have a horrible situation,” Wilson said. “I don’t advocate putting them [everywhere] … but I can see them in Montreal, I can see them in certain parts of Toronto, Victoria and Quebec City, but only if they make sense. You need the nurses on side, you need the city on side and you need the local police department on side.

“I’m not advocating them being popped up in any old [place] … but I don’t think ideology should prevent it.”

Haggie said with research indicating that lives are being saved as a result of Insite’s operation, he stressed that other supervised injection sites could be justified elsewhere.

“We haven’t seen [a national strategy] that works,” Haggie said. “[Insite] has made a difference. People are no longer dying in [Vancouver’s] Downtown Eastside.

“The problem in downtown Vancouver was that it was a public health epidemic. There were 300 people, at least, dying each year from overdoses. I think in those jurisdictions that have similar problems — and I’m thinking perhaps in Montreal or maybe in Toronto —there may be a really good case to put a centre like that there, too.”

Shortly after the decision was released Friday morning, Davies, said she felt “an incredible sense of relief and victory.”

“It’s always been about saving people’s lives,” Davies said. “It’s always been about a very important medical intervention to help people and the relentless opposition from the Conservative government has been just an incredible thing to take on. I feel so proud of all of the people who came together — whether they were academics, police officers, front-line activists, health professionals, and most of all, the drug users themselves — who were willing to stand up and have the courage to say they would fight all the way to make sure Insite continued its important work.”

Insite provides clean needles and other drug equipment to users and provides a safe place to inject the drugs.

No drugs are provided at the site and are acquired by the users themselves.

The site, which accommodates users ages 16 and over, also aims to reduce the instances of infectious diseases resulting from using dirty needles, such as HIV and hepatitis C.

A survey of 1,000 hard drug users in the region found that 87% had hepatitis C and 17% were HIV-positive.

About 4,600 intravenous drug users — or roughly half of the city’s users — live in the Downtown Eastside, which has a homeless rate of about 20%.

Wilson said Insite helps a vulnerable section of society and go beyond looking out for people in search of a high.

“I just want to continue to work together to do the best medical interventions we can,” Wilson said. “We’re talking about very seriously ill people — we’re not talking about people partying down there with some drugs on a Friday night. These are very sick people.”

With files from Bradley Bouzane and Jason Fekete, Postmedia News

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