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Camille Bains, Winnipeg Free Press: Doctors say court ruling on Insite opens door for similar facilities in Canada, Insite series 3 of 5

Doctors say court ruling on Insite opens door for similar facilities in Canada, Insite series 3 of 5
by Camille Bains, September 30, 2011

VANCOUVER – Doctors and nurses are hailing a decision by the Supreme Court of Canada to keep a safe injection site open in Vancouver so addicts can shoot up under supervision without the chance of dying on the street.

Dr. Julio Montaner, director of the B.C. Centre for Excellence in HIV/AIDS, said Friday’s ruling opens the door for other cities across the country to operate facilities such as Insite, which records 800 visits a day by people injecting their own heroin and cocaine.

He said the unanimous, 9-0 court decision means the fight to save the lives of people caught in the clutches of addiction will go on now that Insite’s fate is no longer in limbo.

The facility opened in 2003 to curb overdose deaths and spiralling HIV rates when the federal Liberals were in power and under an exemption to Canada’s drug laws.

But the Conservative government has vehemently fought against Insite, saying it fosters addiction.

“It would be very ill spirited of the federal government to take any further approach to try to fight this ruling,” Montaner said after the decision was announced to a boisterous crowd of supporters outside Insite, in Vancouver’s drug-riddled Downtown Eastside.

“I’m sure that with a majority government, they may have legislative means at their disposal that they could exert if they so wished,” he said. “I think the outcry on the part of the Canadian public would be absolutely devastating to the cause.”

Prime Minister Stephen Harper said the government will analyze the decision and act within its constraints.

“We’re disappointed,” he said in Quebec City. “We have a different policy.”

The continuing operation of Insite flies in the face of the government’s tough-on-crime approach.

“The preference of this government in dealing with drug crimes is obviously to prosecute those who sell drugs and create drug addiction in our population and in our youth, and when it comes to treating drug addiction to try to do so with programs of prevention and treatment,” Harper said.

Shelly Tomish, one of two plaintiffs at the centre of three court battles involving Insite, said the latest victory is “mind boggling” for people who depend on the clinic that’s jointly operated by the Portland Hotel Society and the Vancouver Coastal Health authority.

“I’d probably be dead,” Tomish said. “The amount of heroin I was doing, I was down to 69 pounds. I was paralyzed and in a wheelchair and that was the bottom for me.”

Deb McPherson, president of the B.C. Nurses’ Union, said she doesn’t understand the opposition to Insite, which is also supported by the Canadian Medical Association.

“People are confusing health care with morality and morality has no place in the health-care system,” McPherson said.

The court decision gave British Columbia power over Insite and recognized that health care falls under provincial jurisdiction, trumping Ottawa’s claims that it has jurisdiction over drug laws.

Mike De Jong, B.C.’s health minister, called the ruling “wise and humane,” saying Insite connects vulnerable people to health and addiction services.

“Last year alone, Insite staff made over 5,000 referrals for health and addiction treatment,” he said of the facility that costs the province $3 million in funding every year.

“Today’s ruling will allow the doctors, nurses and staff at Insite to continue to deliver care in a safe environment with a stable future.”

Dozens of studies in top medical journals have suggested Insite saves lives because addicts are given their own needles to inject drugs such as heroin and cocaine rather than sharing syringes that pass on HIV and hepatitis.

Dr. Thomas Kerr, director of the Urban Health Research Initiative at St. Paul’s Hospital, said one of the most compelling studies was published last year in the medical journal The Lancet and showed that overdoses declined sharply in the area around Insite.

“We demonstrated that there was a 35 per cent reduction from a two-year period before Insite opened to two years after,” he said outside Insite.

Kerr said there have been 1,500 overdoses at the safe-injection site, but nobody has died because a nurse supervises addicts as they inject their drugs.

“This is, without question, a facility that saves lives and I think the Supreme Court judgment confirms that,” he said.

“I think what’s unfortunate is that while we’ve been engaged in this absurd legal battle over this facility other lives have been lost in other settings . . . had other jurisdictions been able to move forward with their plans to implement this type of facility.”

Montreal, Edmonton and Victoria have expressed interest in facilities similar to Insite, which is North America’s only such clinic.

Natacha Boudreau, a spokeswoman for Quebec’s health ministry, said the government is analyzing the ruling before making a decision on a similar site, perhaps in Montreal.

“We have been waiting for this judgment and will reflect on it,” she said.

Kerry Williamson, a spokesman for Alberta Health Services, said the government “will examine today’s ruling carefully and consider what impact it may have with respect to our harm reduction programs.”

Maxine Davis, executive director of the Dr. Peter AIDS Foundation, said that clinic started providing HIV patients with an injection room about 18 months before Insite opened to service addicts who may have overdoses in a back alley or hotel room.

She said Friday’s court ruling provides certainty for the foundation and Insite to continue helping marginalized people who often don’t have family support and find acceptance and eventually treatment to kick their drug habit.

Health-care leaders from Toronto, Halifax, Saskatoon and even the Ukraine and Poland have visited the Dr. Peter clinic to learn how they can set up similar facilities, Davis said.

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