Pubdate: Sat, 01 Oct 2011
Source: Edmonton Journal (CN AB)
Copyright: 2011 The Edmonton Journal
Contact: http://www.edmontonjournal.com/opinion/letters/letters-to-the-editor.html
Website: http://www.edmontonjournal.com/
Details: http://www.mapinc.org/media/134
Author: Peter O'Neil, edmontonjournal.com, with files from Marianne White, Bradley Bouzane and Jason Fekete,
Postmedia News; and Jeff Lee and Evan Duggan, Vancouver Sun

TOP COURT REBUFFS PM OVER DRUG INJECTION SITE

OTTAWA -- Prime Minister Stephen Harper said he is disappointed but
will comply with a Supreme Court of Canada ruling on Friday that has
thrown open the door in B.C. and across the country to new supervised
injection sites, dubbed "shooting galleries" by conservative critics.

Canada's top judges, in a sharp rebuke of one of Harper's key
law-and-order planks, said the government's attempt to shut down North
America's only nurse-supervised injection site for drug addicts
violates the Charter of Rights.

The nine judges agreed with studies validating the Insite clinic's
role in reducing overdose deaths and disease, and found that the
government's move to shut it down threatened the health "and indeed
the lives" of addicts who otherwise risked disease and infection using
shared needles.

A 2008 B.C. Supreme Court decision was correct in deciding that
"Insite is effective in reducing the risk of death and disease, and
has no negative impact on the legitimate criminal law objectives of
the federal government," Chief Justice Beverley McLachlin, who is from
B.C., wrote on behalf of her eight colleagues.

The ruling ordered an immediate exemption that will allow the facility
to remain open.

Harper has always opposed "harm reduction" approaches, such as clean
needle exchanges and injection sites, preferring tough enforcement and
prevention programs.

"We're disappointed, we have a different policy," Harper told
reporters in Quebec City. "We'll take a look at the decision, but we
will clearly act in respect and within the constraints of the decision."

Harper said it is "premature" to speculate on the possibility of other
cities establishing supervised injection site. "Obviously, it is going
to lead to some changes in federal policy in order to respect the decision.

"The preference of this government in dealing with drug crime is
obviously to prosecute those who sell drugs and create drug addiction
in our population and in our youth.

"And when it comes to treating drug addiction, to try and do so though
programs of prevention and treatment, rather than through the issues
that were in front of this court in terms of so-called harm reduction."

Marliss Taylor, manager of Streetworks, an Edmonton agency that
delivers nursing and outreach harm reduction services, welcomed the
court ruling and said she hopes the Alberta government will consider
its implications.

"Currently, people inject in very unsafe places and that puts them and
the community at risk," Taylor said in a statement.

"We will be examining our options for the future, because we certainly
believe that people who use drugs need to receive appropriate
infection prevention and health interventions.

"These actions prevent transmission of HIV and (Hepatitis) C, and
represent a great cost saving to the health-care system in Alberta. A
safe injection site is one option that could improve the health of
many in Edmonton.

"In the light of the Supreme Court ruling, which effectively gives the
provinces the right to take the lead in developing safe injection
sites, we're confident that Alberta will consider all the evidence in
determining what programs are likely to be effective and beneficial
here."

The decision, made public shortly before 7 a.m. in Vancouver, sparked
an emotion reaction among the hundreds of supporters who gathered
outside the entrance of the facility.

"We won." someone shouted when the ruling appeared on a screen at the
entrance to the Insite injection site, prompting cheers, hugs and
supportive horn-honks from drivers passing by the crowd on Hastings
Street.

"This is a celebration," said Vancouver city councillor Ellen
Woodsworth, who spent 10 years working in the desperately poor
Downtown Eastside.

A 2007 United Nations report described the area around the facility as
a "two-kilometre-square stretch of decaying rooming houses, seedy
strip bars and shady pawnshops," with HIV and hepatitis C rates
similar to the poorest Third World countries.

In Ottawa, ex-addict Dean Wilson, 55, told reporters gathering at the
courthouse that he managed to end a life-long addiction, thanks to
Insite's detox centre and transitional housing complex.

"It's a validation of all the stuff we worked (for)... . It's a
miracle," said Wilson, who said he's been fighting for 14 years to
ensure Vancouver's addicts have a safe place to shoot up and seek help.

Since Insite opened its doors in 2003, under a special exemption under
the Controlled Drugs and Substances Act (CDSA) granted by the former
Liberal government, interest has been expressed in following suit in
cities such as Montreal, Ottawa, Toronto, Edmonton and Victoria.

The judges said Ottawa's opposition to Insite was violating the rights
of the facility's users and staff, who faced potential arrest on drug
possession charges, under section seven of the Charter of Rights,
which guarantees "life, liberty and the security of person."

And it warned the federal government to take such rights into
consideration if other communities across Canada apply for a similar
CDSA exemption.

"In accordance with the Charter, the Minister (of health) must
consider whether denying an exemption would cause deprivations of life
and security of the person that are not in accordance with the
principles of fundamental justice," the ruling stated.

"Where, as here, a supervised injection site will decrease the risk of
death and disease, and there is little or no evidence that it will
have a negative impact on public safety, the minister should generally
grant an exemption."

The Canadian Medical Association agreed. "We're delighted with this
unanimous decision," said CMA President Dr. John Haggie.

"Insite worked to save lives and it's a proven tool in management of
addiction. We would like to see it as part of a national strategy that
involves prevention, treatment, harm-reduction and enforcement.
Really, this validates that tool of harm-reduction, so we're delighted."

Dr. Patricia Daly, chief medical health officer of the Vancouver
Coastal Health authority, said chief health officers from Canada's 18
largest cities endorse and support the evidence showing that Insite
reduced overdose deaths and HIV and hepatitis C infections caused by
dirty needles.

"They don't necessarily have the means or the will, at this point, to
open their own versions of the safe injection site," she said

"Some of them (other health officers) are quite interested in the
outcome of this court case. I suspect you'll see some other
jurisdictions apply for exemptions across Canada."

The ruling said former health minister Tony Clement's 2008 decision to
deny an exemption to operate Insite under the Controlled Drugs and
Substances Act was "arbitrary," threatened to undermine health and
safety, and would be unconstitutional.

Clement's decision "would have been to prevent injection drug users
from accessing the health services offered by Insite, threatening the
health and indeed the lives of the potential clients," the judges found.

Clement's decision, therefore, violated the rights of Insite users and
staff under section seven of the charter, which protects the "life,
liberty and security" of individual Canadians.

McLachlin wrote: "It is also grossly disproportionate: the potential
denial of health services and the correlative increase in the risk of
death and disease to injection drug users outweigh any benefit that
might be derived from maintaining an absolute prohibition on
possession of illegal drugs on Insite's premises."

The ruling addressed the argument of some small-c conservatives that
drug addicts have made a personal moral choice, and therefore
shouldn't be assisted by the state in breaking the law.

The judges said the ability to make choices must be weighed against
the 2008 B.C. Supreme Court finding that addiction is a "disease in
which the central feature is impaired control over the use of the
addictive substance."

The ruling also said "morality" is irrelevant when it comes to
determining charter rights.

B.C. Liberal MP Hedy Fry, a physician who fought in cabinet to get
Insite federal clearance in 2003, said the ruling is a clear rebuke of
government policy.

"Their 'war on drugs' has not worked in Canada and has proven to be an
abject failure everywhere else in the world. Addiction is a medical
problem and requires medical and public health solutions," she said.

New Democratic Party deputy leader Libby Davies, whose Vancouver East
riding includes the Downtown Eastside, told the House of Commons that
the Tories should remove their "ideological blinders" and support such
facilities.

While the ruling backed Insite supporters on the rights issue,
Canada's top judges disagreed with one component of the 2010 B.C.
Court of Appeal ruling that supported keeping Insite open.

The B.C. court found in 2010 that the federal government, which has
exclusive jurisdiction over criminal law, didn't have the right to
interfere in an area of provincial responsibility, such as health care.

But the Supreme Court in Canada disagreed, noting on Friday that if
B.C. had "interjurisdictional immunity" on the matter, that would mean
that the federal government would also be powerless in other health
areas such as abortion, human cloning and euthanasia.

The judges rejected the argument from some critics that a pro-Insite
ruling would open "floodgates" across Canada.

The decision "is not a license for injection drug users to possess
drugs wherever and whenever they wish. Nor is it an invitation for
anyone who so chooses to open a facility for drug use under the banner
of a 'safe injection facility,' " they wrote.

Mounds of research support the benefits of eight-year-old Insite.
Research has shown the site reduces the number of drug-related deaths
in the area, and research into supervised-injection sites show they
contain the spread of HIV/AIDS, reduce public disorder in the
surrounding areas and help addicts enter detox and other treatment
programs.
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