The Toronto program COUNTERfit, unlike Vancouver's Insite safe injection clinic, pays drug users and dealers to help distribute clean needles on the streets and operates in a legal grey area.

Safe injection sites

A Supreme Court of Canada ruling that came down on Sept. 30, 2011, gave Vancouver's supervised safe injection clinic, Insite, the green light to continue operating. The court ruled against the federal government, saying that withdrawing the exemption from drug laws under which the clinic had been operating, as the government had wanted to do, would violate the Charter of Rights and Freedoms.

The clinic, which opened in 2003 and is located in the heart of Vancouver's troubled Downtown Eastside neighbourhood, provides a safe place for addicts to inject drugs, under the supervision of medical staff and supplies users with clean needles.

Health and social workers say the program helps prevent the spread of disease and drug-related crime.

Grey zone

Toronto has been experimenting with an unorthodox program called COUNTERfit, funded by the Ontario Ministry of Health and the City of Toronto since 1998.

COUNTERfit relies on a different harm-reduction strategy than Insite: It pays drug users and dealers to help distribute clean needles and to work as ambassadors for the program, collecting information about users and the type of drugs that are circulating on the street.

While the Insite court ruling was seen as a victory for health workers and advocates looking to open similar supervised injection sites in other Canadian cities, COUNTERfit continues to operate in a kind of legal grey area. Journalist David McDougall and photojournalist Liam Maloney spent months following some of the people who work with the COUNTERfit program. David explores some of the challenges they face in his radio documentary Grey Zone.