Pubdate: Fri, 30 May 2008 Source: Globe and Mail (Canada) Copyright: 2008, The Globe and Mail Company Contact: http://www.globeandmail.ca/ Details: http://www.mapinc.org/media/168 Author: Gloria Galloway, With a report from The Canadian Press Bookmark: http://www.mapinc.org/find?142 (Supervised Injection Sites) OTTAWA WANTS SAFE-INJECTION SITE SHUT DOWN Arguing Vancouver Clinic Is Not Effective, Health Minister Says He Will Appeal B.C. Supreme Court Ruling That Allows It To Stay Open OTTAWA -- Ottawa moved yesterday to close Canada's only sanctioned safe-injection site, announcing it will appeal a B.C. court ruling that Vancouver's Insite should stay open because reducing the risk of drug overdoses is a vital health service. "In my opinion, supervised injection is not medicine; it does not heal the person addicted to drugs," Health Minister Tony Clement told the House of Commons health committee yesterday. "Injection not only causes physical harm, it also deepens and prolongs the addiction. Programs to support supervised injection divert valuable dollars away from treatment. And government-sponsored supervised injection sends a very mixed message to young people who are contemplating the use of illicit drugs." Mr. Clement told the committee he will ask Justice Minister Rob Nicholson to appeal a British Columbia Supreme Court ruling that saved Insite, North America's only sanctioned safe-injection facility, from closing at the end of June when its exemption from Canada's drug laws expires. Allowing addicts to inject themselves with illegal drugs at a supervised site in Vancouver prevents the death of one person a year, Mr. Clement said. "The evidence is that Insite's injection program saves, at best, one life per year. A precious life, yes. I believe we can do better and we must," Mr. Clement said, citing a report from an advisory committee he struck to investigate the merits of the site. "My job as Health Minister is to balance that one life against any possible negative effect of supervised injection that might take one life elsewhere." The advisory committee, which released its report in March, concluded that although Insite staff have intervened in more than 336 overdoses since 2006 and no overdose deaths have occurred at the site, "Insite saves about one life a year as a result of intervening in overdose events." The committee said long-term studies would be needed to verify that number, and the "mathematical modelling" may not be valid. On the whole, the panel found Insite to be cost effective and helpful to addicts looking for treatment. "Over a million injections have taken place at the site," said Liz Evans, a nurse who is executive director of the group that runs the site. "You don't have to be a rocket scientist to know that of the over 900 overdose incidents that have occurred since it's opened, probably more than four of them could have resulted in a death." The facility operates in the city's blighted Downtown Eastside on the strength of exemptions granted by Ottawa under a section of the Controlled Drugs and Substances Act. "In this case, we have given it due process, we've looked at all the evidence, and our position is that the exemption should not be continued," Mr. Clement said. Removing the exemption will shut Insite down if an appeal court reverses the B.C. court's judgment. In his ruling this week, Mr. Justice Ian Pitfield upheld arguments that Insite provided vital health services to addicts by reducing the possibility of drug overdoses, curbing the risk of transmitting infectious diseases and giving users access to counselling that may lead to abstinence. As a result, Insite's injection-drug users have the right to protection from drug laws under Section 7 of the Canadian Charter of Rights and Freedoms that guarantees everyone "life, liberty and security of the person," the judge found. He gave the federal government until June 30, 2009, to redraft laws against possession and trafficking of illegal drugs to accommodate Insite's operation. Without that adjustment, those key sections of the law are unconstitutional, Judge Pitfield said. If the ruling is allowed to stand, advocates will press for additional sites in Vancouver and across Canada, Mr. Clement said. He stressed that he approves of many of the services offered at Insite, including needle exchanges and condom distribution, and would not want it closed entirely. But he does not agree with supervised injections. The minister's rejection of the safe-injection site came after the health committee heard from a series of witnesses supporting its continuation. Others, like Thomas Kerr, director of the urban health research program at the B.C. Centre of Excellence in HIV/AIDS, cited the more than 25 peer-reviewed scientific papers that have found, among other things, that the injection site reduces public disorder, overdoses and disease while connecting the users of illegal drugs with avenues for treatment. But Mr. Clement discounted that research, saying many of the studies have been conducted by the same authors who "plow their ground with regularity." When asked when Mr. Nicholson will launch the appeal, his office referred calls to Health Canada, which would only say that it will ask the minister to do so at the earliest opportunity. Mr. Clement's announcement that he will ask for an appeal was greeted by cheers from a large group of people in the committee room who had been organized to attend to back the government's position. But opposition MPs sided in favour of Insite. David Butler-Jones, Canada's chief public health officer, looked decidedly uncomfortable when asked whether he agreed with Mr. Clement. "The science, I think, speaks for itself. The debate speaks for itself," Dr. Butler-Jones replied. "We provide the best advice we can. Governments and jurisdictions, as appropriate, make their decisions and have the political context in which they make their decisions." - --- MAP posted-by: Larry Seguin