The Supreme Court of the Canada will hear arguments this week that will likely determine the future of Vancouver's supervised injection site, known as Insite.
The court will have to decide whether Insite is a health-care facility under the jurisdiction of the B.C. government, and whether closing it violates the rights of impoverished drug addicts.
Supporters, including the province, say a body of peer-reviewed studies has proven Insite prevents overdose deaths, reduces the spread of HIV and hepatitis, and curbs crime and open drug use.
But the federal government rejects that evidence, arguing the facility fosters addiction and runs counter to its tough-on-crime agenda.
"I'm unsure about what the future actually holds," said Liz Evans, the founder and executive director of the Portland Hotel Society, which runs the facility.
"We all are well aware that drugs aren't good for people and people use them for all sorts of reasons," said Evans.
"The issue we have is that the people who use them illicitly and are pushed to the margins and are using things that are impure, are putting their lives at risk," she said.
Courts kept clinic open
The clinic was opened in 2003 as the first of its kind in North America. It allows drug addicts to inject their own drugs in a clean environment under the supervision of a nurse, but it requires an exemption from federal Health Act legislation to operate.
The initial exemption was granted by the federal Liberal government, but since then Conservative government has indicated it wants to end the exemption and see the supervised injection site closed.
Advocates for the clinic successfully challenged the federal government, winning a B.C. Supreme Court decision later upheld by the B.C. Appeal Court in January 2010 that found Insite is a health facility and so falls under provincial jurisdiction, not federal.
Federal lawyers appealed to case to the Supreme Court of Canada, arguing that Insite makes it easier for people to break the law.
Funded by B.C. government
The B.C. government has spent about $3 million a year running Insite, making it central part of its harm-reduction strategy on Vancouver's Downtown Eastside.
Over two dozen studies in various medical journals have hailed the facility as a success story, suggesting it has reduced overdose deaths, HIV and hepatitis rates and crime in the 10-block radius of the impoverished Downtown Eastside, where the city's intravenous drug users are concentrated.
The B.C. Centre for Excellence in HIV-AIDS has said that since Insite opened, there's been a 30 per cent increase in the number of addicts who enter detox. Other Canadian cities, such as Victoria and Toronto, have said they want to open their own safe-injection clinics, modelled on Insite.