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Supervised injection sites in Canada

The controversy behind supervised injection sites is nothing new. As previously stated in The Daily’s news article, “Supreme Court rules in favour of supervised injection site” published on October 24, the Supreme Court ruled on September 30 in favour of allowing Insite, Vancouver’s supervised injection site, to continue running. According to Quebec Health Minister Yves Bolduc, the city of Montreal plans to follow suit in the coming year.

Supervised injection sites are a place where those addicted to drugs go to inject them under the supervision of health care specialists. They get their drugs from their usual source and take them into a building full of nurses, counselors and other health authorities to inject. The purpose of this arrangement is to keep them off the streets, provide clean needles, and allow authorities to intervene in the case of emergency.

InSite, the first, and only, legal injection supervision site in North America, is located in Vancouver. It first opened in 2003 and has since helped over 12,000 drug users safely inject. InSite operates under a harm-reduction model – they strive to decrease the adverse health, social, and economic consequences of drug use without abstinence. They offer a network of nurses, counselors, mental health professionals, and peer support workers, along with clean injection equipment such as syringes, cookers, and tourniquets to prevent infection.

According to InSite for Community Safety, a website linked to InSite, there have been only thirty new cases of HIV/AIDS in downtown east side of Vancouver the year after InSite’s opening. This is massive progress compared to 1996’s 2100 new cases. These sites also save large amounts in health costs yearly – lifetime costs of an HIV infection are about $500,000, a significant amount compared to InSite’s relatively meager 2010-11 budget of $2,969,440.

There are 12 injection booths at InSite, where drug users inject under the supervision of nurses and healthcare staff who intervene immediately in the case of any complication. InSite has successfully intervened in 221 overdoses and has referred over 5,000 drug users to social and health services, such as detox and addiction treatment.

Supervised injections sites have many names, including: drug consumption facilities, medically supervised injection sites, safer injection facilities, or – most controversially – safe injection sites. Most officials are hesitant to call them safe, on the premise that drugs are inherently unsafe.

Not only are these sites safer for the drug users themselves, but they also make the community surrounding them safer. Contrary to what politicians opposed to supervised injection sites may argue, Health Canada has shown that these sites do not attract drug-related crime. In addition, they reduce drug-related litter in the streets, overall needle-sharing, and do not negatively impact those seeking addiction treatment. Furthermore, they promote education about drug abuse so that the public can get the facts. Health Canada also reports that studies conducted by “a private security firm hired by the Chinatown Business Association show that between 2003 and 2006 there was a decrease in sex trade activity (by 19 per cent), thefts (by 32 per cent), shop lifting (by 20 per cent), sexual assault (by 66 per cent) and squeegee activity (by 95 per cent) on the Chinatown area.”

The main argument against InSite and similar institutions is that drug use is a crime, and should not be condoned in any way. For example, the Royal Canadian Mounted Police released a report in 2006 claiming that there is an increase in the number of drug users proportional to the decreased risks associated with InSite. Tony Clement of the Conservative Party called InSite an “abomination” and, in 2008, refused to renew InSite’s exemption from the federal Controlled Drugs and Substances Act. In general, the Conservatives see injection sites as a step towards drug legalization, undermining laws and policies, as implied by Stephen Harper’s comment that “we as a government will not use taxpayers’ money to fund drug use.”

“Unlike what some people believe, the sites do not increase crime in the community. They save lives. Drug abuse is a disease,” said Quebec’s Health and Social Services Minister Yves Bolduc to the Globe and Mail.

“The evidence is overwhelming,” Mark Townsend, executive director of the PHS Community Services Society said to the press after the court ruling in Ottawa. “You have forty peer-reviewed studies funded by the federal government themselves that says it saves lives, it saves money, it’s a useful part of a comprehensive strategy.”

And, as the Supreme Court concluded, “there can only be one response: to grant the exemption” and keep safe injections sites alive.