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Drugs
The battle over Insite
The science is clear and the benefits are real. So why is the debate over the future of the injection site perpetuated?
By Leah Martin
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Nearing the end of its sixteen-month extension, Insite, North America’s only supervised injection site, is wondering whether or not it will have the renewed legal status needed to continue offering health services past December 31, 2007.
The latest question being asked is, Who’s jurisdiction does Insite fall under? The recent court action launched by the Portland Hotel Community Services Society and two plaintiffs who are users of Insite’s services argue that it should not be in the hands of the federal government.
Though a substantial amount of scientific evidence reflecting the outcomes of Insite’s services has been provided to Health Minister Tony Clement and Prime Minister Stephen Harper, both remain resistant to making a clear decision. “What’s the hold up?” people are asking. Failure to address this crucial matter regarding one of Vancouver’s most sensitive social issues has raised votes of non-confidence in the federal government across the board.
The court action, spearheaded by well-known human rights lawyer Joseph Arvay, served on August 17, 2007, argues two main points. The first point declares that, according to the Constitution Act of 1867, subsection 91 & 92, there is a distribution between the provinces and the federal government of legislative powers to create laws and establish services based on provincial needs in the best interest of its citizens. Since Insite is incorporated into, and supported by, the provincial health system, Vancouver Coastal Health authority should be able to act as designates of the legal exemption from penalties on the grounds of a medical and scientific purpose for Insite to continue operating.
The second point furthers this claim by declaring under the Consitution Act of 1982, which includes the Canadian Charter of Rights and Freedom, that if an individual’s rights to life and security of the person are being infringed upon, and not in accordance with the principles of fundamental justice, the individual has a right to challenge this in the courts. If Insite closes, the government could potentially be putting many lives at risk. Insite’s services are complementary to other health clinics in the downtown area catering to people with addictions. Though a variety of services exist, still many users are not receiving the attention they need. At Insite, attention to wound care and infection control can be managed, as well as access to counselors and referrals to other agencies. Insite also teaches health and safety to users by providing clean supplies and information on practicing health-conscious use while trying to manage addiction.
Before this case was launched the main factor influencing the status of the injection site depended on the ability of an Expert Advisory Committee (EAC) appointed by Health Canada to grant six groups of researchers funds to conduct secondary analysis of the twenty-four studies already published. The researchers would be expected to do this in a meager three or four months. This secondary analysis would help Health Minister Clement decide if Insite “helped people get off drugs.” The research grants were allotted as of September 2007, and the deadline given is February 2008. This can almost guarantee users another two months extension while the conclusions are being assessed by Health Canada.
If Health Canada denies Insite the legal exemption they need to operate, this new court action will help give Insite the leverage they need to fight for their right to exist, as they can petition the courts to order Insite to remain active until the matter is resolved. This case will proceed regardless of the activity of the EAC.
The main incentive behind this case is to get Stephen Harper to see the value behind harm reduction-based services. Other objectives in the case address the value and respect of peer-reviewed research as a means to guide policy-making, as well as setting a precedent concerning provincial health matters needing federal approval, like creating a niche for harm reduction or the ability of each province to create services based on the needs of their own population.
No one’s health issue should become a political game. This is why a small, organized group called Insite for Community Safety have been running a campaign geared towards educating the public and gathering public responses on the topic of injection sites. There are seventy-six injection facilities in eight different countries around the world, some established as early as 1976. It is not a new idea, nor is it of questionable success. The science, no matter what language it comes in, provides the same answers: injection sites are a positive solution.
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