Vancouver injection site becomes election issue

Vancouver's controversial safe injection site became an election issue Monday after yet another published study showed it has saved lives, prompting the study's author to say Conservative policy on the site has no basis in fact.
Marc Townsend, manager of the Portland Hotel Society, enters Insite, Canada's only safe injection site for intravenous drug addicts in Vancouver. The society along with Vancouver Coastal Health Authority operates the site. (Richard Lam/Canadian Press)

Vancouver's controversial safe injection site became an election issue Monday after yet another published study showed it has saved lives, prompting the study's author to say Conservative policy on the site has no basis in fact.

Critics demanded Prime Minister Stephen Harper drop his government's opposition to the clinic and abandon efforts to have it shut down.

Harper was in Yellowknife on Monday where he touted his government's national drug strategy, saying it is based on prevention and treatment.

But the Conservative government has said in the past that it doesn't condone the safe injection site and claims it fosters addiction.

The latest study was published this week in the influential medical journal The Lancet. It was written by Dr. Thomas Kerr, along with his colleagues from the Urban Health Research Initiative at Vancouver's St. Paul's Hospital.

"Canadians should be concerned about how the federal government is approaching problems like drug addiction — that they're really not basing their decision on science, they're basing it on ideology," Kerr said.

Fatal overdoses decrease

The clinic, Insite, 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 study concluded the site has helped reduce the number of fatal overdoses in Vancouver's notorious Downtown Eastside by more than a third.

"This is further evidence showing that Insite is meeting its objectives [and] it's very important because it's showing it's preventing death," said Kerr.

Researchers tracked fatal drug overdoses in the clinic's immediate area over a 33-month period before the facility opened in September 2003, and for 27 months after it opened. The fatal overdose rate plunged 35 per cent after the site opened, the study found, while the number of fatal overdoses in the rest of the city fell by just nine per cent during the same period.

But the 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, however, arguing that Insite makes it easier for people to break the law.

This drew criticism from then-B.C. health minister Kevin Falcon, who pointed to the large body of independent research supporting the clinic.

The Supreme Court of Canada is expected to hear arguments on the matter next month.

'U.S. style war on drugs'

Kerr said Monday the Conservative's stance on the matter is unenlightened.

"We're really taking a step backwards by trying to employ a U.S. style war on drugs, which is a well documented policy failure," he said.

"Insite has also been shown to be highly cost effective. So if you're concerned about the economy, this is clearly something that you should support."

Janice Buchanan, vice-president of the BC Nurses' Union, called on the Harper government to drop its appeal in light of the Lancet study, saying the study shows Insite helps addicts get into detox and recover.

"Instead of wasting taxpayer's money on lawyers and courts to try to shut down this legitimate health-care service, the ruling Conservatives — and all other political parties — should use this moment as an opportunity to ensure that their health-care policies are based on evidence," Buchanan said in a news release.

Preventing death

The B.C. government has spent about $3 million a year on Insite, a pillar of its harm-reduction strategy to battle drug addiction.

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.

Liberal MP Hedy Fry, a physician whose Vancouver Centre riding encompasses the Downtown Eastside, said Harper must act on the evidence.

"If you recognize that addiction is an illness and it is a medical problem and you should deal with it with medical solutions, one of the most important things is prevention of death," Fry said. "[Insite is] achieving this objective in a remarkable manner."

Fry said the site is an effective public health tool.

"Stephen Harper lives in the flat-earth society. Evidence is what you look at. It works? Good."