Safe sites for drugs save lives

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The published study on Insite's impact on Vancouver's Downtown Eastside should put to rest the Harper government's fretting about whether any good evidence exists that the safe injection site improves the lives of drug addicts. The significant cut in overdose deaths in the Downtown Eastside after Insite opened is about as real as harm reduction gets. Regardless of how the government's challenge on the clinic's right to exist results -- it is now before the Supreme Court of Canada -- Ottawa should commit to supporting the clinic.

That support may not translate into federal funding for Insite, a clinic where addicts can inject their own drugs under supervision of staff that provides rudimentary health care and counselling to users. But it does mean that Ottawa should no longer stand in the way of other clinics like Insite from opening.

The government will defend its authority to regulate safe injection sites at the Supreme Court next month, after successive British Columbia judges struck down the necessity of the clinic to get an exemption. At present, such clinics can operate under exemption from federal drug laws by way of a minister's permit.

Insite opened in 2003 under a Liberal government and was in danger of being shut down in 2008 under the Harper government, which said it would focus public policy on addiction prevention and treatment. Then health minister Tony Clement said that there was no good evidence that Insite helped addicts.

On Monday, the British medical journal The Lancet published a study, funded by Vancouver Coastal Health and the Canadian Institutes for Health Research, that found the rate of overdose deaths in the Downtown Eastside neighbourhood fell by 35 per cent, compared to a fall of nine per cent in the rest of Vancouver. Researchers compared roughly the same period of time before and after Insite opened.

A similar clinic in Montreal is looking for approval to open, but that province is awaiting the Supreme Court's judgment. There are some 65 safe injection clinics globally, giving addicts a secure place to shoot up, access to medical care and counselling. Bringing addicts into a clinic to shoot up benefits the neighbourhood, too.

Nothing prevents government from investing in prevention, treatment and harm reduction at the same time. Nothing, perhaps, but ideology. Support for safe injection clinics does not sanction drug use, it merely recognizes that there is a drug problem and that it can have wide-ranging costs to people and the health and justice systems. Now, there is solid science to show that all those costs can be reduced through humane delivery of health care at street level. Insite did not prevent all overdoses, but staff saved the users from dying.

The Harper government may or may not win its challenge at the Supreme Court, a legal battle over jurisdiction. But that should not trigger the closure of a neighbourhood resource that saves lives -- other evidence exists that such clinics also reduce the multiple health issues that ride along with drug abuse. The signs are that Insite, operating at capacity, needs to expand.

The government's intransigence on the delivery of a necessary, popular health service is preventing other safe injection sites from opening in Canada. It should now see its policy costs lives every year, and allow other cities to follow Vancouver's lead.

Republished from the Winnipeg Free Press print edition April 21, 2011 A14