TORONTO – Gaining the support of provincial, municipal and community authorities. Providing more scientific evidence on the medical benefits of safe injection sites. Showing the facility is financially sustainable.
The federal government dropped the gauntlet on advocates of supervised injection sites Thursday when it proposed a new bill that contained a handful of regulations that would make it trickier for facilities similar to Vancouver’s Insite to open.
The new rules tack on additional requirements: applicants must consult with provincial and local governments, regional public health officials, as well as doctors, nurses and community groups.
They need to prove they are financially able. They need to present scientific evidence of the value in safe injection sites. And applicants need to consider the impact on public safety and security.
It’s a laundry list of rules introduced by Health Minister Leona Aglukkaq.
Read more: Supervised drug sites face steeper hurdles
“We all have a voice when it comes to our health and safety. I encourage them to be heard when it comes to supervised consumption sites,” she told reporters at a press conference.
Ultimately, Aglukkaq has the final say on whether the application is a success.
What do advocates and opponents say?
Those working on Insite along with safe injection advocates say Ottawa is “working out of spite,” introducing a series of very restrictive hoops to jump through.
Mark Townsend, who manages the Portland Hotel Society, said the proposed legislation could scare other groups away from filing applications to open supervised injection facilities.
“You’re trying to put up road blocks and trip people up. That’s what it feels like, unfortunately,” he told Global News.
Townsend played a role in the creation of Vancouver’s Insite in 2003. It’s North America’s first supervised injection site – set up in the Downtown Eastside, it helps addicts inject drugs safely, with sterile needles and a safe environment. Since 2010, it has administered more than one million injections.
But the inaugural facility came together with plenty of luck.
“It’s a massive amount of work. It took many, many people and we were lucky,” Townsend said. He noted that at the time, Insite had the support of city’s mayor, premier, and the Vancouver Coastal Health Authority. He says these officials considered the evidence before casting judgment.
“Not everyone’s going to have that,” Townsend said.
Other advocates are concerned about the wording of the bill.
“It’s not clear to me how all these criteria are going to be put together. It’s not clear to me whether one group who is strongly opposed would be able to have influence over the whole,” Walter Cavalieri, director of the Canadian Harm Reduction Network said.
Cavalieri said the concern lies in vague terms that could be manipulated.
Meanwhile, the NDP health critic Libby Davies said the government’s bill is effectively blocking any chance of setting up a new clinic.
On the other end of the spectrum, the Canadian Police Association said it would oppose any supervised injection sites, in almost every circumstance.
“While treating drug addiction is an important goal, my experience in Vancouver is that these sites also lead to an increase in criminal behaviour and disorder in the surrounding community and have a significant impact on police resources,” Tom Stamatakis, president of the CPA, said in a statement.
What happened in the 2011 Supreme Court ruling?
Aqlukkaq said the proposed legislation stems from a 2011 Supreme Court of Canada ruling.
That September, the country’s highest court ruled unanimously that the contentious Vancouver clinic could stay open, ending a years-long battle between the facility and Ottawa, which was calling for shutting Insite down.
The landmark decision played a key role in determining whether similar facilities would be established elsewhere. Ultimately, the ruling forced the government to keep the Vancouver clinic open against its will.
“Insite saves lives. Its benefits have been proven. There has been no discernible negative impact on the public safety and health objectives of Canada during its eight years of operation,” the ruling had said.
But the court added that if more exemptions for safe injection sites appear, the health minister should use discretion and strike a balance between community safety and charter rights.
Do we need safe injection sites in other parts of Canada?
A four-year Ontario study looking at the value of expanding safe injection sites suggests that both Toronto and Ottawa would benefit from these controversial facilities.
The extensive study – dubbed the broadest study of its kind – included focus groups, interviews with drug users, health officials, police, residents and business owners. It pulled in polling data, health data and projections for the future, its co-author Dr. Ahmed Bayoumi said.
Ultimately, it called for three safe injection sites in Toronto and two in Ottawa.
Establishing these facilities could stop HIV infections by about six to 10 per cent facility per year, Bayoumi said.
Results from his study showed that in Ontario, about 15 per cent of people didn’t support the idea of opening a safe injection site, meanwhile about 50 per cent were in favour of the facility.
“There were some people who just don’t want them and who adamantly opposed it. What we found was that was a minority of people,” he said.
It’s unclear, right now, if 15 per cent of dissent would be enough to halt an application for a safe injection site in its tracks.
What has research found on safe injection sites?
Dozens of studies conducted in Canada and abroad have suggested facilities such as Insite have helped reduce fatal overdoses and even stalled cases of HIV and hepatitis C.
One 2011 study says it noted a 35 per cent decrease in fatal overdoses in Vancouver since the facility opened.
Other research pointed to the value of safe injection sites as a stepping stone to rehabilitation. One Insite said that more than 30 per cent of users turned to detoxification programs after a year of operation.
Aglukkaq said she wants to consider how many people have relied on the facility and gone off drugs.
“It may save people from overdosing … but they’re still users and how many have actually stopped using heroin and what have you? That’s an important factor as well,” she told reporters.
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