The Canadian HIV/AIDS Legal Network on Tuesday urged Prime Minister Stephen Harper to keep Vancouver's safe injection site open and roll out a needle exchange program in prisons across the country.

"The Canadian government's head is in the sand on the problem of HIV among people who use drugs and prisoners," Joanne Csete, the network's executive director, said during a news conference at the International AIDS Conference in Toronto.

The Insite supervised injection clinic is the only one of its kind in North America.
(Canadian Press/Chuck Stoody)

"Proven harm reduction measures such as Insite, Vancouver's supervised injection facility, are under threat of cancellation by Ottawa. In Canadian prisons, such measures are non-existent — and people are paying the price with their lives."

The supervised injection clinic is the only one of its kind in North America.

It provides clean needles and counselling to intravenous drug users on Vancouver's Downtown Eastside, which has some of the highest HIV and hepatitis C infection rates in the world. Staff are also trained to deal with overdoses.

"Discontinuing this remarkable service would be a step backward for Canada's response to HIV/AIDS," the Canadian HIV/AIDS Legal Network wrote in a July 2006 open letter to Health Minister Tony Clement.

The pilot project can operate legally until Sept. 18 under a three-year Health Canada exemption to Section 56 of the Controlled Drugs and Substances Act.

Clinic helps decrease overdoses: reports

In an RCMP report released Aug. 14 examining the safe injection site, criminologists recommended the federal government extend Insite's mandate.

Harper has said he would wait for the RCMP report's findings before deciding whether to allow the site to continue with federal approval.

The RCMP report concluded that it's too early to see the clinic's impact on the transmission of HIV and other blood-borne diseases — Insite opened in 2003 — but it has helped addicts to learn how to inject safely and prevent overdoses.

A study published in the New England Journal of Medicine in June 2006 showed drug users who frequented the clinic were more likely to go into detox and other rehabilitation facilities.

The safe injection clinic has also been endorsed by the Vancouver Police Department.

Fears not realized

However, the clinic's opponents argue that supervised injection sites would bring crime to the area, increase drug use and encourage non-drug users to pick up the habit.

But criminologist Irwin Cohen, who was commissioned to study Insite for the RCMP report, said those fears have not been realized. And, he said, most of the estimated 5,000 intravenous drug addicts in the area are not using Insite.

There were an average of 607 visits to Insite daily during the two-year period that ended March 31, 2006, according to research by the Vancouver Coastal Health Authority.

The health authority said 453 drug users overdosed at the clinic in that two-year period, but none died.

Clinic staff made 4,083 referrals during the two years, 40 per cent of them to addiction counselling.

Clinics key to controlling AIDS: conference speaker

Harm reduction facilities such as Insite are key in the battle against AIDS, said Alex Wodak, director of the Alcohol and Drug Service at St. Vincent's hospital in Australia since 1982, during a session at the AIDS conference on Tuesday.

"HIV among injection drug users is an important part of the global epidemic," Wodak said during the session. "Harm reduction is an effective, safe and cost-effective way of bringing this part of the epidemic under control."

He said the scientific debate over the benefits of harm reduction is over. The former president of the International Harm Reduction Association said one of the issues now is to push for these programs, despite the view that they accept illegal drug use.

"The choice is either controlling drug-related HIV infections, or sending what some consider to be the right message," he said. "We can't have both."